Hospitalstay in-networkcostspecialistvisit in-networkcostPrimarycare visitin-networkcostnon-preferredbrand drugsout ofnetwork costIn-networkinpatientmentalhealth staycostOut-of-networkskillednursing costcoinsuranceforanesthesiapreferredbrand RXout-of-network costspecialistvisit out-of-networkcostOut-of-networkout-of-pocket limitspecialtydrugs in-networkcostout-of-networkemergencyroom visitcostemergencymedicaltransportationin-networkcostIn-networkUrgentCare visitcostGenericdrugs in-networkcostfamilydeductiblein-networkdurablemedicalequipmentcostOut-of-networkdiagnosistest costOut-of-pocketlimitexclusionsCoveragePeriodIn-networkimagingcosthospitalstay out-of-networkcostIn-networkOutpatientMentalhealth carecostdo yourequire areferral tosee aspecialist?PlanTypenon-preferredbrand drugsin-networkcostservicesnotcoveredby planin-networkphysician/surgeonfeesIndividualDeductibleIn-networkout-of-PocketlimitIn-networkpreventativecare/screeningcostHospitalstay in-networkcostspecialistvisit in-networkcostPrimarycare visitin-networkcostnon-preferredbrand drugsout ofnetwork costIn-networkinpatientmentalhealth staycostOut-of-networkskillednursing costcoinsuranceforanesthesiapreferredbrand RXout-of-network costspecialistvisit out-of-networkcostOut-of-networkout-of-pocket limitspecialtydrugs in-networkcostout-of-networkemergencyroom visitcostemergencymedicaltransportationin-networkcostIn-networkUrgentCare visitcostGenericdrugs in-networkcostfamilydeductiblein-networkdurablemedicalequipmentcostOut-of-networkdiagnosistest costOut-of-pocketlimitexclusionsCoveragePeriodIn-networkimagingcosthospitalstay out-of-networkcostIn-networkOutpatientMentalhealth carecostdo yourequire areferral tosee aspecialist?PlanTypenon-preferredbrand drugsin-networkcostservicesnotcoveredby planin-networkphysician/surgeonfeesIndividualDeductibleIn-networkout-of-PocketlimitIn-networkpreventativecare/screeningcost

Summary Benefit Card Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Hospital stay in-network cost
  2. specialist visit in-network cost
  3. Primary care visit in-network cost
  4. non-preferred brand drugs out of network cost
  5. In-network inpatient mental health stay cost
  6. Out-of-network skilled nursing cost
  7. coinsurance for anesthesia
  8. preferred brand RX out-of-network cost
  9. specialist visit out-of-network cost
  10. Out-of-network out-of-pocket limit
  11. specialty drugs in-network cost
  12. out-of-network emergency room visit cost
  13. emergency medical transportation in-network cost
  14. In-network Urgent Care visit cost
  15. Generic drugs in-network cost
  16. family deductible
  17. in-network durable medical equipment cost
  18. Out-of-network diagnosis test cost
  19. Out-of-pocket limit exclusions
  20. Coverage Period
  21. In-network imaging cost
  22. hospital stay out-of-network cost
  23. In-network Outpatient Mental health care cost
  24. do you require a referral to see a specialist?
  25. Plan Type
  26. non-preferred brand drugs in-network cost
  27. services not covered by plan
  28. in-network physician/ surgeon fees
  29. Individual Deductible
  30. In-network out-of-Pocket limit
  31. In-network preventative care/screening cost