t) Except as stated below, charges for drugs needed due to an on-the-job or job-related Injury or Illness; or conditions for which benefits are payable by Workers' Compensation, or similar laws. This exclusion does not apply to the following persons for Exception: whom coverage under compensation is optional unless such persons are actually workers’ covered for compensation: a self-employed person or a partner of a limited workers’ liability partnership, members of a limited liability company or partners of a partnership who actively perform services on behalf of the self-employed business, the limited liability partnership, limited liability company or the partnership. u) Compounded drugs that do not contain at least one ingredient that requires a Prescription Order. [v) Prescription Drugs or new dosage forms that are used in conjunction with a treatment or procedure that is determined to not be a Covered Service.] w) Drugs when used for cosmetic purposes. This exclusion is not applicable to Members with a medically diagnosed congenital defect or birth abnormality who have been covered under the group policy from the moment of birth. x) Drugs used solely for the purpose for weight loss. [y) Life enhancement drugs for the treatment of sexual dysfunction, (e.g. Viagra).] z) Prescription Drugs dispensed outside of the United States, except as required for Emergency treatment.] With respect to [Network] services and supplies, any service provided without prior Referral by the [Member's] Primary Care Provider except as specified in this Contract. Services related to except as provided in the Home Health Care Private Duty Nursing, sections of this Contract. Services or supplies that are not furnished by an eligible Provider. Services or supplies related to rest or convalescent cures. Room and board charges for a [Member] in any Facility for any period of time during which he or she was not physically present overnight in the Facility. With respect to [Non-Network] benefits, except as stated in the Preventive Care section of this Contract, Routine Examinations or preventive care, including related x-rays and laboratory tests, except where a specific Illness or Injury is revealed or where a definite symptomatic condition is present; or pre-marital or similar examinations or tests not required to diagnose or treat Illness or Injury. Services or supplies related to Routine Foot Care, except:
t) Except as stated below, charges for drugs needed due to an on-the-job or job-related Injury or Illness; or conditions for which benefits are payable by Workers' Compensation, or similar laws. Exception: This exclusion does not apply to the following persons for whom coverage under workers’ compensation is optional unless such persons are actually covered for workers’ compensation: a self-employed person or a partner of a limited liability partnership, members of a limited liability company or partners of a partnership who actively perform services on behalf of the self-employed business, the limited liability partnership, limited liability company or the partnership. u) Compounded drugs that do not contain at least one ingredient that requires a Prescription Order. [v) Prescription Drugs or new dosage forms that are used in conjunction with a treatment or procedure that is determined to not be a Covered Service.] w) Drugs when used for cosmetic purposes. This exclusion is not applicable to Members with a medically diagnosed congenital defect or birth abnormality who have been covered under the group policy from the moment of birth. x) Drugs used solely for the purpose for weight loss. [y) Life enhancement drugs for the treatment of sexual dysfunction, (e.g. Viagra).] z) Prescription Drugs dispensed outside of the United States, except as required for Emergency treatment.] With respect to [Network] services and supplies, any service provided without prior Referral by the [Member's] Primary Care Provider except as specified in this Contract. Services related to Private Duty Nursing, except as provided in the Home Health Care sections of this Contract. Services or supplies that are not furnished by an eligible Provider. Services or supplies related to rest or convalescent cures. Room and board charges for a [Member] in any Facility for any period of time during which he or she was not physically present overnight in the Facility. With respect to [Non-Network] benefits, except as stated in the Preventive Care section of this Contract, Routine Examinations or preventive care, including related x-rays and laboratory tests, except where a specific Illness or Injury is revealed or where a definite symptomatic condition is present; or pre-marital or similar examinations or tests not required to diagnose or treat Illness or Injury. Services or supplies related to Routine Foot Care, except: