videos, personal trainers, club membership and weight reduction programs are not Exercise Equipment, Covered Services under this Plan. as determined by PHP, drugs, medicines, treatments, or procedures as Experimental or Investigational, listed in the Exclusions Section under “Experimental or Investigational” of the Participant Benefit Booklet. involving the musculoskeletal system. Extracorporeal shock wave therapy are not Covered Services under this Plan. Eye Exercises and Refractions are not covered except for those that are eligible for per diem coverage under Food and Lodging Expenses the “Transplant Services” provision in the Covered Services section. except as provided in the Participant Benefit Booklet. Foot care (routine), as listed in the Participant Benefit Booklet. Genetic Inborn Errors of Metabolism visits without physical assessment or diagnostic or therapeutic intervention provided. “Get acquainted” unless part of a wound treatment kit. Gloves, (or baldness) treatments, medications, supplies and devices including wigs, and special Hair loss brushes. that is associated with an injury that is obtained or associated in the commission of a crime. Health Care and the evaluation for the fitting of hearing aids except for school-aged children under 18 Hearing aids years old (or under 21 years of age if still attending high school). for care that: Home Health Care Services Is provided primarily for the convenience of the Participant or the Participant’s family; Consists mostly of bathing, feeding, exercising, preparing meals, homemaking, moving the patient, giving medications, or acting as a sitter Is provided by a nurse who ordinarily resides in the Participant’s home or is a member of the Participant’s immediate family. Hospice benefits are not available for the following services or Food, housing, and delivered meals; or Volunteer services; such as, but not limited to, aromatherapy, clothing, pillows, special chairs, Comfort items pet therapy, fans, humidifiers, and special beds (excluding those Covered under Durable Medical Equipment benefits); or or Homemaker and housekeeping services; or Private duty nursing; or Pastoral and spiritual counseling; Bereavement counseling Human Chorionic Gonadotrophin (HCG) injections Hypnotherapy of artificial organs or mechanical devices except as specified in the Participant Benefit Booklet Implantation
Exercise Equipment, videos, personal trainers, club membership and weight reduction programs are not Covered Services under this Plan. Experimental or Investigational, as determined by PHP, drugs, medicines, treatments, or procedures as listed in the Exclusions Section under “Experimental or Investigational” of the Participant Benefit Booklet. Extracorporeal shock wave therapy involving the musculoskeletal system. Eye Exercises and Refractions are not Covered Services under this Plan. Food and Lodging Expenses are not covered except for those that are eligible for per diem coverage under the “Transplant Services” provision in the Covered Services section. Foot care (routine), except as provided in the Participant Benefit Booklet. Genetic Inborn Errors of Metabolism as listed in the Participant Benefit Booklet. “Get acquainted” visits without physical assessment or diagnostic or therapeutic intervention provided. Gloves, unless part of a wound treatment kit. Hair loss (or baldness) treatments, medications, supplies and devices including wigs, and special brushes. Health Care that is associated with an injury that is obtained or associated in the commission of a crime. Hearing aids and the evaluation for the fitting of hearing aids except for school-aged children under 18 years old (or under 21 years of age if still attending high school). Home Health Care Services for care that: Is provided primarily for the convenience of the Participant or the Participant’s family; Consists mostly of bathing, feeding, exercising, preparing meals, homemaking, moving the patient, giving medications, or acting as a sitter Is provided by a nurse who ordinarily resides in the Participant’s home or is a member of the Participant’s immediate family. Hospice benefits are not available for the following services Food, housing, and delivered meals; or Volunteer services; or Comfort items such as, but not limited to, aromatherapy, clothing, pillows, special chairs, pet therapy, fans, humidifiers, and special beds (excluding those Covered under Durable Medical Equipment benefits); or Homemaker and housekeeping services; or Private duty nursing; or Pastoral and spiritual counseling; or Bereavement counseling Human Chorionic Gonadotrophin (HCG) injections Hypnotherapy Implantation of artificial organs or mechanical devices except as specified in the Participant Benefit Booklet
Provider-Resource-Guide-2017-2018.docx