Immunizations and Shots No benefits are provided for immunizations and shots, unless they are required because of an injury or immediate risk of infection. Note: provides full benefits for: pneumococcal vaccine and its administration; and Medicare influenza vaccine and its administration. (See your handbook for details.) Medicare Medical Care Outpatient Visits No benefits are provided for medical care (for example, office visits) except as outpatient described in Part 4. Medical Devices, Appliances, Materials and Supplies No benefits are provided for medical devices, appliances, materials and supplies, except as otherwise described in Part 4. Some examples of non-covered items are: air conditioners; air purifiers; arch supports; bath seats; bed pans; bath tub grip bars; chair lifts; computers; dehumidifiers; dentures; elevators; foot orthotics; hearing aids; heating pads; hot water bottles; humidifiers; orthopedic and corrective shoes that are not part of a leg brace; raised toilet seats; and shoe (foot) inserts. Also, no benefits are provided for and prosthetic devices such as durable medical equipment artificial arms, legs and eyes. There are a few exceptions to this exclusion. Benefits are provided as described in Part 4 for: diabetic testing materials, including glucometers (which are classified under the same category as when covered by and durable medical equipment Medicare); durable supplied as part of approved home dialysis or hospice services. medical equipment Missed Appointments No benefits are provided for charges for appointments that you do not keep. and other Physicians providers may charge you if you do not keep your scheduled appointments. They may do so if you do not give reasonable notice to the office. You must pay for these charges. Appointments that you do not keep are not counted against any visit or dollar limits for benefits described in this Benefit Description. Non-Covered Providers Unless otherwise specified, this Medex plan provides benefits only for covered services furnished by providers: eligible to provide services covered by that have a payment Medicare; agreement with and that have been approved by Blue Cross and Blue Shield; Blue Cross and for payment for the specific No benefits are provided for any Blue Shield covered service. services and supplies furnished by the kinds of providers that are not covered by this Medex plan. This Benefit Description specifies the kinds of providers that are covered. (See Part 9, “Providers.”)
Immunizations and Shots No benefits are provided for immunizations and shots, unless they are required because of an injury or immediate risk of infection. Note: Medicare provides full benefits for: pneumococcal vaccine and its administration; and influenza vaccine and its administration. (See your Medicare handbook for details.) Medical Care Outpatient Visits No benefits are provided for outpatient medical care (for example, office visits) except as described in Part 4. Medical Devices, Appliances, Materials and Supplies No benefits are provided for medical devices, appliances, materials and supplies, except as otherwise described in Part 4. Some examples of non-covered items are: air conditioners; air purifiers; arch supports; bath seats; bed pans; bath tub grip bars; chair lifts; computers; dehumidifiers; dentures; elevators; foot orthotics; hearing aids; heating pads; hot water bottles; humidifiers; orthopedic and corrective shoes that are not part of a leg brace; raised toilet seats; and shoe (foot) inserts. Also, no benefits are provided for durable medical equipment and prosthetic devices such as artificial arms, legs and eyes. There are a few exceptions to this exclusion. Benefits are provided as described in Part 4 for: diabetic testing materials, including glucometers (which are classified under the same category as durable medical equipment when covered by Medicare); and durable medical equipment supplied as part of approved home dialysis or hospice services. Missed Appointments No benefits are provided for charges for appointments that you do not keep. Physicians and other providers may charge you if you do not keep your scheduled appointments. They may do so if you do not give reasonable notice to the office. You must pay for these charges. Appointments that you do not keep are not counted against any visit or dollar limits for benefits described in this Benefit Description. Non-Covered Providers Unless otherwise specified, this Medex plan provides benefits only for covered services furnished by providers: eligible to provide services covered by Medicare; that have a payment agreement with Blue Cross and Blue Shield; and that have been approved by Blue Cross and Blue Shield for payment for the specific covered service. No benefits are provided for any services and supplies furnished by the kinds of providers that are not covered by this Medex plan. This Benefit Description specifies the kinds of providers that are covered. (See Part 9, “Providers.”)
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