Chiropractic Services Sample Clauses

Chiropractic Services. Medical transportation not directly related to labor or threatened labor, miscarriage or non-viable pregnancy, and/or delivery of the covered unborn child. Personal comfort items including but not limited to personal care kits provided on inpatient admission, telephone, television, newborn infant photographs, meals for guests of patient, and other articles which are not required for the specific treatment related to labor with delivery or post partum care. Experimental and/or investigational medical, surgical or other health care procedures or services which are not generally employed or recognized within the medical community Treatment or evaluations required by third parties including, but not limited to, those for schools, employment, flight clearance, camps, insurance or court Private duty nursing services when performed on an inpatient basis or in a skilled nursing facility. Coverage while traveling outside of the United States and U.S. Territories (including Puerto Rico, U.S. Virgin Islands, Commonwealth of Northern Mariana Islands, Guam, and American Samoa). Mechanical organ replacement devices including, but not limited to artificial heart Hospital services and supplies when confinement is solely for diagnostic testing purposes and not a part of labor with delivery Prostate and mammography screening Elective surgery to correct vision Gastric procedures for weight loss Cosmetic surgery/services solely for cosmetic purposes Out-of-network services not authorized by the Health Plan except for emergency care related to the labor with delivery of the covered unborn child. Services, supplies, meal replacements or supplements provided for weight control or the treatment of obesity Acupuncture services, naturopathy and hypnotherapy Immunizations solely for foreign travel Routine foot care such as hygienic care Diagnosis and treatment of weak, strained, or flat feet and the cutting or removal of corns, calluses and toenails (this does not apply to the removal of nail roots or surgical treatment of conditions underlying corns, calluses or ingrown toenails) Corrective orthopedic shoes Convenience items Orthotics primarily used for athletic or recreational purposes Custodial care (care that assists with the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, toileting, special diet preparation, and medication supervision that is usually self-administered or provided by a caregiver. This care does no...
Chiropractic Services. In a physician's office - limited to 12 visits per plan year. 0% - After deductible 40% - After deductible
Chiropractic Services. Provides diagnostic x-rays, lab tests, machines and pathological tests covered in full up to the maximum allowance when performed by a licensed Chiropractor. Approved orthopedic devises, manipulations of the spine, treatments, and chiropractic office visits covered at 80%.**
Chiropractic Services. For all chiropractic services, Blue Shield has contracted with ASH Plans to act as the Plan’s chiropractic services administrator. Benefits are provided for chiropractic services performed by a chiropractor or other appropriately licensed or certified Health Care Provider. The chiropractic Benefit includes the initial examination, subsequent office visits, adjustments, and plain film X- ray services in a chiropractor’s office. Benefits are limited to a per Member per Calendar Year visit maximum as shown on the Summary of Benefits. Clinical trials for treatment of cancer or life-threatening diseases or conditions Benefits Benefits are available for routine patient care when you have been accepted into an approved clinical trial for treatment of cancer or a life-threatening disease or condition. A life-threatening disease or condition is a disease or condition that is likely to result in death unless its progression is interrupted. The clinical trial must have therapeutic intent and the treatment must meet one of the following requirements: • Your Participating Provider determines that your participation in the clinical trial would be appropriate based on either the trial protocol or medical and scientific information provided by you; or • You provide medical and scientific information establishing that your participation in the clinical trial would be appropriate. Coverage for routine patient care received while participating in a clinical trial requires prior authorization. Routine patient care is care that would otherwise be covered by the plan if those services were not provided in connection with an approved clinical trial. The Summary of Benefits section lists your Cost Share for Covered Services. These Cost Share amounts are the same whether or not you participate in a clinical trial. Routine patient care does not include: • The investigational item, device, or service itself; • Drugs or devices not approved by the U.S. Food and Drug Administration (FDA); • Travel, housing, companion expenses, and other non-clinical expenses; • Any item or service that is provided solely to satisfy data collection and analysis needs and that is not used in the direct clinical management of the patient; • Services that, except for the fact that they are being provided in a clinical trial, are specifically excluded under the plan; • Services normally provided by the research sponsor free for any enrollee in the trial; or • Any service that is clearly inconsistent with w...
Chiropractic Services. In a physician's office - limited to 12 visits per plan year. $45 20% - After deductible
Chiropractic Services. Except as specified under Complementary Therapies in the Benefits Section. • Biofeedback – Except as specified under Complementary Therapies in the Benefits Section. Cosmetic Surgery Cosmetic Surgery is not Covered. Examples of Cosmetic Surgery that are not Covered include breast augmentation, dermabrasion, dermaplaning, excision of acne scarring, acne surgery (including cryotherapy), asymptomatic keloid/scar revision, micro phlebectomy, sclerotherapy (except for truncal veins), and nasal rhinoplasty. This plan does not cover cosmetic surgery, services, or procedures to change family characteristics or conditions caused by aging. This plan excludes coverage for cosmetic surgery or services for psychiatric or psychological reasons unrelated to care for gender dysphoria and medically necessary gender confirmation care. This plan does not cover services related to or required as a result of a cosmetic service, procedure, surgery or subsequent procedures to correct unsatisfactory cosmetic results attained during an initial surgery. Circumcisions, performed other than for newborns, are not Covered unless Medically Necessary. Reconstructive Surgery following a mastectomy is not considered Cosmetic Surgery and will be covered. Refer to the Benefits Section. Cosmetic Treatments, Devices, Orthotics, and Prescription Drugs/Medications Cosmetic treatment, devices, Orthotics and Prescription Drugs/Medications are not Covered. Costs for Extended Warranties and Premiums for Other Insurance Coverage Costs for extended warranties and premiums for other insurance coverage are not Covered. Dental Services Dental care and dental X-rays are not Covered, except as provided in the Benefits Section. Dental implants are not Covered. Malocclusion treatment, if part of routine dental care and orthodontics, is not Covered. Orthodontic appliances and orthodontic treatment (braces), crowns, bridges and dentures used for the treatment of Temporo/Craniomandibular Joint disorders are not Covered, unless the disorder is trauma related. Diabetes Services Routine foot care, such as treatment of flat feet or other structural misalignments of the feet, removal of corns, and calluses, is not Covered, unless Medically Necessary due to diabetes or other significant peripheral neuropathies. Coverage of diabetes services requires medical diagnosis of diabetes from a licensed practitioner/provider. Equipment, appliances, prescription drug medication, insulin or supplies must have FDA approval and a...
Chiropractic Services. In a physician's office - limited to 12 visits per plan year. $45 Not Covered