Common use of Expanded Services Clause in Contracts

Expanded Services. 1. The following services are defined as Expanded Services that may be offered by the Health Plan following the Agency’s written approval: a. Services in excess of the amount, duration and scope of those listed in Section V, Covered Services; b. Services and benefits not listed in Section V, Covered Services; c. The Health Plan may offer, upon written Agency approval, an over-the-counter expanded drug benefit, not to exceed twenty-five dollars ($25.00) per household, per month. Such benefits shall be limited to nonprescription drugs containing a national drug code ("NDC") number, first aid supplies and birth control supplies. Such benefits must be offered directly through the Health Plan's fulfillment house or through a Subcontractor. The Health Plan shall make payments for the over-the-counter drug benefit directly to the Subcontractor, if applicable. 2. The following is a list of the Health Plan’s Expanded Services: a. Annual comprehensive oral exam, x-rays (one per year), 2 cleanings per year, silver amalgam fillings, one peridontic deep cleaning per year, 2 peridontic scaling and root planning per year; b. Unlimited eye exams and eyeglasses, if medically necessary; c. Up to $25 credit per household each month for selected over the counter drugs and/or health supplies; d. Free approved round trip transportation to medical appointments; e. Hearing exam and one hearing aid every three years, if medically necessary (hearing aid only). f. Circumcision up to 1 year.