Massage Therapy. Educational services except for Diabetes Self-Management Training Program, and as specifically provided or arranged by Cigna. Nutritional counseling or food supplements, except as stated in this Policy. Durable medical equipment not specifically listed as Covered Services in the Covered Services section of this Policy. Excluded durable medical equipment includes, but is not limited to: orthopedic shoes or shoe inserts; air purifiers, air conditioners, humidifiers; exercise equipment, treadmills; spas; elevators; supplies for comfort, hygiene or beautification; disposable sheaths and supplies; correction appliances or support appliances and supplies such as stockings, and Consumable medical supplies other than ostomy supplies and urinary catheters, including, but not limited to, bandages and other disposable medical supplies, skin preparations and test strips except as otherwise stated in this Policy. Physical, and/or Occupational Therapy/Medicine except when provided during an inpatient Hospital confinement or as specifically stated in the Benefit Schedule and under ‘Physical and/or Occupational Therapy/Medicine’ in the section of this Policy titled “Comprehensive Benefits What the Policy Pays For”. Any Drugs, medications, or other substances dispensed or administered in any outpatient setting except as specifically stated in this Policy. This includes, but is not limited to, items dispensed by a Physician. All Foreign Country Provider charges are excluded under this Policy except as specifically stated under “Treatment received from Foreign Country Providers” in the section of this Policy titled “Comprehensive Benefits What the Policy Pays For”. Growth Hormone Treatment except when such treatment is medically proven to be effective for the treatment of documented growth retardation due to deficiency of growth hormones, growth retardation secondary to chronic renal failure before or during dialysis, or for patients with AIDS wasting syndrome. Services must also be clinically proven to be effective for such use and such treatment must be likely to result in a significant improvement of the Insured Person’s condition. Growth hormone treatment for diopathic short stature, or improved athletic performance is not covered under any circumstances. Routine foot care including the cutting or removal of corns or calluses; the trimming of nails, routine hygienic care and any service rendered in the absence of localized Illness, Injury or symptoms involving the feet except for Insureds with the diagnosis of diabetes. Charges for which We are unable to determine Our liability because the Insured Person failed, within 60 days, or as soon as reasonably possible to: (a) authorize Us to receive all the medical records and information We requested; or (b) provide Us with information We requested regarding the circumstances of the claim or other insurance coverage. Charges for the services of a standby Physician. Charges for animal to human organ transplants. Claims received by Cigna after 18 months from the date service was rendered, except in the event of a legal incapacity. Prescription Drug Benefits
Appears in 2 contracts
Sources: Insurance Policy, Health Insurance Policy
Massage Therapy. ▪ Educational services except for Diabetes Self-Management Training Program, and as specifically provided or arranged by Cigna. ▪ Nutritional counseling or food supplements, except as stated in this Policy. ▪ Durable medical equipment not specifically listed as Covered Services in the Covered Services section of this Policy. Excluded durable medical equipment includes, but is not limited to: orthopedic shoes or shoe inserts; air purifiers, air conditioners, humidifiers; exercise equipment, treadmills; spas; elevators; supplies for comfort, hygiene or beautification; disposable sheaths and supplies; correction appliances or support appliances and supplies such as stockings, and Consumable medical supplies other than ostomy supplies and urinary catheters, including, but not limited to, bandages and other disposable medical supplies, skin preparations and test strips except as otherwise stated in this Policy. ▪ Physical, and/or Occupational Therapy/Medicine except when provided during an inpatient Hospital confinement or as specifically stated in the Benefit Schedule and under ‘Physical and/or Occupational Therapy/Medicine’ in the section of this Policy titled “Comprehensive Benefits What the Policy Pays For”. ▪ Any Drugs, medications, or other substances dispensed or administered in any outpatient setting except as specifically stated in this Policy. This includes, but is not limited to, items dispensed by a Physician. ▪ All Foreign Country Provider charges are excluded under this Policy except as specifically stated under “Treatment received from Foreign Country Providers” in the section of this Policy titled “Comprehensive Benefits What the Policy Pays For”. ▪ Growth Hormone Treatment except when such treatment is medically proven to be effective for the treatment of documented growth retardation due to deficiency of growth hormones, growth retardation secondary to chronic renal failure before or during dialysis, or for patients with AIDS wasting syndrome. Services must also be clinically proven to be effective for such use and such treatment must be likely to result in a significant improvement of the Insured Person’s condition. Growth hormone treatment for diopathic short stature, or improved athletic performance is not covered under any circumstances. ▪ Routine foot care including the cutting or removal of corns or calluses; the trimming of nails, routine hygienic care and any service rendered in the absence of localized Illness, Injury or symptoms involving the feet except for Insureds with the diagnosis of diabetes. ▪ Charges for which We are unable to determine Our liability because the Insured Person failed, within 60 days, or as soon as reasonably possible to: (a) authorize Us to receive all the medical records and information We requested; or (b) provide Us with information We requested regarding the circumstances of the claim or other insurance coverage. ▪ Charges for the services of a standby Physician. ▪ Charges for animal to human organ transplants. ▪ Claims received by Cigna after 18 months from the date service was rendered, except in the event of a legal incapacity. Prescription Drug Benefits
Appears in 1 contract
Sources: Health Insurance Policy