Common use of PROSTHETIC APPLIANCES Clause in Contracts

PROSTHETIC APPLIANCES. Purchase of the following items when authorized in writing by the patient's attending physician: standard type artificial limb or eye, repairs to prosthetic appliances, xxxxx socks, surgical stockings up to a maximum of $400 per calendar year, splints, trusses, casts, cervical collars, braces (excluding dental braces), catheters, urinary kits, external breast prostheses (following mastectomies), surgical brassieres, incontinence supplies, ostomy supplies (where a surgical stoma exists), tracheotomy supplies and corrective prosthetic lenses and frames (once only for persons who lack an organic lens or after cataract surgery). Lymphedema sleeves/compression sleeves with a mean compression factor of 20mmHG, up to a maximum of 2 sleeves per body part or limb per calendar year. Wigs and hairpieces for patients with temporary hair loss, up to a maximum of $1,500 per lifetime. Custom-made orthopedic boots or shoes, adjustments t o stock item footwear and custom molded foot orthoses (orthotics) are subject to a combined maximum of $500 per employee per calendar year and $750 per 2 calendar years for spouse and dependent children. The purchase of a cystistat kit will be considered an eligible expense when a pre-authorization is completed by the attending physician, outlining the diagnosis and recommended course of treatment. The patient will be re-evaluated after the eighth treatment and additional preauthorization must be obtained if further treatment is required. This benefit is limited to one course of treatment.

PROSTHETIC APPLIANCES. Purchase of the following items when authorized in writing by the patient's ’s attending physician: standard type artificial limb or eye, repairs to prosthetic appliances, xxxxx socks, surgical stockings up to a maximum of $400 per calendar year, splints, trusses, casts, cervical collars, braces (excluding dental braces), catheters, urinary kits, external breast prostheses (following mastectomies), surgical brassieres, incontinence supplies, ostomy supplies (where a surgical stoma exists), tracheotomy supplies and corrective prosthetic lenses and frames (once only for persons who lack an organic lens or after cataract surgery). Surgical stockings, to a maximum of four (4) pairs per calendar year. Lymphedema sleeves/compression sleeves with a mean compression factor of 20mmHG, up to a maximum of 2 sleeves per body part or limb per calendar year. Wigs and hairpieces for patients with temporary hair lossloss as a result of a medical treatment, up to a maximum of $1,500 per lifetime. Custom-made orthopedic orthopaedic boots or shoes, adjustments t o to stock item footwear and custom molded moulded foot orthoses (orthotics) are subject to a combined maximum of $500 per employee per calendar year and $750 per 2 calendar years for spouse and dependent dependant children. The purchase of a cystistat kit will be considered an eligible expense when a pre-pre- authorization is completed by the attending physician, outlining the diagnosis and recommended course of treatment. The patient will be re-evaluated after the eighth treatment and additional preauthorization pre-authorization must be obtained if further treatment is required. This benefit is limited to one course of treatment.

PROSTHETIC APPLIANCES. Purchase of the following items when authorized in writing by the patient's ’s attending physician: standard type artificial limb or eye, repairs to prosthetic appliances, xxxxx socks, surgical stockings up to a maximum of $400 per calendar year, splints, trusses, casts, cervical collars, braces (excluding dental braces), catheters, urinary kits, external breast prostheses (following mastectomies), surgical brassieres, incontinence supplies, ostomy supplies (where a surgical stoma exists), tracheotomy supplies and corrective prosthetic lenses and frames (once only for persons who lack an organic lens or after cataract surgery). Surgical stockings, to a maximum of 6 pairs per calendar year. Lymphedema sleeves/compression sleeves with a mean compression factor of 20mmHG, up to a maximum of 2 sleeves per body part or limb per calendar year. Wigs and hairpieces for patients with temporary hair lossloss as a result of a medical treatment, up to a maximum of $1,500 per lifetime. Custom-made orthopedic orthopaedic boots or shoes, adjustments t o to stock item footwear and custom molded moulded foot orthoses (orthotics) are subject to a combined maximum of $500 per employee person per calendar year and $750 per 2 calendar years for spouse and year. This maximum does not apply to dependent children. The purchase of a cystistat kit will be considered an eligible expense when a pre-pre- authorization is completed by the attending physician, outlining the diagnosis and recommended course of treatment. The patient will be re-evaluated after the eighth treatment and additional preauthorization pre-authorization must be obtained if further treatment is required. This benefit is limited to one course of treatment.