Prosthetic Devices. Standard Prosthetic Devices are artificial devices, which replace or augment a missing or impaired part of the body. The purchase, fitting and necessary adjustments of Prosthetic Devices and supplies that replace all or part of the function of a permanently inoperative or malfunctioning body part are Covered when they replace a limb or other part of the body, after accidental or surgical removal, congenital conditions and/or when the body’s growth necessitates replacement. Prosthetic Devices must be Medically Necessary and may require Prior Authorization. Examples of Prosthetic Devices include, but are not limited to: · Breast prostheses when required because of mastectomy and prophylactic mastectomy o Prosthetics related to other Medically Necessary services for Gender Confirmatory therapy and Gender Affirming care are Covered · Artificial limbs · Prosthetic eye · Prosthodontic appliances · Penile prosthesis · Joint replacements · Heart pacemakers · Tracheostomy tubes and cochlear implants
Appears in 2 contracts
Samples: Subscriber Agreement, Subscriber Agreement
Prosthetic Devices. Standard Prosthetic Devices are artificial devices, which replace or augment a missing or impaired part of the body. The purchase, fitting and necessary adjustments of Prosthetic Devices and supplies that replace all or part of the function of a permanently inoperative or malfunctioning body part are Covered when they replace a limb or other part of the body, after accidental or surgical removal, congenital conditions conditions, and/or when the body’s growth necessitates replacement. Prosthetic Devices must be Medically Necessary and may require Prior Authorization. Examples of Prosthetic Devices include, but are not limited to: · Breast prostheses when required because of mastectomy and prophylactic mastectomy o Prosthetics related to other Medically Necessary services for Gender Confirmatory therapy and Gender Affirming care are Covered · Artificial limbs · Prosthetic eye · Prosthodontic appliances · Penile prosthesis · Joint replacements · Heart pacemakers · Tracheostomy tubes and cochlear implants
Appears in 1 contract
Samples: Subscriber Agreement
Prosthetic Devices. Standard Prosthetic Devices are artificial devices, which replace or augment a missing or impaired part of the body. The purchase, fitting and necessary adjustments of Prosthetic Devices and supplies that replace all or part of the function of a permanently inoperative or malfunctioning body part are Covered when they replace a limb or other part of the body, after accidental or surgical removal, congenital conditions and/or when the body’s growth necessitates replacement. Prosthetic Devices must be Medically Necessary and may require Prior Authorization. Examples of Prosthetic Devices include, but are not limited to: · • Breast prostheses when required because of mastectomy and prophylactic mastectomy o Prosthetics related to other Medically Necessary services for Gender Confirmatory therapy and Gender Affirming care are Covered · • Artificial limbs · • Prosthetic eye · • Prosthodontic appliances · • Penile prosthesis · • Joint replacements · • Heart pacemakers · • Tracheostomy tubes and cochlear implants
Appears in 1 contract
Samples: Presbyterian Health Plan