ARTIFICIAL INSEMINATION a procedure, also known as intrauterine insemination (IUI) or intracervical/intravaginal insemination (ICI), by which sperm is directly deposited into the vagina, cervix or uterus to achieve fertilization and pregnancy.
ARTIFICIAL INSEMINATION. Benefits will be provided for Artificial Insemination and associated diagnostic, medical and surgical services and pharmacological or hormonal treatments used in conjunction with Artificial Insemination when ordered by a Physician and determined to be Medically Necessary and Appropriate.
ARTIFICIAL INSEMINATION. New technology not defined under the Covered Services Section of this Rider unless authorized by the Medical Director.
ARTIFICIAL INSEMINATION. Services performed by a Professional Provider for the promotion of fertilization of a female recipient’s own ova (eggs) by the introduction of mature sperm from partner or donor into the recipient’s vagina or uterus, with accompanying simple sperm preparation, sperm washing and/or thawing.
ARTIFICIAL INSEMINATION. This is NOT a Covered Expense under this Program.
ARTIFICIAL INSEMINATION of the Agreement;
34. For contraceptive services including contraceptive Prescription Drugs, contraceptive devices, implants and injections and all related services, except when provided for purposes other than birth control, or as set forth in a predefined schedule described in Subsection R. PREVENTIVE SERVICES, SECTION DB - DESCRIPTION OF BENEFITS of this Agreement;
35. Except for Preventive Covered Medications set forth in a predefined schedule described in Subsection R. PREVENTIVE SERVICES of SECTION DB - DESCRIPTION OF BENEFITS of this Agreement and which are prescribed for preventive purposes, the following drugs or services are not covered:
a. Drugs and supplies that can be purchased without a Prescription Order;
b. Over-the-Counter Drugs which are not set forth in a predefined schedule described in Subsection R. PREVENTIVE SERVICES of SECTION DB - DESCRIPTION OF BENEFITS of this Agreement and are not prescribed for preventive purposes;
c. Topical antifungals;
d. Antitussives (cough/cold);
e. Charges for administration of Prescription Drugs and/or injectable insulin whether by a Physician or other person;
f. Charges for a Prescription Drug when such drug or medication is used for unlabeled or unapproved indications where such use has not been approved by the Food and Drug Administration (FDA);
g. Topical acne retinoid products when prescribed for cosmetic purposes such as to minimize the appearance of facial wrinkles, facial mottled hyperpigmentation, hypopigmentation associated with photoaging, and facial skin roughness;
h. Hair growth stimulants;
i. For compounded medications;
j. For Prescription Drugs and Over-the-Counter Drugs not appearing on the Formulary, except where an exception has been granted pursuant to the procedure set forth in SECTION HC - HEALTH CARE MANAGEMENT SERVICES, Subsection D. HEALTH CARE MANAGEMENT SERVICES, Paragraph 9. Prescription Drug Exceptions;
ARTIFICIAL INSEMINATION. Notes: 1. Involuntary infertility means the inability to conceive after one (1) year of unprotected vaginal intercourse.
ARTIFICIAL INSEMINATION. In-vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT) • Ovulation induction; • Intracytoplasmic sperm injection (ICSI); • Fresh and cryopreserved embryo transfer; • Assisted hatching; • Microsurgical Sperm aspiration;
ARTIFICIAL INSEMINATION. Artificial insemination is provided upon payment of a $20.00 Supplemental Charge per visit.
ARTIFICIAL INSEMINATION. Notes:
1. Involuntary infertility means the inability to conceive after one (1) year of unprotected vaginal intercourse.
2. Diagnostic procedures and any covered drugs administered by or under the direct supervision of a Plan Provider are covered under this provision. Refer to the Outpatient Prescription Drug Rider, if applicable, for coverage of outpatient infertility drugs. Note: Diagnostic procedures and drugs administered by or under the direct supervision of a Plan Provider are covered under this provision. Infertility Services Exclusions: • Any charges associated with freezing, storage and thawing of fertilized eggs (embryos), female Member’s eggs and/or male Member’s sperm for future attempts. • Assisted reproductive procedures and any related testing or service that includes the use of donor sperm, donor eggs or donor embryos. • Any charges associated with obtaining donor eggs, donor sperm or donor embryos. • Infertility Services when the member does not meet medical guidelines established by the American Society of Reproductive Medicine and the American Society for Reproductive Endocrinology. • Services not preauthorized by the Health Plan. • Services to reverse voluntary, surgically induced infertility. • Infertility Services when the infertility is the result of an elective male or female surgical procedure. • Assisted reproductive technologies and, procedures including but not limited to: in vitro fertilization; gamete intrafallopian transfers (GIFT); zygote intrafallopian transfers (ZIFT); assisted hatching; and prescription drugs related to such procedures.
