Corrective Appliances. Corrective Appliances are devices that are designed to support a weakened body part and are manufactured or custom-fitted to an individual. Covered Services include custom-made or custom-fitted Medically Necessary Corrective Appliances when Prior Authorized by SHL’s Managed Care Program, to include the following: Rigid Cervical Collars; Abdominal Binder/Corsets; Shoes when prescribed for a diabetic condition, otherwise only when an integral part of a lower body brace; Helmets when prescribed in connection with cranial orthosis. Corrective Appliances do not include: Bionic, myoelectric, microprocessor-controlled, and computerized prosthetics; or Deluxe upgrades determined not to be Medically Necessary. Replacements, repairs and adjustments to Corrective Appliances are Covered Services when required by normal wear and tear or by a significant change in the Insured's condition when ordered by a duly-licensed Provider.
Appears in 5 contracts
Samples: Epo Agreement of Coverage, Group Health Insurance Certificate of Coverage, Epo Agreement of Coverage
Corrective Appliances. Corrective Appliances are devices that are designed to support a weakened body part and are manufactured or custom-fitted to an individual. Covered Services include custom-made or custom-fitted Medically Necessary Corrective Appliances when Prior Authorized by SHLHPN’s Managed Care Program, to include the following: Rigid Cervical Collars; Abdominal Binder/Corsets; Shoes when prescribed for a diabetic condition, otherwise only when an integral part of a lower body brace; Helmets when prescribed in connection with cranial orthosis. Corrective Appliances do not include: Bionic, myoelectric, microprocessor-controlled, and computerized prosthetics; or Deluxe upgrades determined not to be Medically Necessary. Replacements, repairs and adjustments to Corrective Appliances are Covered Services when required by normal wear and tear or by a significant change in the InsuredMember's condition when ordered by a duly-licensed Provider.
Appears in 4 contracts
Samples: Agreement of Coverage, Agreement of Coverage, Agreement of Coverage
Corrective Appliances. Corrective Appliances are devices that are designed to support a weakened body part and are manufactured or custom-fitted to an individual. Covered Services include custom-made or custom-fitted Medically Necessary Corrective Appliances when Prior Authorized by SHL’s Managed Care Program, to include the following: • Rigid Cervical Collars; • Abdominal Binder/Corsets; • Shoes when prescribed for a diabetic condition, otherwise only when an integral part of a lower body brace; • Helmets when prescribed in connection with cranial orthosis. Corrective Appliances do not include: • Bionic, myoelectric, microprocessor-controlled, and computerized prosthetics; or • Deluxe upgrades determined not to be Medically Necessary. Replacements, repairs and adjustments to Corrective Appliances are Covered Services when required by normal wear and tear or by a significant change in the Insured's condition when ordered by a duly-licensed Provider.
Appears in 1 contract
Corrective Appliances. Corrective Appliances are devices that are designed to support a weakened body part and are manufactured or custom-fitted to an individual. Covered Services include custom-made or custom-fitted Medically Necessary Corrective Appliances when Prior Authorized by SHLHPN’s Managed Care Program, to include the following: • Rigid Cervical Collars; • Abdominal Binder/Corsets; • Shoes when prescribed for a diabetic condition, otherwise only when an integral part of a lower body brace; • Helmets when prescribed in connection with cranial orthosis. Corrective Appliances do not include: • Bionic, myoelectric, microprocessor-controlled, and computerized prosthetics; or • Deluxe upgrades determined not to be Medically Necessary. Replacements, repairs and adjustments to Corrective Appliances are Covered Services when required by normal wear and tear or by a significant change in the InsuredMember's condition when ordered by a duly-licensed Provider.
Appears in 1 contract
Samples: Group Enrollment Agreement