Common use of COVERED AND NON-COVERED SERVICES Clause in Contracts

COVERED AND NON-COVERED SERVICES. i) Benefits and services covered by the plan, including benefit maximums and limits. ii) Definition of medical necessity used to determine whether benefits will be covered (same as plan-county contract definition). iii) Medicaid services not covered by the plan or excluded from managed care; how to access these services. iv) Prior authorization and other requirements for treatments and services. v) Family planning and reproductive health services free access policy. vi) HIV counseling and testing free access policy. vii) Direct access policy for dental services provided at Article 28 clinics operated by academic dental centers when dental is in the Benefit Package. viii) Plan policy relating to transportation, including who to call and what to do if plan does not cover transportation. ix) Plan toll-free number for Enrollee to call for more information.

COVERED AND NON-COVERED SERVICES. i) Benefits and services covered by the plan, including benefit maximums and limits. ii) Definition of medical necessity used to determine whether benefits will be covered (same as plan-county contract definition)., iii) Medicaid services not covered by the plan or excluded from managed care; how to access these services. iv) Prior authorization and other requirements for treatments and services., v) Family planning and reproductive health services free access policy. vi) HIV counseling and testing free access policy. vii) Direct access policy for dental services provided at Article 28 clinics operated by academic dental centers when dental is in the Benefit Package. viii) Plan policy relating to transportation, including who to call and what to do if plan does not cover transportation. ix) Plan toll-free number for Enrollee to call for more information.