Dialysis Services. This plan covers dialysis services and supplies provided when you are inpatient, outpatient or in your home and under the supervision of a dialysis program. Dialysis supplies provided in your home are covered as durable medical equipment.
Dialysis Services. The provision of dialysis services is limited to AvMed Network locations by an AvMed Network Health Professional.
Dialysis Services. Inpatient Inpatient dialysis services are covered as a hospital service. See Section 8.0 - definition of hospital services.
Dialysis Services. The provision of dialysis services is limited to AvMed contracted locations, by a participating Health Professional as described in Section 9.17.
Dialysis Services. Dialysis services for chronic renal failure are covered when provided in a Hospital, an outpatient facility or in the home. Pre-Authorization is required for dialysis performed in an outpatient facility or at home. Durable Medical Equipment Durable Medical Equipment (“DME”) is Medical Equipment, including mobility enhancing equipment that can withstand repeated use, is not disposable, is used for a medically therapeutic purpose, is generally not useful in the absence of Illness or Injury, and is appropriate for use in the home. DME may be rented or purchased at the discretion of the plan; the total cost of any DME rental may not exceed the purchase price. Repair or replacement is covered only when needed due to normal use, a change in the patient’s physical condition, or the growth of a child. Duplicate items are not covered. When more than one option exists, benefits will be limited to the least expensive model or item appropriate to treat the patient’s covered condition. Examples of DME include: • Crutches; • Oxygen and equipment for administering oxygen; • Xxxxxxx; and • Wheelchairs. This benefit also covers: • Breast Pumps; • Diabetic monitoring equipment, such as the initial cost of an insulin pump and supplies related to such equipment. Diabetic supplies such as insulin, syringes, needles, lancets, test strips, etc., are covered under the Prescription Drugs benefit; • Medical supplies needed for the treatment or care of an appropriate covered condition, including but not limited to compression garments, mastectomy bras and supplies, and ostomy supplies. Please note that supplies available over-the-counter are excluded from this benefit; • Limited Medical Vision Hardware: Benefits are provided for vision hardware for the following medical conditions of the eye: corneal ulcer, bullous keratopathy, recurrent erosion of cornea, tear film insufficiency, aphakia, Xxxxxxxx's disease, congenital cataract, corneal abrasion and keratoconus; and • State sales tax for durable medical and mobility enhancing equipment. Surgically implanted devices may be covered under the appropriate surgical benefit and are not considered DME. Benefits for DME are determined by the type of device and its intended use, and not by the entity that provides or bills for the device. DME and medical supply charges listed below are not covered: • Biofeedback equipment; • Equipment or supplies whose primary purpose is preventing Illness or Injury; • Exercise equipment; • Eyeglasses or co...
Dialysis Services. Inpatient/outpatient/in your home 0% - After Deductible 20% - After Deductible
Dialysis Services. Coverage includes equipment, training and medical supplies, when rendered at any location by a Provider licensed to perform dialysis, including a Dialysis Center.
Dialysis Services. This plan covers dialysis services and supplies provided when you are inpatient, outpatient or in your home and under the supervision of a dialysis program. Dialysis supplies provided in your home are covered as durable medical equipment. Durable Medical Equipment (DME), Medical Supplies, Prosthetic Devices, Enteral Formula or Food, and Hair Prosthesis (Wigs) This plan covers durable medical equipment and supplies, prosthetic devices and enteral formula or food as described in this section. Durable Medical Equipment (DME) DME is equipment which: • can withstand repeated use; • is primarily and customarily used to serve a medical purpose; • is not useful to a person in the absence of an illness or injury; and • is for use in the home. DME includes supplies necessary for the effective use of the equipment. This plan covers the following DME: • wheelchairs, hospital beds, and other DME items used only for medical treatment; and • replacement of purchased equipment which is needed due to a change in your medical condition or if the device is not functional, no longer under warranty, or cannot be repaired. DME may be classified as a rental item or a purchased item. In most cases, this plan only pays for a rental DME up to our allowance for a purchased DME. Repairs and supplies for rental DME are included in the rental allowance. Preauthorization may be required for certain DME and replacement or repairs of DME. Medical Supplies Medical supplies are consumable supplies that are disposable and not intended for re- use. Medical supplies require an order by a physician and must be essential for the care or treatment of an illness, injury, or congenital defect. Covered medical supplies include: • essential accessories such as hoses, tubes and mouthpieces for use with medically necessary DME (these accessories are included as part of the rental allowance for rented DME); • catheters, colostomy and ileostomy supplies, irrigation trays and surgical dressings; and • respiratory therapy equipment. Diabetic Equipment and Supplies This plan covers diabetic equipment and supplies for the treatment of diabetes in accordance with R.I. General Law §27-20-30. Covered diabetic equipment and supplies include: • therapeutic or molded shoes and inserts for custom-molded shoes for the prevention of amputation; • blood glucose monitors including those with special features for the legally blind, external insulin infusion pumps and accessories, insulin infusion devices and injection a...
Dialysis Services. The benefit package includes medically necessary dialysis services as set forth in MAD Program Manual Section MAD-761, DIALYSIS SERVICES. Dialysis providers shall assist members in applying for and pursuing final Medicare eligibility determination.
Dialysis Services. The Contractor shall identify and provide all on-site and off-site peritoneal and/or hemodialysis services, supplies, equipment, and other related expenses. The Contractor shall provide a Board Certified Nephrologist to supervise all dialysis services. The Contractor is responsible for developing a renal dialysis Quality Improvement and Infection Control Program to include accountability of sharps and waste.
