Common use of Direct Access Specialist Benefits Clause in Contracts

Direct Access Specialist Benefits. The following services are covered without a Referral when rendered by a Participating Provider. • Direct Access to Gynecologists. Benefits are provided to female Members for services performed by a Participating gynecologist for diagnosis and treatment of gynecological problems. 1. if the Member is age 1 through 18 and wears eyeglasses or contact lenses, 1 exam(s) every 12-month period. 2. if the Member is age 19 and over and wears eyeglasses or contact lenses, 1 exam(s) every 24-month period. 3. if the Member is age 1 through 45 and does not wear eyeglasses or contact lenses, 1 exam(s) every 36-month period. 4. if the Member is age 46 and over and does not wear eyeglasses or contact lenses, 1 exam(s) every 24-month period.

Direct Access Specialist Benefits. The following services are covered without a Referral when rendered by a Participating Provider. • Direct Access to Gynecologists. Benefits are provided to female Members for services performed by a Participating gynecologist for diagnosis and treatment of gynecological problems. See the Infertility Services section of this Certificate for a description of covered Infertility services. 1. if the Member is age 1 through 18 and wears eyeglasses or contact lenses, 1 exam(s) one exam every 12-month period. 2. if the Member is age 19 and over and wears eyeglasses or contact lenses, 1 exam(s) one exam every 24-month period. 3. if the Member is age 1 through 45 and does not wear eyeglasses or contact lenses, 1 exam(s) one exam every 36-month period. 4. if the Member is age 46 and over and does not wear eyeglasses or contact lenses, 1 exam(s) one exam every 24-month period.

Direct Access Specialist Benefits. The following services are covered without a Referral when rendered by a Participating Provider. • Direct Open Access to Gynecologists. Benefits are provided to female Members age 13 and older for services performed by a Participating gynecologist for diagnosis and treatment of gynecological problems. See the Infertility Services section of this Certificate for a description of Infertility benefits. 1. if the Member is age 1 through 18 and wears eyeglasses or contact lenses, 1 exam(s) one exam every 12-month period. 2. if the Member is age 19 and over and wears eyeglasses or contact lenses, 1 exam(s) one exam every 24-month period. 3. if the Member is age 1 through 45 and does not wear eyeglasses or contact lenses, 1 exam(s) one exam every 36-month period. 4. if the Member is age 46 and over and does not wear eyeglasses or contact lenses, 1 exam(s) one exam every 24-month period.