Medical Foods. We cover medical foods and formulas for outpatient total parenteral nutritional therapy; outpatient elemental formulas for malabsorption; and dietary formula when medically necessary for the treatment of Phenylketonuria (PKU) and inborn errors of metabolism. No benefits will be paid for any other non-medical dietary formulas, oral nutritional supplements, special diets, prepared foods/meals and formula for access problems. We cover charges for chiropractic and osteopathic services. These services shall be provided at the request of the member who presents a condition of an orthopedic or neurological nature necessitating treatment for which falls within the scope of a licensed chiropractor or osteopath. See the Schedule of Benefits for benefit levels or additional limits.
Appears in 4 contracts
Samples: Evidence of Coverage, Evidence of Coverage, Evidence of Coverage
Medical Foods. We cover medical foods and formulas for outpatient total parenteral nutritional therapy; outpatient elemental formulas for malabsorption; and dietary formula when medically necessary for the treatment of Phenylketonuria (PKU) and inborn errors of metabolism. No benefits will be paid for any other non-medical dietary formulas, oral nutritional supplements, special diets, prepared foods/meals and formula for access problems. We cover charges for chiropractic and osteopathic services. These services shall be provided at the request of the member who presents a condition of an orthopedic or neurological nature necessitating treatment for which falls within the scope of a licensed chiropractor or osteopath. See the your Schedule of Benefits for benefit levels or additional limits.
Appears in 1 contract
Samples: Evidence of Coverage