Optical Services. Routine eye examinations and refractions received at a GHC Facility once every twelve (12) months, except when Medically Necessary. When dispensed through GHC Facilities, one contact lens per diseased eye in lieu of an intraocular lens, including exam and fitting, is covered for Members following cataract surgery performed by a GHC Provider, provided the Member has been continuously covered by GHC since such surgery. Replacement of a covered contact lens will be covered only when needed due to a change in the Member’s Medical Condition, but no more than once in a twelve (12) month period. Excluded: evaluations and surgical procedures to correct refractions not related to eye pathology and complications related to such procedures, and contact lens fittings and related examinations, except as set forth above.
Appears in 4 contracts
Samples: Group Medical Coverage Agreement, Group Medical Coverage Agreement, Group Medical Coverage Agreement
