Orthotic Devices. Coverage for Orthotic Devices or Orthotic Appliances is limited to custom-made leg, arm, back and neck braces when related to a surgical procedure or when used in an attempt to avoid surgery and when necessary to carry out normal activities of daily living, excluding sports activities. Replacements are covered only when Medically Necessary due to a change in bodily configuration.
Orthotic Devices. Orthotic devices, which are defined as appliances or apparatus that support or align movable parts of the body, correct deformities or improve the functioning of movable parts of the body.
Orthotic Devices. The Plan provides Benefits for certain Orthotic Devices, when Medically Necessary, including but not limited to orthopedic braces, back or surgical corsets, and splints. The Plan does not provide Benefits for the following whether available over-the-counter or by prescription: arch supports, shoe inserts, other foot support devices, orthopedic shoes (unless attached to a brace), support hose, and garter belts.
Orthotic Devices. An orthotic device is a rigid or semi-rigid supportive device that restricts or eliminates motion of a weak or diseased body part. Benefits for orthotic devices include the purchase, fitting, necessary adjustment, repairs, and replacement of orthotic devices. Examples of orthotic devices are: diabetic shoes; braces for arms, legs, and back; splints; and trusses. Diabetic shoes and foot orthotics mandated by Pennsylvania state law are covered. Also, orthopedic shoes and other supportive devices of the feet are covered only when they are an integral part of a leg brace. Otherwise, foot orthotics and other supportive devices for the feet are not covered.
Orthotic Devices. Purchase, fitting, necessary adjustment, repairs and replacement of a rigid or semi-rigid supportive device which restricts or eliminates motion of a weak or diseased body part.
Orthotic Devices that is, a supportive device for the body or a part of the body, head, neck, or extremities including, but not limited to leg, back, arm and neck braces. In addition, benefits will be provided for adjustments, repairs or replacement of the device because of a change in your physical condition as determined by your Primary Care Physician or Woman's Principal Health Care Provider.
Orthotic Devices. Orthotic Devices including braces and trusses for the leg, arm, neck and back and special surgical corsets may be covered when prescribed by a Physician and designed and fitted by an Orthotist. Benefits may be provided for necessary replacement of an Orthotic Device you own when due to irreparable damage, wear, a change in your Condition, or when necessary due to growth of a child. Payment for splints for the treatment of temporomandibular joint (TMJ) dysfunction is limited to one splint in a six-month period unless a more frequent replacement is determined by us to be Medically Necessary. Coverage for Orthotic Devices is based on the most cost-effective Orthotic Device which meets your medical needs as determined by us.
Orthotic Devices. The PPO will pay for the purchase of Standard Orthotic Devices when prescribed in advance by a Preferred Provider or when approved in advance by the PPO. Standard Orthotic Devices must be obtained from a Preferred Provider unless authorized in advance by the PPO. Coverage of Orthotic Devices is subject to the Exclusions set forth in Section 4.59 of this Certificate.
Orthotic Devices. The initial purchase, fitting, and repair of a custom made rigid or semi-rigid supportive device used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body, or which limits or stops motion of a weak or diseased body part. The cost of casting, molding, fittings, and adjustments are included. Applicable tax, shipping, postage and handling charges are also Covered Services. The casting is a Covered Service when an orthotic appliance is billed with it, but not if billed separately.
(a) Covered Services include the following. • Cervical collars. • Ankle foot orthosis. • Corsets (back and special surgical). • Splints (extremity). • Trusses and supports • Slings. • Wristlets. • Built-up shoe. • Custom made shoe inserts.
(b) Orthotic appliances may be replaced one time per Plan Year unless specifically approved in writing by us. Additional replacements will be allowed for Covered Persons under age 18 due to rapid growth, or for any Covered Person when an appliance is damaged and cannot be repaired.
(c) Coverage for an orthotic custom fabricated brace or support designed as a component for a prosthetic limb is described in more detail below.
(d) Non-Covered Services include the following. • Orthopedic shoes (except therapeutic shoes for diabetics). • Foot support devices, such as arch supports and corrective shoes, unless they are an integral part of a leg brace. • Standard elastic stockings, garter belts, and other supplies not specially made and fitted (except as specified under Medical Supplies). • Garter belts or similar devices.
Orthotic Devices. We will not provide benefits for orthotic devices, including but not limited to custom made shoes, orthopedic shoes, arch supports, elastic support stockings and shoe inserts, or for services for evaluation, fitting, or modification of such devices.
