Vision and Hearing. Except for those Benefits under the Pediatric Vision Services Rider of this Policy.
Vision and Hearing. 1. Cost and fitting charge for eyeglasses and contact lenses. This exclusion does not apply to the initial pair of eyeglasses or contacts needed due to cataract surgery or an accident if the eyeglasses or contacts were not needed prior to the accident.
2. Routine vision exams, including refractive exams to determine the need for vision correction. SAMPLE
3. Implantable lenses used only to fix a refractive error (such as Intacs corneal implants).
4. Eye exercise or vision therapy.
5. Surgery that is intended to allow you to see better without glasses or other vision correction. Examples include radial keratotomy, laser and other refractive eye surgery.
6. Over-the-counter hearing aids.
7. Purchase cost and associated fitting and testing charges for hearing aids, bone anchored hearing aids and all other hearing assistive devices. Cochlear implants are a Covered Health Care Service for which Benefits are available under the applicable medical/surgical Covered Health Care Services categories in this Policy.
1. Health care services and supplies that do not meet the definition of a Covered Health Care Service. Covered Health Care Services are those health services, including services, supplies, or Pharmaceutical Products, which we determine to be all of the following: ▪ Provided for the purpose of preventing, evaluating, diagnosing or treating a Sickness, Injury, Mental Illness, substance-related and addictive disorders, condition, disease or its symptoms. ▪ Medically Necessary. ▪ Described as a Covered Health Care Service in this Policy under Section 1: Covered Health Care Services and in the Schedule of Benefits. ▪ Not otherwise excluded in this Policy under Section 2: Exclusions and Limitations.
2. Physical, psychiatric or psychological exams, testing, all forms of vaccinations and immunizations or treatments that are otherwise covered under this Policy when: ▪ Required only for school, sports or camp, travel, career or employment, insurance, marriage or adoption. ▪ Related to judicial or administrative proceedings or orders. This exclusion does not apply to services that are determined to be Medically Necessary.
Vision and Hearing. 1. Cost and fitting charge for eyeglasses and contact lenses (except for the first pair of contacts for treatment of keratoconus or post-cataract surgery). This exclusion does not apply to benefits as described under Section 11: Pediatric Vision Care Services.
