EXPERIMENTAL OR INVESTIGATIONAL definition

EXPERIMENTAL OR INVESTIGATIONAL means any healthcare service that has progressed to limited human application, but has not been recognized as proven and effective in clinical medicine. See Experimental or Investigational Services in Section 3 for a more detailed description of the type of healthcare services we consider experimental or investigational.

EXPERIMENTAL OR INVESTIGATIONAL means that we determine the Service is:

EXPERIMENTAL OR INVESTIGATIONAL means the use of any treatment, procedure, facility, equipment, drug, device, or supply not accepted as standard medical treatment of the condition being treated or any of such items requiring Federal or other governmental agency approval not granted at the time services were provided.

Examples of EXPERIMENTAL OR INVESTIGATIONAL in a sentence

• The following transplants are covered in the benefit package: heart transplants, lung transplants, heart-lung transplants, liver transplants, kidney transplants, autologous bone marrow transplants, allegoric bone marrow transplants and corneal transplants, as detailed in MAD Program Manual Section MAD-764, TRANSPLANT SERVICES, Section MAD-765, EXPERIMENTAL OR INVESTIGATIONAL PROCEDURES, TECHNOLOGIES, OR NON-DRUG THERAPIES.

• The CONTRACTOR shall not deem a technology or its application experimental, investigational or unproven and deny coverage unless that technology or its application fulfills the definition of “experimental, investigational or unproven” contained in the MAD Program Policy Manual, Section 765, EXPERIMENTAL OR INVESTIGATIONAL PROCEDURES, TECHNOLOGIES OR THERAPIES.

More Definitions of EXPERIMENTAL OR INVESTIGATIONAL

EXPERIMENTAL OR INVESTIGATIONAL means a service that is determined to be experimental or investigational. In determining whether services are Experimental or Investigational, the Company will consider the following:

EXPERIMENTAL OR INVESTIGATIONAL. : means any procedure, treatment, facility, supply, device, or drug that:

EXPERIMENTAL OR INVESTIGATIONAL means any portion or part of any procedure, device, drug, treatment, or medicine, or the use thereof, which falls within any of the following categories:

EXPERIMENTAL OR INVESTIGATIONAL means that it is determined that the Service is:

EXPERIMENTAL OR INVESTIGATIONAL means that the Claims Administrator determines the Service is:

EXPERIMENTAL OR INVESTIGATIONAL means treatment, a device or prescription medication which is recommended by a Physician, but is not considered by the medical community as a whole to be safe and effective for the condition for which the treatment, device or prescription medication is being used, including any treatment, procedure, facility, equipment, drugs, drug usage, devices, or supplies not recognized as accepted medical practice; and any of those items requiring federal or other governmental agency approval not received at the time services are rendered. The Company will make the final determination as to what is Experimental or Investigational.

EXPERIMENTAL OR INVESTIGATIONAL means any treatments, procedures, devices, drugs or medicines for which one or more of the following is true: