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Wheelchairs, crutches and walkers.

Osteoporosis screening.

Acupuncture furnished by a Physician, Osteopathic Physician, or Chiropractor

(The member's copayment is waived when these covered services are furnished during a covered day surgery admission or an emergency room visit.)

(The member's copayment is waived for the provider's interpretation costs and when these covered services are furnished during a covered day surgery admission or an emergency room visit.)

Medical, dental, oral, and facial surgery (including orthodontic treatment and prosthetic management) for members under age 18 to treat cleft lip and cleft palate.

Restorative dental services and orthodontic treatment or prosthetic management therapy for members under age 18 to treat cleft lip and cleft palate. (If a copayment normally applies for office surgery, the office visit copayment will be waived for these covered services. Any deductible and coinsurance will still apply.)

This health plan covers the following preventive dental care, when the care is furnished by a Dentist or other covered provider.

For Members Under Age 18 - Coverage is provided for preventive dental care such as periodic oral exams, cleanings, and fluoride treatments for members under age 18 who are being treated for conditions of cleft lip and cleft palate.

For Members Under Age 12 - Coverage is provided for enrolled dependent children who are under age 12 for: one complete initial oral exam by the child's dentist; one periodic oral exam every six months; one cleaning every six months; one fluoride treatment every six months; and bitewing x-rays once every six months.