Search

Composite resin fillings on front teeth and, the amount allowed for amalgram fillings toward the cost of composite resins fillings on bicuspids and molars (one filling for each tooth surface each 12 months).

Pin retention for fillings.

Space maintainers required due to premature loss of teeth for a member under age 19.

Study models and casts used in planning treatment (once each 60 months).

The member's copayment is waived when the visit is only for immunizations.

Medicare-covered drugs and supplies include: drugs administered by a Medicare covered provider; antigens; clotting factors for a member with hemophilia; erythropoietin; drugs for immunosuppressive therapy; injectable drugs for osteoporosis for homebound menopausal women; chemotherapy and anti-emetic drugs; and materials to test for presence of blood sugar.

A benefit period starts on the first day (that is not part of a prior benefit period) on which the member receives covered inpatient services in a hospital or skilled nursing facility. It ends when the member has gone 60 days without being an inpatient in a hospital, skilled nursing facility or similar facility.

This health plan covers inpatient Skilled Nursing Facility services for the number of days described in the benefit limit. The admission must meet all Medicare rules. This includes the requirement that the member is admitted to a Medicare-certified Skilled Nursing Facility after an inpatient stay in a hospital for at least three days in a row. These covered services include:

This health plan covers medically necessary services to diagnose and treat speech, hearing and language disorders when the services are furnished by a covered health care provider. These covered services include:

Medical care furnished by a Physician or Nurse Practitioner and medical care furnished by a Physician other than the attending Physician to treat an uncommon aspect or complication of the member's illness or injury.