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For Medicare-approved enteral formulas, Medex pays the Medicare Part B coinsurance. For enteral formulas and low protein food products that are not covered by Medicare, Medex pays full benefits.

Medex pays the Medicare Part B coinsurance.

(PIC refers to an approved prolonged illness condition. Refer to the policy for more information.)

(PIC" refers to an approved prolonged illness condition. Refer to the policy for more information.)"

(These benefits may be reduced if benefits have already been provided for these covered services under a prior Blue Cross Blue Shield coverage in the same eligible time period.)

(In-network benefits are provided when covered services are furnished by a non-preferred Optometrist.)

This health plan covers family planning services furnished by a Community Health Center, General Hospital, Physician, Nurse Practitioner or Nurse Midwife. These covered services include:

Consultations, exams, procedures and medical services related to the use of all contraceptive methods to prevent pregnancy that have been approved by the United States Food and Drug Administration.

Injection of birth control drugs, including the prescription drug when it is supplied by the provider during the visit.

Insertion of a contraceptive implant system (such as levonorgestrel or etonogestrel), including the implant system itself.