What is covered?
What is not covered?
Must underlying plans be present for medical reimbursement to cover vision, dental and hearing?
Master Social Workers and Family Counselors are excluded under some medical plans (currently they only allow Psychologist or Psychiatrist). Will the Medical Reimbursement Plan cover?
 
What is covered?

Generally, if an expense is medically necessary and qualifies under Section 213 of the Internal Revenue Code, it would be eligible for reimbursement under this insurance plan. Some covered charges include:

  • Prescription drugs
  • Private-duty nursing
  • Hospital expenses, including private-room charges
  • Dental and orthodontic expenses
  • Home health care
  • Alcoholism and drug-abuse treatment and facilities
  • Vision care, including all types of frames
  • Inpatient and outpatient psychiatric care
  • Charges for the diagnosis of infertility
  • Charges for the treatment of infertility up to 10% of annual maximum per calendar year
  • Medical transportation, including air services and hotel
  • Medical supplies and equipment
  • Speech therapy for speech loss or impairment due to illness or surgery
  • Pregnancy
  • Programs to stop smoking
  • Chiropractic services
  • Cosmetic surgery *
  • Weight control drugs or clinics *
  • Capital expenses *
    *Limitations apply

Note: Individuals must be under the care of a legally qualified physician to receive reimbursements.

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What is not covered?
  • Non-prescription drugs
  • Losses due to war
  • Expenses the individual is not legally obligated to pay in the absence of insurance
  • Charges for appointments not kept
  • Hospitalization, services, treatments or supplies furnished by the U.S. or foreign government agency, unless otherwise prohibited by law
  • Service contracts or warranties relating to vision care
  • Custodial care
  • Accident or illness for which the individual is entitled to benefits under any worker’s compensation or occupational disease law
  • Health club dues or exercise equipment
  • Blood Storage
  • Hospital charges for confinement in a long-term care unit or skilled nursing facility unless confinement commences within 14 days after discharge from a qualifying hospital confinement
  • No benefits are payable unless the individual is under the direct care of a legally qualified physician for reasonable and necessary treatment

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Must underlying plans be present for medical reimbursement to cover vision, dental and hearing?

No. If vision, dental, and hearing are not covered by the underlying plan; medical reimbursement will cover the charges.

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Master Social Workers and Family Counselors are excluded under some medical plans (currently they only allow Psychologist or Psychiatrist). Will the Medical Reimbursement Plan cover?

No. If vision, dental, and hearing are not covered by the underlying plan; medical reimbursement will cover the charges.

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