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Frequently Asked Questions - BeniComp Select Coverage

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Interested in BeniComp Select Executive Medical Reimbursement but have questions about the application process?

FAQs - BeniComp Select Coverage
What is covered?

A BeniComp Select policy reimburses eligible medical expenses not otherwise covered by health insurance. 

Generally, if an expense is medically necessary and qualifies under Section 213(d) of the Internal Revenue Code, it would be eligible for reimbursement under this insurance plan. Some covered charges include, but are not limited to:

  • Deductibles, co-pays, prescription drugs
  • Private-duty nursing and home health care
  • Hospital expenses, including private-room charges
  • Dental and orthodontic expenses
  • 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 the annual maximum per calendar year
  • Medical transportation, including air services and hotel
  • Medical supplies and equipment
    • This also includes the expenses of operating and maintaining a wheelchair
  • Speech therapy for speech loss or impairment due to illness or surgery
  • Pregnancy
  • Smoking Cessation Programs
  • Chiropractic services
  • X-Rays
  • Wigs purchased upon the advice of a physician for the mental health of a patient who has suffered hair loss due to a disease
  • Acupuncture
  • Prescribed Birth Control
  • Lasik Surgery 
  • Contact Lenses
  • Breast Pumps & Supplies
  • Hearing Aids
  • Vasectomy
What is not covered?

No benefits are payable unless the individual is under the direct care of a legally qualified physician for reasonable and necessary treatment.

Any premiums including, but not limited to Base Plan (or Cobra Continuation of the Base Plan), Medicare Part B, Medicare Part D, Prescription Drug Plans

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

Baby sitting, childcare, and/or nursing services for a healthy child. You cannot include any amount paid for childcare even if this enables you, your spouse, and/or dependent(s) to receive medical treatment. 

 

Must the underlying plan include vision, dental and hearing for BeniComp Select to cover the charges?

No. If vision, dental, and hearing are not covered by the underlying plan; BeniComp Select will reimburse the charges.

Master Social Workers and Family Counselors are excluded under some medical plans (currently they only allow Psychologists or Psychiatrists). Will these be covered under BeniComp Select?

Yes, master social services and psychologists are covered by BeniComp Select, even if the services are not covered by the underlying plan.

Are elective procedures covered?

Generally, if an expense is medically necessary and qualifies under Section 213 (d) of the Internal Revenue Code, it is eligible for reimbursement. Elective procedures that are not medically necessary are not covered by BeniComp Select. 

Weight-Loss Programs


You can include expenses you incur to lose weight if they are treatments for specific diseases diagnosed by a physician such as obesity, hypertension, or heart disease. This includes fees you pay for membership in a weight reduction group as well as fees for attendance at periodic meetings.

You cannot include membership dues in a gym, health club, or spa as medical expenses, but you can include separate fees charged there for weight loss activities.

You cannot include the cost of diet food or beverages in medical expenses because the diet food and beverages substitute for what is normally consumed to satisfy nutritional needs. You can include the cost of special food in medical expenses only if:

  1. The food doesn't satisfy normal nutritional needs,
  2. The food alleviates or treats an illness, and
  3. The need for the food is substantiated by a physician.

The amount eligible for reimbursement is limited to the amount by which the cost of the special food exceeds the cost of a normal diet.

Can Premiums be submitted for reimbursement?

Due to recent IRS regulations, BeniComp Select will no longer reimburse any premiums effective January 1, 2016 including, but not limited to:

  • Base Plan (or Cobra Continuation of the Base Plan)
  • Medicare Part B
  • Medicare Part D
  • Prescription Drug Plans

 

For more information and to view the revised policy form, please click here.