2006-041-RES-Health Reimbursement

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Over-the-counter - Over-the-counter drugs (t.lmt is, drugs availabl~ without a prescription) are reimbursable. However, to be reimbursed over-the-counter drugs must be legally procured; generally accepted as falling within the category of medicine and drugs; used to diagnose, cure, mitigate, treat or prevent a disease or disorder of a structure or function of the body; and not used for general good health. Reimbursable over-the-counter drugs include antacids, allergy medicines, pain relievers and cold medicines. Dietary supplements, such as vitamins, cosmetics and other products used to maintain general good health are not reimbursable. Oxygen - Amounts paid for oxygen or oxygen equipment to relieve breathing problems caused by a medical condition are reimbursable. Patterning exercises - See Therapy. Personal use items - Items that are ordinarily used for personal, living and family purposes are not reimbursable unless they are used primarily to prevent or alleviate a physical or mental defect or illness. For example, the cost of a wig purchased at the advice of a physician for the mental health of a patient who has lost all of his or her hair from disease is reimbursable. If an item purchased in a special form primarily to alleviate a physical defect is one that in normal form is ordinarily used for personal, living and family purposes, the cost of the special form in excess of the cost of the normal form is reimbursable. Also see Braille books and magazines. Phone equipment - Telephone equipment designed for a hearing-impaired person are reimbursable, as are the cost of repairs. Physical exams - Physical exams are generally reimbursable, except for employment-related physicals. See, Employment-related expenses. Pre-existing conditions - Medical expenses not covered because of the plan's pre-existing condition limitation are reimbursable. Pregnancy test - The cost of an over-the-counter pregnancy test is not reimbursable. A pregnancy test performed by a physician, however, is reimbursable. Prescription drugs. See Medicines. Private hospital room. The extra cost of a private hospital room is reimbursable. PRK (photorefractive keratectomy) - See Radial keratotomy. Prosthesis - See Artificial limb. Psychiatric care - Expenses for psychiatric care are reimbursable. These expenses include the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care. Also see Psychoanalysis and Transportation. Psychoanalysis - Expenses for psychoanalysis are reimbursable. Psychologist - Expenses for psychological care are reimbursable. Reasonable and customary charges, amounts in excess of - Medical expenses in excess of a Medical Plan's. reasonable and customary charges are reimbursable. Resort. See Spa or resort. Retin-A - Reimbursable when prescribed by a physician to treat a specific medical condition (such as acne), but not for cosmetic purposes (such as wrinkles). Rogaine - Reimbursable when prescribed by a physician for a specific medical condition (such as hypertension), but not for cosmetic purposes (that is, to stimulate hair growth). Schools, special - Expenses paid to a special school for a mentally impaired or physically disabled person are reimbursable if the main reason for using the school is its resources for treating the disability. This includes the cost. of a school that: . teaches Braille to a visually impaired child; . teaches lip-reading to a hearing-impaired child; or . provides remedial language training to correct a condition caused by a birth defect. Page 17