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
- 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
- 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
- Concierge doctor annual premium
- 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.