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<br />) <br /> <br />11.16 Eye care including: <br /> <br />11.16.01 Eye examinations for Members 18 years of age or older for the purpose of detennining the <br />need for sight correction (such as eye glasses or contact lenses); <br /> <br />) <br /> <br />Training or orthoptics, including eye exercises; or <br /> <br />Radial keratotomy, refractory keratoplasty, Lasik surgery or any other corneal surgical <br />procedure to correct refractive error. <br /> <br />11.17 Foot supports are not covered. These include orthopedic or specialty shoes, shoe build-ups, shoe <br />orthotics, shoe braces, and shoe supports. Also excluded is routine foot care, including trimming of <br />corns, calluses, and nails. <br /> <br />11.16.02 <br />11.16.03 <br /> <br />11.18 Gastric stapling, gastric bypass, gastric banding, gastric bnbbles, and other procedures for the <br />treatment of obesity or morbid obesity, as well as any related evaluations or diagnostic tests. Ongoing <br />visits other than establishing a program of obesity control. <br /> <br />11.19 Gender reassignment surgery as well as any service, supply, or medical care associated with gender <br />reassigmnent or gender identity disorders. <br /> <br />11.20 Home monitoring devices and measuring devices (other than apnea monitors), and any other <br />equipment or devices for use outside the Hospital. <br /> <br />11.21 IIospital Scrvices that are associated with excluded surgery or Dental Care. <br /> <br />11.22 Hearing examinations for Members 18 years of age or older for the purpose of determining the need <br />for hearing correction. <br /> <br />11.23 Infertility diagnosis, treatment, and supplies, including infertility testing, treatment of infertility, <br />diagnostic procedures and artificial insemination, to determine or correct the cause or reason for <br />infertility or inability to achieve conception. This includes artificial insemination, in-vitro fertilization, <br />ovum or embryo placement or transfer, gamete intra-fallopian tube transfer, or cryogenic or other <br />preservation techniques used in such or similar procedures. Also excluded are obstetrical benefits when <br />such pregnancy is the subject of a preplalmed adoption arrangement, or surrogacy, as defined under <br />Chapter 63, Florida Statutes. Medications for the treatment of infertility are not covered. <br /> <br />11.24 Immunizations and medications for the purpose of foreign travel or employment. <br /> <br />11.25 Mandibular and maxillary osteotomies except when Medically Necessary to treat conditions caused <br />by congenital or developmental deformity, disease, or injury. <br /> <br />11.26 Medical care or surgery not authorized by a Participating Provider, except for Emergency Medical <br />Services and Care, or not within the benefits covered by AvMed. <br /> <br />11.27 Medical supplies including, but not limited to: pre-fabricated splints, Thromboemboletic/Support hose <br />and all other bandages, except as provided in Section 9.33. <br /> <br />11.28 Organ donor treatmeut aud services. The Medical Services and Hospital Services for a donor or <br />prospective donor who is an AvMed Member when the recipient of an organ transplant is not an AvMed <br />Member. Coverage is provided for costs associated with the bone marrow donor-patients to the same <br />extent as the insured recipient. The reasonable costs of searching for the bone marrow donor is limited <br />to family members and the National Bone Marrow Donor Program. Post-transplaut donor <br />complications will not be covered. <br /> <br />11.29 Over-the-counter medications, and prescription medications not otherwise covered including all <br />contraceptives (medications and devices), hypodermic necdles and syringes and Self-Administered <br />Injectable Medications except insulin and insulin syringes for the treatment of diabetes as outlined in <br />Section 9.06. <br /> <br />-) <br /> <br />) <br /> <br />35 <br /> <br />A V-CHOICE-2009 <br />MP-5320 (10/09) <br />