| HMO | Medical Supplies |
| Aetna US Healthcare | Covers: Casts and dressings; needles, syringes, injectable supplies for diabetes.
Excludes: False teeth, arch supports, elastic hose, cervical collars, corsets, wigs or cranial prosthesis, diapers, canes, crutches, special appliances, supplies or equipment and other DME. |
| Blue Cross Blue Shield | Covers: Medical supplies, including colostomy bags, catheters, oxygen, needle, syringes, and special bandages.
Cost Sharing: Coinsurance applies. |
| CIGNA / Healthsource | Covers: Non-durable medical supplies from a participating provider’s office or by an approved home health care agency for the treatment of a specific medical condition.
Limits: Maximum benefit applies. Cost Sharing: Copayment applies. Excludes: Medical supplies, such as, but not limited to, bandages, cotton gauze, hot or cold packs, syringes and needles (except for insulin syringes and all diabetic supplies). |
| Doctors Health Plan | Covers: Non-durable medical supplies supplied in a participating provider’s office or by an approved home health care agency for the treatment of a specific medical condition.
Limits: Requires precertification or prior authorization from Doctors and must be provided by participating provider or facility unless there is no participating provider available. |
| Generations | Covers: Medical supplies such as colostomy bags, catheters, oxygen, needles, and syringes when ordered by a physician based on medical necessity.
Excludes: Deluxe versions of durable medical equipment or prosthetic devices unless medically necessary. Also excludes over the counter medications and supplies commonly procured for home treatment of simple ailments and injuries. |
| Optimum Choice | Covers: Medically necessary supplies.
Cost Sharing: 50% coinsurance for supplies. This payment is waived if the supplies eliminate a hospital admission Excludes: Supplies that are provided for experimental, investigational or cosmetic purposes. |
| PARTNERS | Covers: Selected, medically necessary supplies.
Limits: Supplies must be prescribed and arranged by PCP and authorized in advance by plan. Plan maintains a list of covered supplies and the conditions under which they are covered. |
| Coventry/Principal Health Care of the Carolinas | Covers: Medically necessary supplies such as diabetic syringes and needles, crutches, casts, splints, and other corrective medical appliances, such as orthopedic braces.
Excludes: Over-the-counter devices and/or supplies, such as ACE wraps, elastic supports, and soft cervical collars; sunglasses, corsets, clothing, disposable items, air mattresses, and needles and syringes. Also excludes purchase or rental of supplies of common household use such as exercise cycles, air purifiers, central or unit air conditioners, water purifiers, allergenic pillows or mattresses and water beds. |
| QualChoice | Covers: Medically necessary supplies including syringes for a diagnosis of insulin dependent diabetes, ostomy bags and skin bond for diagnosis of colostomy, and support stockings for a diagnosis of phlebitis or other circulatory condition. Also covers infusion services and arch supports when ordered by a physician.
Limits: Must be ordered by a physician and participating provider or supplier. Arch supports are limited to one pair per year. Excludes: First- aid supplies, air conditioners, humidifiers, dehumidifiers, air purifiers, and exercise equipment. These items are excluded even if they are prescribed by a physician. |
| The Wellness Plan of North Carolina, Inc. | Covers: Ostomy bags, diabetic, and other authorized supplies. |
| United HealthCare | Covers: Diabetic and ostomy supplies.
Excludes: Supplies which can be purchased over-the-counter, except as specified. |
| WellPath | Covers: Insulin syringes, and disposable supplies required for diabetic testing with a blood glucose testing device (e.g. test strips, alcohol swabs and lancets) prescribed for a member to control his/her diabetes.
Excludes: Disposable or consumable outpatient supplies, such as sheaths, bags, elastic garments and bandages, syringes, needles, blood or urine testing supplies, ostomy bags, home testing kits, oxygen, vitamins, dietary supplements and replacements, and special food items. |