Article III - Benefits
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UMWA Health and Retirement Funds

Article III - Benefits

A. HEALTH BENEFITS
(11) GENERAL EXCLUSIONS
 
· Allergy
     ‑‑dust allergy apparatus, 178
     ‑‑tests/inpatient treatment, 84‑467
 
· Anesthesia services
     ‑‑dental procedure, 81‑095, 81‑244, 84‑367, 84‑460
 
· Biofeedback therapy, 81‑222, 81‑643, 81‑674
 
· Black lung tests, 319, 84‑059, 84‑284
 
· Blood glucose monitoring, 81‑273
 
· Contact lenses, 84‑282
 
     ‑‑covered under unusual circumstances, CA-058 
 
     ‑‑dentures, 84‑396, 88‑067
     ‑‑extensive surgical procedures, 96, 112, 81‑672, 84‑142, 84‑532, 02-041
     ‑‑ impacted wisdom teeth, 23, 30, 81‑038, 81‑136, 84‑172, 88‑308, 88‑764
     ‑‑oral surgery, 81‑259, 81‑388, CA‑00702-041
     ‑‑outpatient hospitalization, 17, 84‑085
     ‑‑periodontal disease, 76, 187, CA‑025
     ‑‑root canals, 105, 84‑594
     ‑‑teeth extractions, 84‑603, 88‑298, 88‑32307-0006
     ‑‑temporomandibular joint dysfunction (TMJ), 52, 67, 313, 81‑233, 81‑241, 81‑544, 81‑599, 81‑670, 81‑676, 81‑683, 88‑311
 
· Dyslexia therapy93-06898-003
 
 
· Exercise equipment
     ‑‑bicycle ergometer and pulsemeter, 81‑415
     ‑‑exercise bicycle, 88‑148
     ‑‑heart rate monitor, CA‑020
     ‑‑treadmill, 88‑269
 
     ‑‑biofeedback therapy, 81‑643, 81‑674
     ‑‑bone marrow transplant, 88‑364
     ‑‑emerging medical procedure, CA-082 
     ‑‑light box for seasonal affective disorder, 88-652
     ‑‑Lung Volume Reduction Surgery (LVRS), CA‑033
     ‑‑medication, 84‑123, 88‑256
     ‑‑morphometric analysis, CA‑032
     ‑‑percutaneous diskectomy, 88‑036
     ‑‑thermography, 88‑359, 88‑390
     ‑‑Interspinous distraction device, 11-0136
 
· Eyeglasses/‑surgically caused refractive error, 84‑129, 84‑231, 84‑282
     ‑‑vision impaired by medical condition, 84‑514
 
· Finance charges, 81‑293, 81‑516, 81‑573, 88‑666, 93‑101
 
· Heart rate monitor, see exercise equipment
 
· Insulin infusion pump, 81‑273, 81‑287
 
· In vitro fertilization, 88-685
 
· Iontophoresis, CA-082 
 
· Medicare Part A & B, 81‑044, 84‑497, 84‑516
 
· Mental deficiencies/ inpatient treatment, 81‑447
 
     ‑‑prescription drugs, 88‑290
     ‑‑surgical reduction, 78-17584‑247, 84‑434, 88‑114, 88‑619
     ‑‑weight loss program, 81‑238, 81‑476, 84‑573, 88‑233, 88‑313, 88‑404, 88‑700
     ‑‑excess skin, 07-0010
 
· Obstetrical charges/ excessive fee, 78-029
 
· Orthoptic (see heading under Vision Care)
 
· Physical conditioning, 88‑135, 88‑242
 
· Podiatrist services, routine care, 84‑079
 
· Preexisting conditions, 81‑638, 88‑326
 
· Pregnancy, 18
 
· Private duty nursing, 84‑283
 
· Private room charges, 165, 81‑307, 84‑349, 84‑533, 84‑540, 88‑167, 88‑208
 
· Private tutor, 98-023
 
· Reversal of sterilization procedures, 241, 81‑018, 81‑078, 84‑150
 
· Services,
     ‑‑furnished by governmental, tax-support or voluntary agency, 93-06898-003 
     ‑‑not specifically provided, 159, 81‑161, 81‑238, 81‑273, 84‑111, 84‑170, 84‑241, 88‑135, 88‑154, 88‑242, 88‑321
 
· Services rendered after eligibility period ends, 239, 81‑509, 84‑078, 84‑160, 84‑190, 88‑329
 
· Special education, 81‑161
 
· Visual therapy (see Vision Care listing)
 
 
· Workers’ compensation, 36, 81‑402, 81‑575, 81‑686, 84‑090, 88‑055, 88‑525, 88‑726