Educational Classes

A health care professional must provide evidence of medical necessity for the cost of an educational class specific to a medical condition such as learning to manage diabetes or learning Braille to be an eligible medical expense. Include evidence of medical necessity by providing a Letter of Medical Necessity (LMN) that specifically identifies the recommendation and expense is for treatment of a medical condition with the request for reimbursement.

Durable Medical Equipment (DME)

The cost to purchase or rent durable medical equipment is an eligible medical expense. Examples of eligible items include:
bed wetting alarm
blood pressure kit
crutches
hearing aid
medical alert equipment
adaptive equipment that assists with daily living activities such as bath chairs, wheelchairs or bedside toilet.

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How Health Plans Ensure Claims and Appeals Notices Are Culturally and Linguistically Appropriate

How Health Plans Ensure Claims and Appeals Notices Are Culturally and Linguistically Appropriate

Health plans must communicate effectively with all members, regardless of their language. The Affordable Care Act (ACA) mandates that claims ...

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