2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 68
(29) Hair Loss: Expenses for care and treatment of hair loss including wigs, hair transplants or any drug that
promises hair growth, whether or not prescribed by a Physician, will not be considered eligible, except as
specified under Eligible Medical Expenses.
(30) Hearing Aids: Expenses for hearing aids (including the fitting thereof) will not be considered eligible unless
prescribed by a Physician or an Audiologist, and except as specified under Eligible Medical Expenses.
(31) Home Births: Expenses related to giving birth at home will not be considered eligible.
(32) Homeopathic Treatment: Expenses for naturopathic and homeopathic treatments, services and supplies will
not be considered eligible.
(33) Hospital Employees: Expenses for professional services billed by a Physician or nurse who is an employee
of a Hospital or Skilled Nursing Facility and paid by the Hospital or facility for the service will not be considered
eligible.
(34) Human Subject Study: Expenses which are performed subject to the Covered Person’s informed consent
under a treatment protocol that explains the treatment or procedure as being conducted under a human
subject study experiment will not be considered eligible, except for clinical trials as specified under Eligible
Medical Expenses.
(35) Hypnotherapy: Expenses for hypnotherapy will not be considered eligible.
(36) Infertility: Expenses for confinement, treatment, testing or services related to infertility (the inability to
conceive) or the promotion of conception will not be considered eligible.
(37) Maintenance Therapy: Expenses for Maintenance Therapy of any type when the individual has reached the
maximum level of improvement will not be considered eligible.
(38) Massage Therapy: Expenses for massage therapy will not be considered eligible, unless when part of an
overall patient treatment plan. Expenses for Rolfing will not be considered eligible.
(39) Maternity: Maternity expenses Incurred by a Dependent other than an Employee's Spouse will not be
considered eligible.
(40) Medically Necessary: Expenses which are determined not to be Medically Necessary will not be considered
eligible.
(41) Missed Appointments: Expenses for missed appointments will not be considered eligible.
(42) No Legal Obligation: Expenses for services provided for which the Covered Person has no legal obligation
to pay will not be considered eligible. This exclusion will not apply to eligible expenses that may be covered
by state Medicaid coverage where federal law requires this Employer's plan to be primary.
(43) Not Performed Under the Direction of a Physician: Expenses for services and supplies which are not
prescribed or performed by or under the direction of a Physician will not be considered eligible.
(44) Not Recommended by a Physician: Expenses by a Hospital or covered residential treatment center if
hospitalization is not recommended or approved by a legally qualified Physician will not be considered eligible.
(45) Nutritional Supplements: Expenses for nutritional supplements, special infant formulas, or other enteral
supplementation will not be considered eligible, unless received in an inpatient Hospital environment, or as
prescribed by a Physician, or as specified under Eligible Medical Expenses. Equipment used to administer
nutritional supplements or other enteral supplementation may be covered by the Plan.
(46) Obesity: Expenses for weight loss programs or treatment of obesity will not be considered eligible, except for
Morbid Obesity (see Eligible Medical Expenses).
64