Exclusions

The Medically Indigent Program does not cover the following services:

(a)voluntary abortions, abortions and interrupted pregnancy that are not medically necessary;

(b)elective cosmetic surgery, except as provided for in the Women’s Health Act;

(c)custodial care, domiciliary care, private duty nursing services or rest cures, except as provided for in hospices;

(d)personal comfort or convenience items;

(e)any service not medically necessary for the diagnosis or treatment of a disease, injury or condition;

(f)non-emergency use of Emergency Room;

(g)over-the-counter drugs not listed in the Drug Formulary;

(h)drugs not listed in the Drug Formulary, unless otherwise provided in this Act; CH. 2 DIVISION OF PUBLIC WELFARE

(i)experimental drugs, experimental and palliative treatments or procedures, unless approved by the Administrator;

(j)fertility procedures, reversal of sterilization and services related to artificial conception;

(k)treatment, services and supplies related to sexual dysfunction;

(l)trans-sexual surgery and related services;

(m)motorized limbs;

(n)services for any incarcerated person;

(o)care or services furnished by immediate relatives or members of the patient’s household, unless rendered as a duly licensed medical practitioner employed by a health care Provider;

(p)health care services, which are provided and reimbursed by other local or Federal programs, MIP is the payer of last resort;

(q)speech and language therapy;

(r)tissue and organ transplants, and any other related hospital, surgical drug, radiology, laboratory or other medical services before, during and after transplant;

(s)treatment and services for artificial weight reduction, including gastric bypass stapling or reversal, or liposuction;

(t)treatment by any method for temporomandibular joint disorders, including, but not limited to, crowning, wiring or repositioning of teeth;

(u)treatment for injuries sustained in the commission of an illegal or criminal act, including driving under the influence;

(v)any work-related injury, subject to compensation pursuant to the Workers Compensation Law;

(w)care for military service connected disabilities to which the patient is legally entitled to government benefits or care;

(x)orthopedic footwear, unless attached to an artificial foot or unless attached as a permanent part of a leg brace; and

(y)benefits and services not specifically listed as covered.