Employee Medical Plan Covered Expenses
The medical plan provides extensive and valuable benefits for you and your eligible dependents. Benefits are available for medically necessary services and supplies necessary to diagnose, care for, or treat a physical or medical condition. Any portion of a claim which is itemized as sales, excise or other taxes is not reimbursable.
To be medically necessary, the service or supply must be:
- care or treatment which is expected to improve or maintain your health or to relieve pain and suffering without aggravating the condition or causing additional health problems;
- a diagnostic procedure which is expected to provide information to determine the course of treatment; and
- no more costly than another service or supply which could fulfill these requirements.
The Employee Insurance Information Booklet lists further specifications. Refer to the booklet (and appropriate addenda) for information regarding the following covered expenses:
- Physician's services
- Nurse advice line
- Emergency room visits
- Hospitalization
- Home health care
- Skilled nursing care
- Skilled nursing facility
- Outpatient procedures and plan-required second opinions
- Employee-elected second opinions
When is a colonoscopy covered?
Your AlaskaCare Health Plan may cover a colonoscopy, but only under certain conditions.
Colonoscopies are covered when medically necessary as defined by the plan. Additionally, a preventive care benefit that includes screening colonoscopies subject to certain guidelines was added to the Employee Plan effective July 1.