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(2)__Durable medical equipment when medically necessary | | and appropriate, including rental or purchase of durable | | medical equipment for therapeutic use, oxygen equipment | | and hearing aids; and |
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| | | (3)__Medical transportation, as appropriate, to the | | nearest facility that can render necessary and | | appropriate emergency medical treatment; and |
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| | | J.__Prescription drugs, including prescription legend drugs, | | prescribed nonlegend drugs, insulin and diabetic syringes | | but excluding: |
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| | | (1)__Experimental and investigational drugs unless | | prescribed as part of an established clinical trial and | | drugs prescribed as part of that trial that are covered | | by another financing mechanism; and |
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| | | (2)__Hair growth supplements, smoking deterrent agents, | | weight control drugs, nonroutine immunization agents, | | infertility treatments and nonprescription legend | | vitamins with the exception of those used to supplement | | the diets of pregnant women. |
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| | | 2.__Excluded services.__In addition to those exclusions in | | subsection 1, the following benefits are excluded from coverage | | under the plan: |
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| | | A.__Experimental diagnostic and treatment services other | | than those provided as part of an established clinical trial | | and services provided as part of that trial that are covered | | by another party; |
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| | | B.__Infertility diagnosis and treatment and reversal of | | sterilization; |
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| | | C.__Cosmetic surgery except for congenital anomalies and | | repair of injury resulting from an accident; |
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| | | D.__Nonacute ventilator support provided solely for the | | purpose of prolonging life; |
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| | | E.__Personal comfort items; and |
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| | | F.__Private rooms, except when medically necessary. |
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| | | 3.__Expansion or substitution of covered services.__The board | | may expand benefits beyond those in subsection 1 upon finding | | that the cost of the benefit is justified based |
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