Oregon Medical Insurance Pool (OMIP)

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OMIP Plan Exclusions and Limitations

OMIP contracts place some exclusions and limitations on the benefits available for the treatment of certain conditions and the use of
certain procedures. These exclusions and limitations are explained in the OMIP contract under Benefit Exclusions and Benefit
Limitations. Please be sure to read your entire contract carefully for a complete description of coverage, exclusions and limitations. Following
is a BRIEF list of contract exclusions.

• Acupuncture
• Appliances or equipment primarily for comfort or convenience
• Charges in excess of usual and customary or reasonable amounts for services and supplies
• Chiropractic Care
• Cosmetic or reconstructive surgery
• Custodial care
• Dental examinations and treatment
• Family planning services and supplies
• Hearing aids, eyeglasses and contacts
• Massage or Massage Therapy
• Orthognathic surgery
• Orthopedic Shoes
• Treatment for obesity or weight control

Prescription Exclusions
There are some medications that OMIP does NOT cover. The BENEFIT EXCLUSIONS and BENEFIT LIMITATIONS section of your OMIP
contract includes a list of medications that we do NOT cover. Please review this section of your contract carefully. For a complete listing
of medications that OMIP contracts cover, please request a Preferred Medication List from our Administering Insurer, Regence BlueCross
BlueShield of Oregon, at 1-800-848-7280.

The following is a BRIEF list of the Prescription Medication Plan Exclusions. It’s important to carefully read the contract for a complete description
of coverage and exclusions and/or limitations.

• Contraceptives
• Fertility Medications
• Prescription Medications that the Federal Drug Administration (FDA) newly approves
• Non Prescription Medications
• Prescription Medications for Cosmetic Purposes
• Prescription Medications for Smoking Cessation
• Prescription Medications for Weight Loss, Treatment of Obesity or Morbid Obesity
• Prescription Medications with no proven Therapeutic Indications

But please remember to read through the OMIP packet carefully before making a decision.

This information is taken from the Oregon Department of Consumer and Business Services web site. Every reasonable effort is made to assure the accuracy of the information provided here.  InsuranceQuest, LLC is a licensed and independent agency that can assist consumers in securing this coverage.