FMIP 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 FMIP contract under Benefit Exclusions and Benefit Limitations.
Under no circumstances will FMIP pay more than $2 million in lifetime benefits for any enrollee. This amount applies to all contracts and is reduced by benefits paid under any prior FMIP contract.
Following is a BRIEF list of contract exclusions:
- Abortion (except as defined in the FMIP Contract)
- Acupuncture
- Appliances or equipment primarily for comfort or convenience
- Charges in excess of
reasonable amounts for services and supplies
- Chiropractic care
- Cosmetic or reconstructive surgery
- Custodial care
- Dental examinations and
treatment
- Experimental or investigational procedures
- Family planning services and supplies
- Hearing aids (except as defined in the FMIP Contract), eyeglasses,
and contacts
- Massage or massage therapy
- Naturopathic medicine and treatment
- Off the shelf orthopedic shoes and orthopedic inserts
- Orthognathic
surgery (except as defined in the FMIP Contract)
- Transplant ($250,000 max. per transplant)
- Treatment for obesity or weight control (except as defined in the FMIP Contract)
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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.
Under no circumstances will OMIP pay more than $2 million in lifetime benefits for any enrollee. This amount applies to all contracts and is reduced by benefits paid under any prior OMIP contract.
Following is a BRIEF list of contract exclusions:
- Acupuncture
- Appliances or equipment primarily for comfort or convenience
- Charges in excess of reasonable
amounts for services and supplies
- Chiropractic care
- Cosmetic or reconstructive surgery
- Custodial care
- Dental examinations and treatment
- Experimental
or investigational procedures
- Family planning services and supplies
- Hearing aids (except as defined in the OMIP Contract), eyeglasses, and contacts
- Massage
or massage therapy
- Naturopathic medicine and treatment
- Off the shelf orthopedic shoes and orthopedic inserts
- Orthognathic surgery (except as defined in
the OMIP Contract)
- Treatment for obesity or weight control (except as defined in the FMIP Contract)
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