- tubal ligation;
- vasectomy;
- breast reduction;
- sexual reassignment surgery;
- submucous resection and/or other surgical correction for deviated nasal septum, other than necessary treatment of covered acute purulent sinusitis;
- treatment for weight reduction;
- learning disabilities;
- immunization;
- treatment of infertility;
- routine physical examinations; and
- well baby visits
Elective Treatment
Medical treatment that is not necessitated by a pathological change in the function or structure in any part of the body occurring after the covered person's effective date of coverage Elective treatment includes, but is not limited to:
Emergency Medical Condition
A medical or behavioral condition, the onset of which is sudden, and manifests itself by symptoms of sufficient severity, including severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of immediate, medical attention to result in: (a) placing the health of the person afflicted with such condition in severe jeopardy, or, in the case of a behavioral condition placing the health of such person or others in serious jeopardy, (b) serious impairment to such person's bodily functions; (c) serious dysfunction of any bodily organ or part of such person; or (d) serious disfigurement of such person