| Service |
Coverage |
Authorization Requirements |
Co-Pay: Active duty dependents & retirees with Medicare Part B |
Co-Pay: Retirees without Medicare Part B |
| Hair Transplant |
Not covered |
N/A |
N/A |
N/A |
| Hairpiece or wig |
Limited |
Yes |
No |
Yes |
| Halo |
Covered |
Yes - if $500 or greater |
No |
Yes |
| Hand Held Reacher |
Not Covered |
N/A |
N/A |
N/A |
| Hearing Aid |
Limited (active duty dependents only) |
Yes |
No |
N/A |
| Hearning Exam |
Covered. Limit one every 12 months for annual preventative screening. No limitation for evaluation of medical illness. |
No |
No |
No - annual preventative exam Yes - medical |
| Heat Lamp |
Not covered |
N/A |
N/A |
N/A |
| Heat Pad |
Not covered |
N/A |
N/A |
N/A |
| Hemodialysis |
Covered |
Yes - initial visit minimum |
No |
Yes |
| Hip replacement surgery |
Covered |
Yes |
No |
Yes |
| Holter Monitor |
Covered |
No |
No |
Yes |
| Home Birth |
Covered |
Yes |
No |
No |
| Home Care, Skilled |
Covered |
Yes |
No |
Yes |
| Home Diagnostic Laboratory Services |
Covered |
Yes |
No |
No |
| Home Health Care, home health aid |
Covered only as part of a skilled episode of home health care |
Yes |
No |
Yes |
| Home Health Care, medical social worker |
Covered |
Yes |
No |
Yes |
| Home Health Care, occupational therapist |
Covered |
Yes |
No |
Yes |
| Home Health Care, physical therapist |
Covered |
Yes |
No |
Yes |
| Home Health Care, skilled nurse |
Covered |
Yes |
No |
Yes |
| Home Health Care, speech therapist |
Covered |
Yes |
No |
Yes |
| Home Infusion |
Covered |
Yes |
No |
Yes |
| Home Uterine Monitoring |
Limited |
Yes |
No |
Yes |
| Home Visit Physician Services |
Covered |
Yes |
No |
Yes |
| Hospice, Home |
Covered |
Yes |
No |
No |
| Hospice, Inpatient |
Limited |
Yes |
No |
No |
| Hospital Admission |
Coverd when medically necessary |
Yes - elective; No - emergency |
No |
Yes |
| Hospital Bed, custom or specialty |
Covered |
Yes |
No |
Yes |
| Hospital Bed, electric and related equipment |
Covered |
Obtain from Apria |
No |
Yes |
| Hospital Bed, manual and related equipment |
Covered |
Obtain from Apria |
No |
Yes |
| Hospital Bed, non-custom and related equipment |
Covered |
Obtain from Apria |
No |
Yes |
| Hospital Bed, semi-electric and related equipment |
Covered |
Obtain from Apria |
No |
Yes |
| Humidifier |
Covered only as part of an authorized home oxygen system |
Obtain from Apria |
No |
Yes |
| Hyperbaric Oxygen Therapy (HBOT) |
Covered |
Yes |
No |
Yes |
| Hypnosis |
Not covered |
N/A |
N/A |
N/A |
| Hysteroscopy |
Covered |
No |
No |
Yes |
