Plan Benefits

You may search for benefits by entering a keyword or by clicking on the first letter of the service desired.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Keyword


Service Coverage Authorization Requirements Co-Pay: Active duty dependents & retirees with Medicare Part B Co-Pay: Retirees without Medicare Part B
Laboratory Diagnostic Services Covered No-LabCorp is the Plan's preferred lab No No
Lancets (diabetic testing supply) Covered Yes - obtain from Maxor Mail Order Yes Yes
Laparoscopic Surgery Covered Yes No Yes
Laryngoscopy Covered No No Yes
Laser refractive corneal surgery Not covered N/A N/A N/A
Laser Surgery Covered Yes No Yes
LASIK Surgery Not covered N/A N/A N/A
Learning Disorders, Evaluation and Treatment of Not covered N/A N/A N/A
Lumbar Puncture Covered No No Yes
Lymphedema Pump Covered Obtain from Apria No Yes
Lymphedema Therapy Covered Contact Orthonet No Yes


*       Benefit limitations, restrictions and/or exclusions may apply. Contact member service (usfhp@svcmcny.org or 800-241-4848) for additional information.
*       Most out of network services require pre-authorization (exceptions include emergency services, routine lab work, routine diagnostic radiology)


Apria: 800-294-2275
Health Integrated: 866-390-0933
Maxor Plus Pharmacy: 800-687-0707
Maxor Mail Order Pharmacy: 866-408-2459
OrthoNet: 800-401-0062

Header photo credits: 2nd photo from left by: Seaman John Narewski, top right photo by: Petty Officer 3rd Class James Evans