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Covered Supplies
Alternating Pressure Point Pads
Apnea Monitor
Blood Plasma or Whole Blood
Bone Growth Stimulators
Braces (except dental)
Canes and Crutches
Casts, Splints, Binders (such as cervical collars, knee braces or crutches)
Compression Garment (inflatable & non-inflatable including surgical stockings)
Custom Foot Orthotics (ordered by DPM, MD, OD only)
Electro-Larnyx
Glucose Monitor
Hospital Beds (manual or electric)
Infusion Pumps (enteral or parenteral nutritional therapy only)
Intermittent Compression Units
Kidney Hemodialysis Machines
Muscle Stimulators (used during therapy)
Nasal CPAP
Nebulizers
Nerve Stimulator
Orthotic Devices
Ostomy Supplies (for colostomy or ileostomy)
Oxygen and Rental Equipment (for the administration of oxygen)
Pacemakers
Penile Implants
Prosthesis, Artificial Limbs or Eyes (except replacement thereof)
Radium, Radioactive Isotopes and X-ray Therapy
Surgical Bras (post-mastectomy)
Surgical Dressing (therapeutic and protective coverings applied to wounds or lesions either on the skin or opening to the skin in connection with a surgical procedure performed by a Surgeon, including: adhesive tape, roll gauze, bandages, and disposable compression material)
Therapeutic Mattress
Traction Equipment
Ultra-Violet Equipment
Ventilators
Walkers
Wheel chairs
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Non-Covered
Automatic Blood Pressure Monitor
Bathtub or Shower Seat/Bench/Chair
Beds/Lounge
Biofeedback Equipment
Birth Control Devices
Blood Pressure Cuff
Breast Pumps
Cervical Pillow
Circulators
Colonic Irrigation Units
Communication Devices
Environmental Equipment including: Air Cleaner, Air Filter, Humidifier, Air Conditioner, Dehumidifier, Precipitator, and Vaporizers
Exercise Equipment
Exercycle
Food Blenders
Gravetonical Traction Device
Handrails
Heating Pads
Hot Tubs
Hydraulic Lifts
Lifts, Transfer Boards/Bench
Massage Devices
Nocturnal Enuresis Devices
Sauna Baths/Sitz Baths
Shoe Inserts, Arch Supports, Heel Lifts
Water Piks
Whirlpools/Whirlpool Equipment
Wigs/Toupees
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