What's Not Covered
Some services are not covered by Passport Health Plan. They are:
- Abortions, unless the life of the mother is in danger, or in the event of rape or incest.
- Cosmetic surgeries and medicines.
- Experimental procedures or drug therapy.
- Funeral or burial costs.
- Hysterectomy, if performed for hygiene or sterilization reasons only.
- Infertility treatment (medical or surgical).
- Making mentally ill patients or persons in the hospital sterile. Sterile means you cannot have a baby.
- Oral surgery that is cosmetic.
- Paternity testing.
- Personal care items. For example: hair brushes, shampoo, toothpaste, feminine hygiene products.
- Personal items or services while you are in the hospital, such as television or telephone.
- Reversing or changing back surgeries like tubal ligation (having your tubes tied) or vasectomy.
- Services, medicines and medical equipment that are not medically necessary.
- Services provided in countries other than the United States, unless approved by the Secretary of the Kentucky Cabinet for Health and Family Services.
- Sex change operations.
- Specialty care not set up by your PCP. This does not apply to members with Medicare or Passport Advantage (you have Passport Health Plan and you have chosen Passport Advantage for your Medicare Advantage plan), or children in out-of-home placement (foster care). See the “When You Need to See a Specialist” section on page 15 of the Handbook.
