Guam § 2913 - Exclusions.

§ 2913. Exclusions.

The Medically Indigent Program does not cover the following services:

(a) voluntary abortions, abortions and interrupted pregnancy that are not medically necessary;

(b) elective cosmetic surgery, except as provided for in the Women’s Health Act;

(c) custodial care, domiciliary care, private duty nursing services or rest cures, except as provided

for in hospices;

(d) personal comfort or convenience items;

(e) any service not medically necessary for the diagnosis or treatment of a disease, injury or

condition;

(f) non-emergency use of Emergency Room;

(g) over-the-counter drugs not listed in the Drug Formulary;

(h) drugs not listed in the Drug Formulary, unless otherwise provided in this Act;

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(i) experimental drugs, experimental and palliative treatments or procedures, unless approved by

the Administrator;

(j) fertility procedures, reversal of sterilization and services related to artificial conception;

(k) treatment, services and supplies related to sexual dysfunction;

(l) trans-sexual surgery and related services;

(m) motorized limbs;

(n) services for any incarcerated person;

(o) care or services furnished by immediate relatives or members of the patient’s household,

unless rendered as a duly licensed medical practitioner employed by a health care Provider;

(p) health care services, which are provided and reimbursed by other local or Federal programs,

MIP is the payer of last resort;

(q) speech and language therapy;

(r) tissue and organ transplants, and any other related hospital, surgical drug, radiology,

laboratory or other medical services before, during and after transplant;

(s) treatment and services for artificial weight reduction, including gastric bypass stapling or

reversal, or liposuction;

(t) treatment by any method for temporomandibular joint disorders, including, but not limited to,

crowning, wiring or repositioning of teeth;

(u) treatment for injuries sustained in the commission of an illegal or criminal act, including

driving under the influence;

(v) any work-related injury, subject to compensation pursuant to the Workers Compensation Law;

(w) care for military service connected disabilities to which the patient is legally entitled to

government benefits or care;

(x) orthopedic footwear, unless attached to an artificial foot or unless attached as a permanent

part of a leg brace; and

(y) benefits and services not specifically listed as covered.