Health & Security Plan > SPD > Orthotics – 90%

Summary Plan Description

Orthotics—90%

Benefits are provided for services and supplies prescribed by a physician (MD, DO, DPM) for custom-made foot orthotics constructed of acrylic, plastic or metal, with a maximum of $400 paid in any two consecutive year period. If expenses exceed the $400 two consecutive year maximum, this plan will not pay the additional costs. Covered services include the custom-made device which must be worn at all times that shoes are worn and not just for specific activities. Shoes that accompany these devices are not covered. Physician services, including impression casting, are paid under a separate benefit.