What's Included in 100% Coverage for Cancer Prevention, Diagnosis, and TreatmentPlan members will receive 100% coverage with no deductibles, copays, or coinsurances for services related to the diagnosis and treatment of cancer.
INCLUDED SERVICESThe services listed below are covered in the Kelsey-Seybold Greater Houston Plan according to the regular schedule of benefits as shown in the Summary of Benefits and Coverage.
- Physician and provider care from specialists and oncologists involved in the diagnosis and treatment of cancer.
- Cancer-related diagnostic services, including imaging (MRI, CT, PET, X-ray, and other approved radiologic imaging services), and laboratory testing.
- Outpatient and inpatient treatment for cancer diagnoses, including surgical treatment, radiation therapy, and infusion therapy.
- Inpatient cancer care as approved by Kelsey-Seybold.
- Post-cancer treatment follow-up visits with specialists and oncologists, including diagnostic imaging and laboratory services ordered by treating physicians.
- Supportive Medicine – services that address the unique physical, psychological, and spiritual needs of patients living with serious or life-threatening illnesses.
- Reconstructive and plastic surgery to restore function and appearance related to cancer diagnosis.
These services are not covered in the Kelsey-Seybold Greater Houston Plan.
- Clinical trials approved by treating physicians (partial to full coverage based on case review)
- Durable Medical Equipment (DME), including wheelchairs, walkers, etc.
- Emergency room care
- Genetic testing for breast, ovarian, and prostate cancer
- Home healthcare
- Hospice care at home
- Nutrition consultation
- Ostomy supplies
- Prosthetic devices, including mastectomy brassieres
- Supplies needed for feeding with formulas
- Urgent care visits related to cancer diagnosis
- Treatment for pre-existing conditions not related
- Feeding and nutritional supplements other than those provided during an in-patient stay
NOTE: Prescription drugs are covered separately through the prescription drug benefit program, and all applicable copays and deductibles apply.