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Coverage Classifications (for policies effective on or after 10/1/2009)

 
 

To meet the diverse needs of our insureds, OMIC offers four coverage classifications:

Ophthalmology - No Surgery includes coverage only for non-surgical activities. Covered activities include the diagnosis and non-surgical treatment of diseases (other than screening for or treating retinopathy of prematurity), prescription of glasses or contacts, mechanical epilation, punctal closure with plugs, and removal of superficial foreign bodies from the cornea and conjunctiva.

Ophthalmology - Surgery Class 1 includes coverage for non-surgical ophthalmology (other than screening for or treating retinopathy of prematurity) as defined above and the following surgical procedures: removal of sutures, fluorescein angiography, tear duct probing or irrigation done under local anesthetic, repair of minor lid lacerations limited to the skin and/or muscle, repair of minor conjunctival lacerations, biopsy of lid tumors, biopsy of the conjunctiva, removal of cysts and other non-cancerous skin lesions and tumors, removal of corneal epithelium, incision and drainage, implantation of eye jewelry, laser hair removal, photo-epilation, hair removal using radio frequency/light energies (e.g. "Aurora"), subconjunctival injections, intramuscular injections, intravenous injections, injection of Botox or collagen and other fillers, stromal puncture, micropigmentation, microdermabrasion, superficial chemical peels limited to the epidermis, removal of papillomas and chalazions, electrical epilation, cryotherapy of the lid, and non-incisional entropion or ectropion repair.

Ophthalmology - Surgery Class 2 includes coverage for non-surgical ophthalmology (other than screening for or treating retinopathy of prematurity) and Surgery Class 1 procedures as defined above, assisting in surgery, and the following additional surgical procedures: laser capsulotomy, laser iridotomy, laser iridoplasty, laser punctual closure, punctual closure with cautery, laser trabeculoplasty, wedge resection for suspected non-cancerous tumors, suture tarsorrhaphy, marginal adhesion tarsorrhaphy without incision into the tarsus, laser ablation of corneal lesions, temporal artery biopsy, blue light acne treatment (with or without use of photodynamic therapy), non-invasive cellulite reduction (e.g. VelaSmooth, VelaShape), skin rejuvenation/tightening using non-invasive, non-ablative techniques, periocular injections, periorbital injections, peribulbar injections, retrobulbar injections, and sub-Tenons injections.

Ophthalmology - Surgery Class 3 includes coverage for non-surgical ophthalmology, assisting in surgery, and all surgical procedures considered ordinary and customary for the practice of ophthalmology, including screening for or treating retinopathy of prematurity. Coverage of refractive surgery is subject to underwriting review and endorsement. Coverage of full facelifts for cosmetic purposes, liposuction, and rhinoplasty are subject to underwriting review, endorsement, and payment of additional premium.

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