Policyholder Services

Phakic Implants Exception Request Form

OMIC is willing to consider exceptions to the company’s underwriting requirements for phakic implants with respect to patient selection criteria on a patient-by-patient basis due to special situations.  However, insureds are encouraged to limit their performance of phakic implant surgery to cases that fall within the FDA-approved guidelines.  Exceptions may be requested only in extenuating circumstances.  If you have a patient who falls outside of the FDA-approved patient selection criteria but for whom you believe phakic implants are the most appropriate option, please complete an Exception Request Form and return it to OMIC for consideration prior to scheduling surgery.  

Download OMIC’s exception request form for this procedure using the toolbar above.

Coverage for cases that deviate from OMIC’s underwriting requirements is included under your policy only after this form has been submitted, reviewed, and approved and applies only to procedures performed on the patient for whom the exception was sought. If you have any questions about OMIC’s coverage visit the Coverage Q&A section or Contact Your Rep.

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