Summary Plan Description
90% Network and 80% Non-Network
Services and Supplies Must Be Precertified Unless the Patient Is A Medicare-Eligible Retiree
Benefits are provided for the treatment of organic erectile dysfunction if the patient has a history of one or more of the following:
- Prostate cancer.
- Severe spinal cord disease or injury.
- Insulin-dependent diabetes.
- Severe Peyronie's disease.
Covered treatment includes vacuum erection devices, injection therapy, penile prosthesis, urethral pellets, and prescription medications (please see Prescription Drug Benefits).
Related Health & Security Content
- 2017 Summary of Material Modifications (1/31/2017)
- 2017 Summary of Material Modifications (1/1/2017)
- 2016 Summary of Material Modifications
- 2014 Summary of Material Modifications
2017 Summary of Benefits and Coverage
Delta Dental of Washington
VSP Vision Care
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