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Responsible and Fair
Healthcare For All
Essential Healthcare Coverage
Inclusions
Physician Services:
Routine Physical Exams: periodic physical assessments and screening
(according to established protocols) for cancer etc., well baby care
Routine prenatal,
maternity and gynecological care
Nicotine dependence treatment
Evidence-based childhood and adult immunizations
Physicians visits for injury or sickness
Diagnostic X-Ray/Lab
Emergency room
Inpatient Hospital Services:
Hospital stays for established maximums, greater
stays paid for by hospital or patient
Outpatient and ambulatory surgery according to
established evidence-based protocols
Surgery according to established evidence-based
protocols Physician
hospital services according to needs and evidence-based protocols
Alternative Healthcare Services:
Physical therapy according to established
evidence-based protocols
Chiropractic and acupuncture treatments according to established
evidence-based protocols
Mental Illness:
Biologically-based mental illness according to established
evidence-based protocols
Alcohol and substance abuse according to established evidence-based
protocols
Outpatient
Prescription Medications:
Prescription of generic drugs unless there is an evidence-based
indication for a non-generic drug
Dental Care:
Preventive care and restorative conditions
according to established evidence-based protocols
Coverage exclusions:
Cosmetic surgery, custodial care, hearing aids,
experimental, unproven or ineffective procedures or treatments, routine
foot care, infertility services including, but not limited to, in vitro
fertilization procedures, gamete intrafallopian transfer (GIFT), zygote
intrafallopian transfer (ZIFT), similar and related services, treatment
of mental retardation, reduction of nails, calluses or corns,
rehabilitation therapies except for physical therapy, foods and food
products for metabolic diseases (including obesity), skilled nursing
facility not according to established evidence-based protocols, home
healthcare, hospice care, durable medical equipment, prescription drugs
that generic drugs can replace effectively.
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