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LMS Medical Fund Exclusions List Like other medical schemes, there are certain medical costs that LMS does not cover. These are called exclusions and the most common ones that apply to all option choices are listed below. If you are a member of TRADITIONAL Standard, please see the following page for additional exclusions that apply to your option choice. Summary of the most common exclusions - All option choices 4D and 3D pregnancy scans (unless pre-authorised for appropriate medical conditions) Infertility treatment, reversal of vasectomy and reversal of tubal ligation Abdominoplasties Insulin and morphine pumps (Unless you are on the COMPLETE Plus and TRADITIONAL Ultimate option choices) Accommodation and services provided in a geriatric hospital, old age home, frail care facility or similar institution Intestinal flora (Unless you are on TRADITIONAL Ultimate, or you have positive Savings available) All costs related to wilful and/or self-inflicted injuries Iridology Anabolic steroids Keloid surgery and revision of scars, except following burns or for functional impairment Anti-addiction and anti-habit agents Massages Any institution, nursing home or similar institution, not registered in terms of any law Medicated shampoos and conditioners Any medical or surgical treatment of impotence and sexual dysfunction Medicines used to treat alcohol and substance abuse Appointments not kept Nebulisers Aphrodisiacs Obesity-related surgical treatment Aromatherapy Orthodontic treatment over the age of 21 years Art therapy Orthognathic surgery (to correct jaw misalignment) Autopsies Otoplasties (Bat Ears) Ayurvedics Pain-relieving machines Back rests, chair seats, beds, mattresses, orthopaedic shoes and boots, arch supports and shoe inserts Persons not registered with a professional body constituted in terms of an Act of Parliament Biological and specialised medicines used for both oncology and chronic indications unless considered a Prescribed Minimum Benefit (PMB) and pre-authorised. Physiotherapy not covered under admission to a psychiatric facility CPAP machine Reflexology Blood pressure monitors Registered tonics and stimulants Breast augmentations, reductions and reconstruction Repairs to devices or prostheses Bulk-forming and stimulant laxatives Cochlear implants other than for beneficiaries born into the Scheme and who are beneficiaries of the TRADITIONAL Ultimate option choice Contact lense preparations Contraceptives and devices to prevent pregnancy (Unless you are on the TRADITIONAL Ultimate option choice) Cosmetic procedures Cosmetic preparations, emollients/moisturisers Dental implants Epilation treatment (hair removal) Erythropoietin Evening primrose oil and fish-liver oil preparations and combinations Food, nutritional supplements Gender realignment, including counselling Growth hormones Holidays for recuperative purposes; Homeopaths and homeopathic medicines Humidifiers Hyperbaric oxygen treatment Immunosuppressives and immunostimulants LMS 10028 CDG 13.07.16 Repairs of any appliances (excluding dentures), external accessories or orthotics Rhinoplasties for cosmetic purposes Services for the treatment of any sickness, condition or injury sustained by a beneficiary for which any other party may be liable Sleep therapy Sleep studies/Polysomnogram Slimming preparations Soaps, scrubs and other cleansers Sunglasses, readers, repairs to spectacle frames, coloured contact lenses Sunscreen and sun-tanning preparations Surrogate pregnancies Telephone consultations Topical and oral acne preparations Travelling expenses Veterinary products Vitamin and mineral supplements Treatment/tests related to Integrative Functional Medicine or ‘Anti-Ageing Medicine’ 1 of 2 Additional exclusions specific to TRADITIONAL Standard Allergy testing Any non-Network generated claim apart from those covered under “out of Network” Injuries arising from participation in professional sport, bungee jumping, parachute jumps or any extreme sport Root canal treatment, dentures and other advanced dentistry Services obtained from acupuncturists, biokineticists, chiropractors, herbalists or naturopaths Services for chronic psychiatric conditions and mental disorders except as stated in the Scheme Rules Treatment and operations of choice, and non-essential medical items Teaching aids for handicapped children 2 of 2