September 9, 2010 EFFECTIVE JUNE 1, 2007 – Orthopedic Shoes and Orthotics   Section 4.3.4.M of the Plan, page 77 of the November 1, 2006 Summary Plan Description, is hereby amended effective June 1, 2007 to change the coverage for orthopedic shoes from an annual benefit to a benefit provided when medically necessary and appropriate as follows: M. Orthopedic Shoes and Orthotics – Orthopedic shoes are covered when the shoe is an integral part of a leg brace and its expense is included as part of the cost of the brace. In addition, therapeutic shoes for persons with severe diabetic foot disease are covered up to a maximum of one paid of shoes per calendar yearwhen medically necessary and appropriate. No other coverage is provided for orthopedic shoes. Charges for custom made foot orthotics are covered when medical criteria is met, subject to the following limits: Charges are limited to $150 per foot; Foot orthotics are limited to one pair per yearreplacement when medically necessary and appropriate; Foot orthotics are not covered for pes planus (flat feet), pronation, corns, calluses and hammertoes; and Prefabricated orthoses and arch supports are not covered. The criteria used to determine medical necessity and appropriateness of foot orthotics under this Plan are the same as those used by CMS for the administration of Medicare coverage of foot orthotics. Back to Plan Updates   St. Louis Graphic Arts Joint Health & Welfare Fund 14323 South Outer Forty Rd. - Suite S106 Chesterfield, Missouri 63017 Fund Office: (314) 878-1579 twesthues@slgahw.org Fax: (314) 275-2640   If you have any comments about this web site, please contact us at twesthues@slgahw.org.   Site Concept and Design ©2002 jWeb. Maintenance and Hosting provided by jWeb.