Question: What costs are covered under my Federal Black Lung Program
medical benefits?
Answer: The cost of medical treatment services and associated travel
directly related to the treatment of your lung condition are covered as
authorized under the Federal Black Lung Benefits Act. These costs are payable
in full, in keeping with established customary rates for covered medical
services. There is no deductible.
The following is a list of services that MAY be covered when they are performed
for the treatment of your lung condition:
- Doctor's office calls, hospital visits, and consultations;
- Inpatient and outpatient hospital charges, including emergency room
visits for ACUTE lung conditions, diagnostic laboratory testing and chest
x-rays;
- Federal Black Lung Program APPROVED prescription drugs, both brand name
and generic;
- Ambulance services limited to transportation to the hospital for emergency
ACUTE lung care; and,
- Travel to the doctor, hospital, clinic, or other medical facility for
round trips of 150 miles or less.
The following items require special approval:
- The purchase or rental of home medical equipment such as oxygen systems
(requires Certificate of Medical Necessity completed by prescribing physician);
- Pulmonary rehabilitation (breathing retraining) programs (requires Certificate
of Medical Necessity completed by prescribing physician);
- Home health care visits for skilled nursing (requires Certificate of
Medical Necessity completed by prescribing physician); and,
- Overnight travel, related meals and lodging, and/or mileage that exceeds
150 miles round trip (requires special approval from your Division of
Coal Mine Workers' Compensation (DCMWC) District Office).
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