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Get Uft Ship Form 2017-2023

Benefits are payable up to age 80. 10. Orthopedic Shoes ($200 Annual limit, $1,000 Lifetime) b. Physician's statement recommending need c. Copy of invoice/bill with proof of payment Limitation: Must be "Custom made" or "Customized" 2. Ambulance/Ambulette ($300 Annual limit) b. Copy of invoice/bill with proof of payment c. Copy of primary/secondary insurance coverage (such as Medicare, GHI, HIP, etc. for Ambulance only) 11. Orthotics ($200 Annual limit, $1,000 Lifetime) Same documentation & li.

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