28. Electrical Neural Stimulation (ENS), which includes Transcutaneous Electrical Nerve Stimulation (TENS) units, outside of medically supervised facility settings (e.g., in-home use). 29. Email consultations or e-visits, except as described under the telemedicine benefit. 30. Equipment not primarily intended to improve a medical condition or injury, including, but not limited to: ◦ Air conditioners or air purifying systems ◦ Residential accessibility modifications ◦ Arch supports ◦ Sanitary supplies ◦ Communication aids ◦ Telephone alert systems ◦ Elevators ◦ Vision aids except when covered ◦ Exercise equipment through VSP ◦ Massage devices ◦ Whirlpools, portable whirlpool pumps, ◦ Overbed tables or sauna baths 31. Erectile or sexual dysfunction treatment with drugs or pharmaceuticals 32. Experimental or investigational services, supplies, or drugs (see page 173) 33. Extracorporeal shock wave therapy for musculoskeletal conditions 34. Eye surgery to alter the refractive character of the cornea, such as radial keratotomy, photokeratectomy, or LASIK surgery 35. Facet neurotomy for headache 36. Facet neurotomy for thoracic spine 37. Fecal microbiota transplantation for treatment of inflammatory bowel disease 38. Foot care not related to diabetes: Toenail cutting; diagnosed corns and calluses treatment; or any other maintenance-related foot care 39. Functional neuroimaging for primary degenerative dementia or mild cognitive impairment 40. Gene expression profile testing for multiple myeloma or colon cancer 41. Headaches: ◦ Treatment of chronic tension-type headache with Botox or acupuncture ◦ Treatment of chronic migraine or chronic tension-type headache with massage, trigger point injections, transcranial magnetic stimulation, or manipulation/manual therapy (e.g., chiropractic services) Note: For chronic migraines and tension-type headaches, see page 56 42. Hearing aid items: ◦ Over-the-counter hearing aids that are not prescribed, except for initial assessment, fitting, adjustment, auditory training, and ear molds as necessary to maintain an optimal fit ◦ Charges incurred after your plan coverage ends, unless you ordered the hearing aid before that date and it is delivered within 45 days after your coverage ended ◦ Extended warranties, or warranties not related to the initial purchase of the hearing aid(s) ◦ Purchase of replacement batteries or other ancillary equipment, except those covered under terms of the initial hearing aid purchase 2024 UMP Plus–UW Medicine ACN (PEBB) Certificate of Coverage 109