Infertility Benefits. Benefits are provided for the diagnosis and treatment of the cause of Infertility, including professional, Hospital, Ambulatory Surgery Center, and ancillary services to diagnose and treat the cause of Infertility, with the exception of what is excluded in the Exclusions and limitations section. Home health services Benefits are available for home health services. These services include home health agency services, home infusion and injectable medication services, and hemophilia home infusion services. Home health agency services Benefits are available from a Participating home health care agency for diagnostic and treatment services received in your home under a written treatment plan approved by your Physician. Benefits include: Intermittent home care for skilled services from: o Registered nurses; o Licensed vocational nurses; o Physical therapists; o Occupational therapists; o Speech and language pathologists; o Licensed clinical social workers; and o Home Health Aides. Related medical supplies. Intermittent home care is for skilled services you receive: Fewer than seven days per week; or Daily, for fewer than eight hours per day, up to 21 days. Benefits are limited to a visit maximum as shown in the Summary of Benefits section for home health agency visits. For this Benefit, coverage includes: Up to three visits per day, two hours maximum per visit, with a registered nurse, licensed vocational nurse, physical therapist, occupational therapist, speech and language pathologist, or licensed clinical social worker. A visit of two hours or less is considered one visit. Nursing visits cannot be combined to provide Continuous Nursing Services. Up to four hours maximum per visit with a Home Health Aide. A visit of four hours or less is considered one visit. Benefits do not include: Continuous Nursing Services provided by a registered nurse or a licensed vocational nurse, on a one-to-one basis, in an inpatient or home setting. These services may also be described as “shift care” or “private duty nursing.” Home infusion and injectable medication services Benefits are available through a Participating home infusion agency for home infusion, enteral, and injectable medication therapy. Benefits include: Home infusion agency Skilled Nursing visits; Infusion therapy provided in an infusion suite associated with a Participating home infusion agency; Parenteral nutrition services and associated supplies and solutions; Enteral nutrition services a...
Infertility Benefits. Benefits are provided for the diagnosis and treat- ment of the cause of Infertility, including profes- sional, Hospital, Ambulatory Surgery Center, and ancillary services to diagnose and treat the cause of Infertility, with the exception of what is ex- cluded in the Principal Limitations, Exceptions, Exclusions and Reductions section. reasonably be expected to result in any of the fol- lowing:
Infertility Benefits. Benefits are provided for the diagnosis and treat- ment of the cause of Infertility, including profes- sional, Hospital, Ambulatory Surgery Center, and ancillary services to diagnose and treat the cause of Infertility, with the exception of what is ex- cluded in the Principal Limitations, Exceptions, Exclusions and Reductions section. Home Health Care Benefits Benefits are provided for home health care ser- vices from a Participating home health care agency when the services are ordered by the Member’s Physician, and included in a written treatment plan. Covered Services are subject to any applicable De- ductibles, Copayments and Coinsurance. Visits by home health care agency providers will be payable up to a combined per Member per Calendar Year visit maximum as shown on the Summary of Bene- fits. Intermittent and part-time visits by a home health agency to provide Skilled Nursing and other skilled services are covered up to four visits per day, two hours per visit up to the Calendar Year visit maximum (including all home health visits) by any of the following professional providers:
