Common use of Maternity and Newborn Care Clause in Contracts

Maternity and Newborn Care. This plan covers health care providers and facility charges for prenatal care, delivery and postnatal care for all covered female members. Hospital stays for maternity and newborn care are not limited to less than 48 hours for a vaginal delivery or less than 96 hours following a cesarean section. A length of stay that will be longer than these limits must be prior authorized. See Prior Authorization for details. Newborn children are covered automatically for the first 3 weeks from birth when the mother is eligible to receive obstetrical care benefits under this plan. To continue benefits beyond the 3-week period, please see the dependent eligibility and enrollment guidelines outlined under Eligibility and Enrollment. This benefit covers:  Prenatal and postnatal care and screenings (including in utero care)  Home birth services including associated supplies provided by a licensed women’s health care provider who is working within their license and scope of practice  Nursery services and supplies for newborn  Genetic testing of the child’s father is covered This benefit does not cover:  Outpatient x-ray, lab and imaging. These services are covered under Diagnostic Lab, X-ray and Imaging.  Home birth services provided by family members or volunteers Home Health Care Home health care services must be part of a home health care plan. These services are covered when a qualified provider certifies that the services are provided or coordinated by a state-licensed or Medicare-certified home health agency or certified rehabilitation agency. Covered services provided and billed by a home health agency include:  Home visits and acute nursing (short-term nursing care for illness or injury)  Home medical equipment, medical supplies and devices  Prescription drugs and insulin provided by and billed by a home health care provider or home health agency  Therapeutic services such as respiratory therapy and phototherapy This benefit does not cover:  Over-the-counter drugs, solutions and nutritional supplements  Services provided to someone other than the ill or injured member  Services provided by family members or volunteers  Services or providers not in the written plan of care or not named as covered in this benefit  Custodial care  Nonmedical services, such as housekeeping  Services that provide food, such as Meals on Wheels or advice about food Hospice Care A hospice care program must be provided in a hospice facility or in your home by a hospice care agency or program. You must get prior authorization from us before you get inpatient treatment. See Prior Authorization for details. Covered services include:  Nursing care provided by or under the supervision of a registered nurse  Medical social services provided by a medical social worker who is working under the direction of a physician; this may include counseling for the purpose of helping you and your caregivers to adjust to the approaching death  Services provided by a qualified provider associated with the hospice program  Short term inpatient care provided in a hospice inpatient unit or other designated hospice bed in a hospital or skilled nursing facility; this care may be for the purpose of occasional respite for your caregivers, or for pain control and symptom management  Home medical equipment, medical supplies and devices, including medications used primarily for the relief of pain and control of symptoms related to the terminal illness  Home health aide services for personal care, maintenance of a safe and healthy environment and general support to the goals of the plan of care  Rehabilitation therapies provided for purposes of symptom control or to enable you to maintain activities of daily living and basic functional skills  Continuous home care during a period of crisis in which you require skilled intervention to achieve palliation or management of acute medical symptoms  Palliative care for members facing serious, life-threatening conditions, including expanded access to home based care and care coordination. Participation in palliative care is usually approved for 12 months at a time and may be extended based on the member’s specific condition. This benefit does not cover:  Over-the-counter drugs, solutions and nutritional supplements  Services provided to someone other than the ill or injured member  Services provided by family members or volunteers  Services or providers not in the written plan of care or not named as covered in this benefit  Custodial care, except for hospice care services  Nonmedical services, such as housekeeping, dietary assistance or spiritual bereavement, legal or financial counseling  Services that provide food, such as Meals on Wheels, or advice about food Rehabilitation and Habilitation Therapy This plan covers rehabilitation and habilitation therapy. Benefits must be provided by a licensed physical therapist, occupational therapist, speech language pathologist or a licensed qualified provider. Services must be prescribed in writing by your provider. The prescription must include site, type of therapy, how long and how often you should get the treatment. Rehabilitative therapy is therapy that helps get a part of the body back to normal health or function. It includes therapy to restore or improve a function that was lost because of an accidental injury, illness or surgery. Habilitation therapy is therapy that helps a person keep, learn or improve skills and functioning for daily living. Examples are therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology, aural (hearing) therapy, and other services for people with disabilities in a variety of inpatient and/or outpatient settings, including school-based settings. Services provided for treatment of a mental health condition are provided under the Mental Health, Behavioral Health and Substance Abuse benefit. Day limits listed in the Summary of Your Costs do not apply to cancer, chronic pulmonary or respiratory disease, cardiac disease or other similar chronic conditions or disease.

Maternity and Newborn Care. This plan covers health care providers and facility charges for prenatal care, delivery and postnatal care for all covered female members. Hospital stays for maternity and newborn care are not limited to less than 48 hours for a vaginal delivery or less than 96 hours following a cesarean section. A length of stay that will be longer than these limits must be prior authorized. See Prior Authorization for details. Newborn children are covered automatically for the first 3 weeks from birth when the mother is eligible to receive obstetrical care benefits under this plan. To continue benefits beyond the 3-week period, please see the dependent eligibility and enrollment guidelines outlined under Eligibility and Enrollment. This benefit covers:  Prenatal and postnatal care and screenings (including in utero care)  Home birth services including associated supplies provided by a licensed women’s health care provider who is working within their license and scope of practice  Nursery services and supplies for newborn  Genetic testing of the child’s father is covered This benefit does not cover:  Outpatient x-ray, lab and imaging. These services are covered under Diagnostic Lab, X-ray and Imaging.  Home birth services provided by family members or volunteers Home Health Care Home health care services must be part of a home health care plan. These services are covered when a qualified provider certifies that the services are provided or coordinated by a state-licensed or Medicare-certified home health agency or certified rehabilitation agency. Covered services provided and billed by a home health agency include:  Home visits and acute nursing (short-term nursing care for illness or injury)  Home medical equipment, medical supplies and devices  Prescription drugs and insulin provided by and billed by a home health care provider or home health agency  Therapeutic services such as respiratory therapy and phototherapy This benefit does not cover:  Over-the-counter drugs, solutions and nutritional supplements  Services provided to someone other than the ill or injured member  Services provided by family members or volunteers  Services or providers not in the written plan of care or not named as covered in this benefit  Custodial care  Nonmedical services, such as housekeeping  Services that provide food, such as Meals on Wheels or advice about food Hospice Care A hospice care program must be provided in a hospice facility or in your home by a hospice care agency or program. You must get prior authorization from us before you get inpatient treatment. See Prior Authorization for details. Covered services include:  Nursing care provided by or under the supervision of a registered nurse  Medical social services provided by a medical social worker who is working under the direction of a physician; this may include counseling for the purpose of helping you and your caregivers to adjust to the approaching death  Services provided by a qualified provider associated with the hospice program  Short term inpatient care provided in a hospice inpatient unit or other designated hospice bed in a hospital or skilled nursing facility; this care may be for the purpose of occasional respite for your caregivers, or for pain control and symptom management  Home medical equipment, medical supplies and devices, including medications used primarily for the relief of pain and control of symptoms related to the terminal illness  Home health aide services for personal care, maintenance of a safe and healthy environment and general support to the goals of the plan of care  Rehabilitation therapies provided for purposes of symptom control or to enable you to maintain activities of daily living and basic functional skills  Continuous home care during a period of crisis in which you require skilled intervention to achieve palliation or management of acute medical symptoms  Palliative care for members facing serious, life-threatening conditions, including expanded access to home based care and care coordination. Participation in palliative care is usually approved for 12 months at a time and may be extended based on the member’s specific condition. This benefit does not cover:  Over-the-counter drugs, solutions and nutritional supplements  Services provided to someone other than the ill or injured member  Services provided by family members or volunteers  Services or providers not in the written plan of care or not named as covered in this benefit  Custodial care, except for hospice care services  Nonmedical services, such as housekeeping, dietary assistance or spiritual bereavement, legal or financial counseling  Services that provide food, such as Meals on Wheels, or advice about food Rehabilitation and Habilitation Therapy This plan covers rehabilitation and habilitation therapy. Benefits must be provided by a licensed physical therapist, occupational therapist, speech language pathologist or a licensed qualified provider. Services must be prescribed in writing by your provider. The prescription must include site, type of therapy, how long and how often you should get the treatment. Rehabilitative therapy is therapy that helps get a part of the body back to normal health or function. It includes therapy to restore or improve a function that was lost because of an accidental injury, illness or surgery. Habilitation therapy is therapy that helps a person keep, learn or improve skills and functioning for daily living. Examples are therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology, aural (hearing) therapy, and other services for people with disabilities in a variety of inpatient and/or outpatient settings, including school-based settings. Services provided for treatment of a mental health condition are provided under the Mental Health, Behavioral Health and Substance Abuse benefit. Day limits listed in the Summary of Your Costs do not apply to cancer, chronic pulmonary or respiratory disease, cardiac disease or other similar chronic conditions or disease.

Maternity and Newborn Care. This plan covers health care providers and facility charges for prenatal care, delivery and postnatal care for all covered female members. Hospital stays for maternity and newborn care are not limited to less than 48 hours for a vaginal delivery or less than 96 hours following a cesarean section. A length of stay that will be longer than these limits must be prior authorized. See Prior Authorization for details. Newborn children are covered automatically for the first 3 weeks from birth when the mother is eligible to receive obstetrical care benefits under this plan. To continue benefits beyond the 3-week period, please see the dependent eligibility and enrollment guidelines outlined under Eligibility and Enrollment. This benefit covers:  • Prenatal and postnatal care and screenings (including in utero care)  • Home birth services including associated supplies provided by a licensed women’s health care provider who is working within their license and scope of practice  • Nursery services and supplies for newborn  • Genetic testing of the child’s father is covered This benefit does not cover:  • Outpatient x-ray, lab and imaging. These services are covered under Diagnostic Lab, X-ray and Imaging.  • Home birth services provided by family members or volunteers Home Health Care Home health care services must be part of a home health care plan. These services are covered when a qualified provider certifies that the services are provided or coordinated by a state-licensed or Medicare-certified home health agency or certified rehabilitation agency. Covered services provided and billed by a home health agency include:  • Home visits and acute nursing (short-term nursing care for illness or injury)  • Home medical equipment, medical supplies and devices  • Prescription drugs and insulin provided by and billed by a home health care provider or home health agency  • Therapeutic services such as respiratory therapy and phototherapy This benefit does not cover:  • Over-the-counter drugs, solutions and nutritional supplements  • Services provided to someone other than the ill or injured member  • Services provided by family members or volunteers  • Services or providers not in the written plan of care or not named as covered in this benefit  • Custodial care  • Nonmedical services, such as housekeeping  • Services that provide food, such as Meals on Wheels or advice about food Hospice Care A hospice care program must be provided in a hospice facility or in your home by a hospice care agency or program. You must get prior authorization from us before you get inpatient treatment. See Prior Authorization for details. Covered services include:  • Nursing care provided by or under the supervision of a registered nurse  • Medical social services provided by a medical social worker who is working under the direction of a physician; this may include counseling for the purpose of helping you and your caregivers to adjust to the approaching death  • Services provided by a qualified provider associated with the hospice program  • Short term inpatient care provided in a hospice inpatient unit or other designated hospice bed in a hospital or skilled nursing facility; this care may be for the purpose of occasional respite for your caregivers, or for pain control and symptom management  • Home medical equipment, medical supplies and devices, including medications used primarily for the relief of pain and control of symptoms related to the terminal illness  • Home health aide services for personal care, maintenance of a safe and healthy environment and general support to the goals of the plan of care  • Rehabilitation therapies provided for purposes of symptom control or to enable you to maintain activities of daily living and basic functional skills  • Continuous home care during a period of crisis in which you require skilled intervention to achieve palliation or management of acute medical symptoms  • Palliative care for members facing serious, life-threatening conditions, including expanded access to home based care and care coordination. Participation in palliative care is usually approved for 12 months at a time and may be extended based on the member’s specific condition. This benefit does not cover:  • Over-the-counter drugs, solutions and nutritional supplements  • Services provided to someone other than the ill or injured member  • Services provided by family members or volunteers  • Services or providers not in the written plan of care or not named as covered in this benefit  • Custodial care, except for hospice care services  • Nonmedical services, such as housekeeping, dietary assistance or spiritual bereavement, legal or financial counseling  • Services that provide food, such as Meals on Wheels, or advice about food Rehabilitation and Habilitation Therapy This plan covers rehabilitation and habilitation therapy. Benefits must be provided by a licensed physical therapist, occupational therapist, speech language pathologist or a licensed qualified provider. Services must be prescribed in writing by your provider. The prescription must include site, type of therapy, how long and how often you should get the treatment. Rehabilitative therapy is therapy that helps get a part of the body back to normal health or function. It includes therapy to restore or improve a function that was lost because of an accidental injury, illness or surgery. Habilitation therapy is therapy that helps a person keep, learn or improve skills and functioning for daily living. Examples are therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology, aural (hearing) therapy, and other services for people with disabilities in a variety of inpatient and/or outpatient settings, including school-based settings. Services provided for treatment of a mental health condition are provided under the Mental Health, Behavioral Health and Substance Abuse benefit. Day limits listed in the Summary of Your Costs do not apply to cancer, chronic pulmonary or respiratory disease, cardiac disease or other similar chronic conditions or disease.

Maternity and Newborn Care. This plan covers health care providers and facility charges for prenatal care, delivery and postnatal care for all covered female members. Hospital stays for maternity and newborn care are not limited to less than 48 hours for a vaginal delivery or less than 96 hours following a cesarean section. A length of stay that will be longer than these limits must be prior authorized. See Prior Authorization for details. Newborn children are covered automatically for the first 3 weeks from birth when the mother is eligible to receive obstetrical care benefits under this plan. To continue benefits beyond the 3-week period, please see the dependent eligibility and enrollment guidelines outlined under Eligibility and Enrollment. This benefit covers:  • Prenatal and postnatal care and screenings (including in utero care)  • Home birth services services, including associated supplies supplies, provided by a licensed women’s health care provider who is working within their license and scope of practice  • Nursery services and supplies for newborn  • Genetic testing of the child’s father is covered This benefit does not cover:  • Outpatient x-ray, lab and imaging. These services are covered under Diagnostic Lab, X-ray and Imaging.  • Home birth services provided by family members or volunteers Home Health Care Home health care services must be part of a home health care plan. These services are covered when a qualified provider certifies that the services are provided or coordinated by a state-licensed or Medicare-certified home health agency or certified rehabilitation agency. Covered services provided and billed by a home health agency include:  • Home visits and acute nursing (short-term nursing care for illness or injury)  • Home medical equipment, medical supplies and devices  devices. • Prescription drugs and insulin provided by and billed by a home health care provider or home health agency  • Therapeutic services such as respiratory therapy and phototherapy This benefit does not cover:  • Over-the-counter drugs, solutions and nutritional supplements  • Services provided to someone other than the ill or injured member  • Services provided by family members or volunteers  • Services or providers not in the written plan of care or not named as covered in this benefit  • Custodial care  • Nonmedical services, such as housekeeping  • Services that provide food, such as Meals on Wheels or advice about food Hospice Care A hospice care program must be provided in a hospice facility or in your home by a hospice care agency or program. You must get prior authorization from us before you get inpatient treatment. See Prior Authorization for details. Covered services include:  • Nursing care provided by or under the supervision of a registered nurse  • Medical social services provided by a medical social worker who is working under the direction of a physician; this may include counseling for the purpose of helping you and your caregivers to adjust to the approaching death  • Services provided by a qualified provider associated with the hospice program  • Short term inpatient care provided in a hospice inpatient unit or other designated hospice bed in a hospital or skilled nursing facility; this care may be for the purpose of occasional respite for your caregivers, or for pain control and symptom management  • Home medical equipment, medical supplies and devices, including medications used primarily for the relief of pain and control of symptoms related to the terminal illness  • Home health aide services for personal care, maintenance of a safe and healthy environment and general support to the goals of the plan of care  • Rehabilitation therapies provided for purposes of symptom control or to enable you to maintain activities of daily living and basic functional skills  • Continuous home care during a period of crisis in which you require skilled intervention to achieve palliation or management of acute medical symptoms  • Palliative care for members facing serious, life-life- threatening conditions, including expanded access to home based care and care coordination. Participation in palliative care is usually approved for 12 months at a time and may be extended based on the member’s specific condition. This benefit does not cover:  • Over-the-counter drugs, solutions and nutritional supplements  • Services provided to someone other than the ill or injured member  • Services provided by family members or volunteers  • Services or providers not in the written plan of care or not named as covered in this benefit  • Custodial care, except for hospice care services  • Nonmedical services, such as housekeeping, dietary assistance or spiritual bereavement, legal or financial counseling  • Services that provide food, such as Meals on Wheels, Wheels or advice about food Rehabilitation and Habilitation Therapy This plan covers rehabilitation and habilitation therapy. Benefits must be provided by a licensed physical therapist, occupational therapist, speech language pathologist or a licensed qualified provider. Services must be prescribed in writing by your provider. The prescription must include site, type of therapy, how long and how often you should get the treatment. Rehabilitative therapy is therapy that helps get a part of the body back to normal health or function. It includes therapy to restore or improve a function that was lost because of an accidental injury, illness or surgery. Habilitation therapy is therapy that helps a person keep, learn or improve skills and functioning for daily living. Examples are therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology, aural (hearing) therapy, and other services for people with disabilities in a variety of inpatient and/or outpatient settings, including school-based settings. Services provided for treatment of a mental health condition are provided under the Mental Health, Behavioral Health and Substance Abuse benefit. Day limits listed in the Summary of Your Costs do not apply to cancer, chronic pulmonary or respiratory disease, cardiac disease or other similar chronic conditions or disease.

Maternity and Newborn Care. This plan covers health care providers and facility charges for prenatal care, delivery and postnatal care for all covered female members. Hospital stays for maternity and newborn care are not limited to less than 48 hours for a vaginal delivery or less than 96 hours following a cesarean section. A length of stay that will be longer than these limits must be prior authorized. See Prior Authorization for details. Newborn children are covered automatically for the first 3 weeks from birth when the mother is eligible to receive obstetrical care benefits under this plan. To continue benefits beyond the 3-week period, period please see the dependent eligibility and enrollment guidelines outlined under Eligibility and Enrollment. This benefit covers:  Prenatal and postnatal care and screenings (including in utero care)  Home birth services services, including associated supplies supplies, provided by a licensed women’s health care provider who is working within their license and scope of practice  Nursery services and supplies for newborn  Genetic testing of the child’s father is covered This benefit does not cover:  Outpatient x-ray, lab and imaging. These services are covered under Diagnostic Lab, X-ray and Imaging.  Home birth services provided by family members or volunteers Home Health Care Home health care services must be part of a home health care plan. These services are covered when a qualified provider certifies that the services are provided or coordinated by a state-licensed or Medicare-certified home health agency or certified rehabilitation agency. Covered services provided and billed by a home health agency include:  Home visits and acute nursing (short-term nursing care for illness or injury)  Home medical equipment, medical supplies and devices devices.  Prescription drugs and insulin provided by and billed by a home health care provider or home health agency  Therapeutic services such as respiratory therapy and phototherapy This benefit does not cover:  Over-the-counter drugs, solutions and nutritional supplements  Services provided to someone other than the ill or injured member  Services provided by family members or volunteers  Services or providers not in the written plan of care or not named as covered in this benefit  Custodial care  Nonmedical services, such as housekeeping  Services that provide food, such as Meals on Wheels or advice about food Hospice Care A hospice care program must be provided in a hospice facility or in your home by a hospice care agency or program. You must get prior authorization from us before you get inpatient treatment. See Prior Authorization for details. Covered services include:  Nursing care provided by or under the supervision of a registered nurse  Medical social services provided by a medical social worker who is working under the direction of a physician; this may include counseling for the purpose of helping you and your caregivers to adjust to the approaching death  Services provided by a qualified provider associated with the hospice program  Short term inpatient care provided in a hospice inpatient unit or other designated hospice bed in a hospital or skilled nursing facility; this care may be for the purpose of occasional respite for your caregivers, or for pain control and symptom management  Home medical equipment, medical supplies and devices, including medications used primarily for the relief of pain and control of symptoms related to the terminal illness  Home health aide services for personal care, maintenance of a safe and healthy environment and general support to the goals of the plan of care  Rehabilitation therapies provided for purposes of symptom control or to enable you to maintain activities of daily living and basic functional skills  Continuous home care during a period of crisis in which you require skilled intervention to achieve palliation or management of acute medical symptoms  Palliative care for members facing serious, life-life- threatening conditions, including expanded access to home based care and care coordination. Participation in palliative care is usually approved for 12 months at a time and may be extended based on the member’s specific condition. This benefit does not cover:  Over-the-counter drugs, solutions and nutritional supplements  Services provided to someone other than the ill or injured member  Services provided by family members or volunteers  Services or providers not in the written plan of care or not named as covered in this benefit  Custodial care, except for hospice care services  Nonmedical services, such as housekeeping, dietary assistance or spiritual bereavement, legal or financial counseling  Services that provide food, such as Meals on Wheels, Wheels or advice about food Rehabilitation and Habilitation Therapy This plan covers rehabilitation and habilitation therapy. Benefits must be provided by a licensed physical therapist, occupational therapist, speech language pathologist or a licensed qualified provider. Services must be prescribed in writing by your provider. The prescription must include site, type of therapy, how long and how often you should get the treatment. Rehabilitative therapy is therapy that helps get a part of the body back to normal health or function. It includes therapy to restore or improve a function that was lost because of an accidental injury, illness or surgery. Habilitation therapy is therapy that helps a person keep, learn or improve skills and functioning for daily living. Examples are therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology, aural (hearing) therapy, and other services for people with disabilities in a variety of inpatient and/or outpatient settings, including school-based settings. Services provided for treatment of a mental health condition are provided under the Mental Health, Behavioral Health and Substance Abuse benefit. Day limits listed in the Summary of Your Costs do not apply to cancer, chronic pulmonary or respiratory disease, cardiac disease or other similar chronic conditions or disease.

Maternity and Newborn Care. This plan covers health care providers and facility charges for prenatal care, delivery and postnatal care for all covered female members. Hospital stays for maternity and newborn care are not limited to less than 48 hours for a vaginal delivery or less than 96 hours following a cesarean section. A length of stay that will be longer than these limits must be prior authorized. See Prior Authorization for details. Newborn children are covered automatically for the first 3 weeks from birth when the mother is eligible to receive obstetrical care benefits under this plan. To continue benefits beyond the 3-week period, please see the dependent eligibility and enrollment guidelines outlined under Eligibility and Enrollment. This benefit covers:  • Prenatal and postnatal care and screenings (including in utero care)  • Home birth services including associated supplies provided by a licensed women’s health care provider who is working within their license and scope of practice  • Nursery services and supplies for newborn  • Genetic testing of the child’s father is covered This benefit does not cover:  • Outpatient x-ray, lab and imaging. These services are covered under Diagnostic Lab, X-ray and Imaging.  • Home birth services provided by family members or volunteers Home Health Care Home health care services must be part of a home health care plan. These services are covered when a qualified provider certifies that the services are provided or coordinated by a state-licensed or Medicare-certified home health agency or certified rehabilitation agency. Covered services provided and billed by a home health agency include:  • Home visits and acute nursing (short-term nursing care for illness or injury)  • Home medical equipment, medical supplies and devices  • Prescription drugs and insulin provided by and billed by a home health care provider or home health agency  • Therapeutic services such as respiratory therapy and phototherapy This benefit does not cover:  • Over-the-counter drugs, solutions and nutritional supplements  • Services provided to someone other than the ill or injured member  • Services provided by family members or volunteers  • Services or providers not in the written plan of care or not named as covered in this benefit  • Custodial care  • Nonmedical services, such as housekeeping  • Services that provide food, such as Meals on Wheels or advice about food Hospice Care A hospice care program must be provided in a hospice facility or in your home by a hospice care agency or program. You must get prior authorization from us before you get inpatient treatment. See Prior Authorization for details. Covered services include:  • Nursing care provided by or under the supervision of a registered nurse  • Medical social services provided by a medical social worker who is working under the direction of a physician; this may include counseling for the purpose of helping you and your caregivers to adjust to the approaching death  • Services provided by a qualified provider associated with the hospice program  • Short term inpatient care provided in a hospice inpatient unit or other designated hospice bed in a hospital or skilled nursing facility; this care may be for the purpose of occasional respite for your caregivers, or for pain control and symptom management  • Home medical equipment, medical supplies and devices, including medications used primarily for the relief of pain and control of symptoms related to the terminal illness  • Home health aide services for personal care, maintenance of a safe and healthy environment and general support to the goals of the plan of care  • Rehabilitation therapies provided for purposes of symptom control or to enable you to maintain activities of daily living and basic functional skills  • Continuous home care during a period of crisis in which you require skilled intervention to achieve palliation or management of acute medical symptoms  • Palliative care for members facing serious, life-threatening conditions, including expanded access to home based care and care coordination. Participation in palliative care is usually approved for 12 months at a time and may be extended based on the member’s specific condition. This benefit does not cover:  • Over-the-counter drugs, solutions and nutritional supplements  • Services provided to someone other than the ill or injured member  • Services provided by family members or volunteers  • Services or providers not in the written plan of care or not named as covered in this benefit  • Custodial care, except for hospice care services  • Nonmedical services, such as housekeeping, dietary assistance or spiritual bereavement, legal or financial counseling  • Services that provide food, such as Meals on Wheels, or advice about food Rehabilitation and Habilitation Therapy This plan covers rehabilitation and habilitation therapy. Benefits must be provided by a licensed physical therapist, occupational therapist, speech language pathologist or a licensed qualified provider. Services must be prescribed in writing by your provider. The prescription must include site, type of therapy, how long and how often you should get the treatment. Rehabilitative therapy is therapy that helps get a part of the body back to normal health or function. It includes therapy to restore or improve a function that was lost because of an accidental injury, illness or surgery. Habilitation therapy is therapy that helps a person keep, learn or improve skills and functioning for daily living. Examples are therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology, aural (hearing) therapy, and other services for people with disabilities in a variety of inpatient and/or outpatient settings, including school-based settings. Services provided for treatment of a mental health condition are provided under the Mental Health, Behavioral Health and Substance Abuse benefit. Day limits listed in the Summary of Your Costs do not apply to cancer, chronic pulmonary or respiratory disease, cardiac disease or other similar chronic conditions or disease.