Common use of Osteoporosis Clause in Contracts

Osteoporosis. Benefits will be provided for qualified individuals for reimbursement for scientifically proven bone mass measurement (bone density testing) for the prevention, diagnosis and treatment of osteoporosis for Members meeting Alliant’s criteria. Other Covered Services Your Contract provides Covered Services when the following services are Medically Necessary: • Chemotherapy and radioisotope, radiation and nuclear medicine therapy • Diagnostic x-ray and laboratory procedures • Dressings, when provided by a covered Physician • Oxygen, blood and components, and administration • Use of operating and treatment rooms and equipment Outpatient Services See the Summary of Benefits and Coverage’s for any applicable Deductible, Coinsurance, Copayment, and benefit limitation information. Outpatient services include facility, ancillary, facility use, and professional charges when given as an outpatient at a Hospital, Hospital freestanding facility, Retail Health Clinic, or other Provider as determined by us. These facilities may include a non-Hospital site providing diagnostic and therapy services, surgery, or rehabilitation, or other Provider facility as determined by us. Outpatient Surgery Hospital outpatient department or Freestanding Ambulatory Facility charges are covered at regular Contract benefits as shown in the Summary of Benefits and Coverage’s. Some procedures require Prior Authorization or prior approval. Ovarian Cancer Surveillance Tests • Covered Services are provided for at risk women 35 years of age and older. At risk women are defined as:

Osteoporosis. Benefits will be provided for qualified individuals for reimbursement for scientifically proven bone mass measurement (bone density testing) for the prevention, diagnosis and treatment of osteoporosis for Members meeting Alliant’s criteria. Other Covered Services Your Contract provides Covered Services when the following services are Medically Necessary: •  Chemotherapy and radioisotope, radiation and nuclear medicine therapy •  Diagnostic x-ray and laboratory procedures •  Dressings, when provided by a covered Physician •  Oxygen, blood and components, and administration •  Use of operating and treatment rooms and equipment Outpatient Services See the Summary of Benefits and Coverage’s for any applicable Deductible, Coinsurance, Copayment, and benefit limitation information. Outpatient services include facility, ancillary, facility use, and professional charges when given as an outpatient at a Hospital, Hospital freestanding facility, Retail Health Clinic, or other Provider as determined by us. These facilities may include a non-Hospital site providing diagnostic and therapy services, surgery, or rehabilitation, or other Provider facility as determined by us. Outpatient Surgery Hospital outpatient department or Freestanding Ambulatory Facility charges are covered at regular Contract benefits as shown in the Summary of Benefits and Coverage’s. Some procedures require Prior Authorization Pre-Certification or prior approval. Ovarian Cancer Surveillance Tests •  Covered Services are provided for at risk women 35 years of age and older. At risk women are defined as:

Osteoporosis. Benefits will be provided for qualified individuals for reimbursement for scientifically proven bone mass measurement (bone density testing) for the prevention, diagnosis and treatment of osteoporosis for Members meeting Alliant’s criteria. Other Covered Services Services‌ Your Contract provides Covered Services when the following services are Medically Necessary: • Chemotherapy and radioisotope, radiation and nuclear medicine therapy • Diagnostic x-ray and laboratory procedures • Dressings, when provided by a covered Physician • Oxygen, blood and components, and administration • Use of operating and treatment rooms and equipment Outpatient Services Services‌ See the Summary of Benefits and Coverage’s for any applicable Deductible, Coinsurance, Copayment, and benefit limitation information. Outpatient services include facility, ancillary, facility use, and professional charges when given as an outpatient at a Hospital, Hospital freestanding facility, Retail Health Clinic, or other Provider as determined by us. These facilities may include a non-Hospital site providing diagnostic and therapy services, surgery, or rehabilitation, or other Provider facility as determined by us. Outpatient Surgery Surgery‌ Hospital outpatient department or Freestanding Ambulatory Facility charges are covered at regular Contract benefits as shown in the Summary of Benefits and Coverage’s. Some procedures require Prior Authorization Pre-Certification or prior approval. Ovarian Cancer Surveillance Tests Tests‌ • Covered Services are provided for at risk women 35 years of age and older. At risk women are defined as:

Osteoporosis. Benefits will be provided for qualified individuals for reimbursement for scientifically proven bone mass measurement (bone density testing) for the prevention, diagnosis and treatment of osteoporosis for Members meeting Alliant’s criteria. Other Covered Services Your Contract provides Covered Services when the following services are Medically Necessary: •  Chemotherapy and radioisotope, radiation and nuclear medicine therapy •  Diagnostic x-ray and laboratory procedures •  Dressings, when provided by a covered Physician •  Oxygen, blood and components, and administration •  Use of operating and treatment rooms and equipment Outpatient Services See the Summary of Benefits and Coverage’s for any applicable Deductible, Coinsurance, Copayment, and benefit limitation information. Outpatient services include facility, ancillary, facility use, and professional charges when given as an outpatient at a Hospital, Hospital freestanding facility, Retail Health Clinic, or other Provider as determined by us. These facilities may include a non-Hospital site providing diagnostic and therapy services, surgery, or rehabilitation, or other Provider facility as determined by us. Outpatient Surgery Hospital outpatient department or Freestanding Ambulatory Facility charges are covered at regular Contract benefits as shown in the Summary of Benefits and Coverage’s. Some procedures require Prior Authorization or prior approval. Ovarian Cancer Surveillance Tests •  Covered Services are provided for at risk women 35 years of age and older. At risk women are defined as: