When a Participating Provider determines that a recommended Service is medically appropriate for an individual and the individual satisfies the criteria for the Service or treatment, we will provide coverage for the recommended Service regardless of sex assigned at birth, gender identity, or gender of the individual otherwise recorded by us. If you would like additional information about covered preventive care Services, call Member Services. Information is also available online at kp.org/prevention. 30. Radiation and Chemotherapy Services Prescribed radiation and chemotherapy Services are covered when provided by a Participating Provider. 31. Reconstructive Surgery Services We cover inpatient and outpatient reconstructive surgery Services as indicated below, when prescribed by a Participating Provider. Services are subject to Utilization Review by Kaiser using criteria developed by Medical Group and approved by Kaiser.  To correct significant disfigurement resulting from an injury or from Medically Necessary surgery.  To correct a congenital defect, disease, or anomaly in order to produce significant improvement in physical function.  To treat congenital hemangioma known as port wine stains on the face. Following Medically Necessary removal of all or part of a breast, we also cover reconstruction of the breast, surgery and reconstruction of an unaffected breast to produce a symmetrical appearance, and treatment of physical complications, including lymphedemas. 32. Rehabilitative Therapy Services We cover inpatient and outpatient physical, massage (soft tissue mobilization), occupational and speech therapy Services, when prescribed by a Participating Provider, subject to the benefit descriptions and limitations contained in this “Rehabilitative Therapy Services” section. Covered Services include treatment of neurodevelopmental conditions to restore and/or improve function, or to provide maintenance for conditions which, in the judgment of your Participating Provider, would result in significant deterioration without the treatment. These Services are subject to Utilization Review by Kaiser using criteria developed by Medical Group and approved by Kaiser. However, you do not need authorization for an initial evaluation and management visit and up to six treatment visits for physical, massage (soft tissue mobilization), occupational, and speech therapy Services for a New Episode of Care. Outpatient Rehabilitative Therapy Services We cover outpatient rehabilitative therapy Services for the treatment of conditions which, in the judgment of a Participating Provider, will show sustainable, objective, measurable improvement as a result of the prescribed treatment. Prescribed outpatient therapy Services must receive prior authorization as described under “Prior and Concurrent Authorization and Utilization Review” in the “How to Obtain Services” section. The “Benefit Summary” shows a visit maximum for each rehabilitative therapy Service. That visit maximum will be exhausted (used up) for the Year when the number of visits that we covered during the Year under this EOC plus any visits we covered during the Year under any other evidence of coverage with the same group number printed on this EOC add up to the visit maximum. After you reach the visit maximum, we will not cover any more visits for the remainder of the Year. This limitation does not apply to inpatient hospital Services, or to outpatient rehabilitative therapy Services to treat mental health conditions covered under this EOC. EWCLGHDHP1983ACT0124 66 WAPEBB-CD-ACT