 Rehabilitative therapy Services for purposes of symptom control or to enable you to maintain activities of daily living.  Services of volunteers.  Short-term inpatient Services including respite care and care for pain control and acute and chronic symptom management.  Skilled nursing Services, including assessment, evaluation, and case management of nursing needs, treatment for pain and symptom control, provision of emotional support to you and your family, and instruction to caregivers. 16. Hospital Services Inpatient Hospital Services We cover Services when you are admitted as an inpatient in a Participating Hospital. Additional types of inpatient Services are covered as described under other headings in this section. Some inpatient Services may be subject to prior authorization from Company in accordance with Utilization Review criteria developed by Medical Group and approved by Company. For more information about Services that require Utilization Review, or to request a copy of the criteria for a specific condition or Service, please contact Member Services. Covered inpatient Services include but are not limited to:  Anesthesia.  Blood, blood products, blood storage, and their administration, including the Services and supplies of a blood bank.  Chemotherapy and radiation therapy Services.  Dialysis Services.  Drugs and radioactive materials used for therapeutic purposes, except for the types of drugs excluded under the “Prescription drugs, insulin, and diabetic supplies” section.  Durable Medical Equipment and medical supplies.  Emergency detoxification.  Gender Affirming Treatment.  General and special nursing care Services.  Internally implanted devices, including cochlear implants, except for internally implanted insulin pumps.  Interrupted pregnancy surgery when performed in an inpatient setting.  Laboratory, X-rays and other imaging, and special diagnostic procedures.  Medical foods and formulas if Medically Necessary.  Medical social Services and discharge planning.  Operating and recovery rooms.  Orthognathic surgery and supplies for treatment of temporomandibular joint (TMJ) disorder or injury, sleep apnea or congenital anomaly.  Palliative care.  Participating Provider’s Services, including consultation and treatment by Specialists. EWCLGHDHP1983ACT0124 49 WAPEBB-CD-ACT