7. Diabetic Education Medically Necessary diabetic education, including diabetic counseling and diabetic self-management training is covered. The Member’s PCP or Participating Provider must prescribe the Services. 8. Diagnostic Testing, Laboratory, Mammograms and X-ray Laboratory or special diagnostic procedures such as CT scans, MRI, mammograms, including tomosynthesis (3-D mammography), imaging, including X-ray, ultrasound imaging, cardiovascular testing, nuclear medicine, and allergy testing, prescribed by the Member’s PCP or Participating Provider, and provided at a Participating Facility are covered. Screening and special diagnostic procedures during pregnancy and related genetic counseling when Medically Necessary for prenatal diagnosis of congenital disorders are included. You must receive prior authorization by Kaiser for MRI, CT scans, PET scans, and bone density/DXA scans. (See “Prior and Concurrent Authorization and Utilization Review” in the “How to Obtain Services” section.) Some Services, such as preventive screenings and routine mammograms, are not covered under this “Diagnostic Testing, Laboratory, Mammograms and X-ray” benefit but may be covered under the “Preventive Care Services” section. We cover preventive care Services without charge. Diagnostic Testing, Laboratory, Mammograms and X-ray Limitations Covered genetic testing Services are limited to preconception and prenatal testing for detection of congenital and heritable disorders, and testing for the prediction of high-risk occurrence or reoccurrence of disease when Medically Necessary. These Services are subject to Utilization Review by Kaiser using criteria developed by Medical Group and approved by Kaiser. 9. Dialysis—Outpatient Outpatient professional and facility Services necessary for dialysis when referred by the Member’s PCP or Participating Provider are covered. Dialysis is covered while you are temporarily absent from our Service Area. A temporary absence is an absence lasting less than twenty-one (21) days. Services must be preauthorized prior to departure from our Service Area. 10. Durable Medical Equipment (DME) and External Prosthetic Devices and Orthotic Devices This Plan covers the rental or purchase of Durable Medical Equipment (DME) and related medical supplies, External Prosthetic Devices, and Orthotic Devices. Outpatient Durable Medical Equipment (DME) We cover outpatient Durable Medical Equipment (DME) subject to Utilization Review by Kaiser using criteria developed by Medical Group and approved by Kaiser. DME must be for use in your home (or a place of temporary or permanent residence used as your home). When you receive DME in a home health setting in lieu of hospitalization, DME is covered at the same level as if it were received in an inpatient hospital care setting. We decide whether to rent or purchase the DME, and we select the vendor. We also decide whether to repair, adjust, or replace the DME item when necessary. Covered DME includes but is not limited to the following:  Bilirubin lights.  CADD (continuous ambulatory drug delivery) pumps. EWCLGHDHP1983ACT0124 43 WAPEBB-CD-ACT