Naturopathy Naturopathy. Enrollee pays $20 Copayment for primary care provider office visits Limited to 3 visits per medical diagnosis per calendar year without Preauthorization. Additional visits are covered with After Deductible, Enrollee pays 15% Plan Preauthorization. Coinsurance for specialty care provider office visits Laboratory and radiology services are covered only when obtained through a Network Facility. Exclusions: Herbal supplements; nutritional supplements; any services not within the scope of the practitioner’s licensure Newborn Services Newborn services are covered the same as for any other Hospital - Inpatient: After Deductible, Enrollee condition. Any Cost Share for newborn services is separate pays $500 Copayment per admission from that of the mother. During the baby’s initial hospital stay while the birth Preventive services for newborns are covered under mother and baby are both confined, any applicable Preventive Services. Deductible and Copayment for the newborn are waived When an Enrollee gives birth, the newborn is entitled to the benefits set forth in the EOC from birth through 3 weeks of Hospital - Outpatient: After Deductible, Enrollee age. After 3 weeks of age, no benefits are available unless the pays 15% Plan Coinsurance newborn child qualifies as a Dependent and is enrolled. See Section VI. for enrollment information. Outpatient Services: Enrollee pays $20 Copayment for primary care provider office visits After Deductible, Enrollee pays 15% Plan Coinsurance for specialty care provider office visits Nutritional Counseling Nutritional counseling. Enrollee pays $20 Copayment for primary care provider office visits Services related to a healthy diet to prevent obesity are covered as Preventive Services. See Preventive Services for After Deductible, Enrollee pays 15% Plan additional information. Coinsurance for specialty care provider office visits Exclusions: Nutritional supplements; weight control self-help programs or memberships, such as Weight Watchers, Jenny Craig, or other such programs Nutritional Therapy Medical formula necessary for the treatment of After Deductible, Enrollee pays 15% Plan phenylketonuria (PKU), specified inborn errors of Coinsurance metabolism, or other metabolic disorders. Enteral therapy is covered when Medical Necessity criteria After Deductible, Enrollee pays 15% coinsurance PEBB_SCA_2024 32