walking, getting into and out of bed, bathing, dressing, feeding and preparing special diets, and supervising prescription drugs that are ordinarily self-administered. Deductible Your deductible is a fixed dollar amount you must meet each calendar year for your health care expenses before the plan starts paying for covered services. For this plan, you must meet your deductible for medical and prescription drug expenses before the plan starts paying for covered medical services and covered prescription drugs. You pay the first $1,600 in health care expenses for one member enrolled; you pay the first $3,200 in health care expenses for two or more members enrolled. Only expenses covered by the plan apply to your deductible. For example, if you receive LASIK surgery (see exclusion on page 108), the plan does not apply this payment to your deductible. Some services are not subject to this deductible (see the “Summary of benefits” section). See the “What you pay for services” section for details on how your deductible works. Dependent A dependent is an eligible spouse, state-registered domestic partner, child, or other eligible family member as described in “Dependent eligibility” (see the “Eligibility for subscribers and dependents” sections on page 140 and 155) that is either covered by or eligible to be covered by the plan under the subscriber’s account. Detoxification Detoxification is a medically supervised treatment program for individuals with alcohol or drug intoxication, designed to rid the body of toxic substances and manage withdrawal symptoms. Developmental delay Developmental delay is a significant lag in reaching developmental milestones as expected during infancy and early childhood. The cause may be present at birth or acquired after birth from a disease or disorder of the body, an injury, a disorder of the mind or emotions, or harmful effects of the surrounding environment. Only a physician or other provider may diagnose a developmental delay. Durable medical equipment (DME) Durable medical equipment (DME) is: • Designed for prolonged use. • For a specific therapeutic or clinical purpose, or to assist in the treatment of an injury or illness. • Medically necessary (meeting all plan medical necessity criteria). • Primarily and customarily used only for a medical purpose. See page 108 for examples of equipment that is not covered. Effectiveness Effectiveness means the extent to which a specific intervention, procedure, service, level of service, supply, prescription drug, or drug dose may reasonably be expected to produce the intended results and to have expected benefits that outweigh potential harmful effects under real-world circumstances. 2024 UMP CDHP (PEBB) Certificate of Coverage 173