Habilitative (Neurodevelopmental) Services The plan covers inpatient and outpatient habilitative (neurodevelopmental) services to assist a person to keep, learn, or improve skills and functioning for daily living. This could be related to issues such as: • A congenital anomaly (such as cleft lip or palate). • Conditions of developmental delay, including autism. For the purposes of this benefit, developmental delay means a significant lag in achieving skills such as: • Cognitive (thinking). • Language (speech, reading, writing). • Motor (crawling, walking, feeding oneself). • Social (getting along with others). You must have a prescription for occupational, physical, and speech therapy services from a covered provider type (see the “Covered and noncovered provider types” section), such as a physician. Inpatient habilitative services Preauthorization is required for inpatient habilitative admissions. The plan covers therapy services when they are provided during inpatient habilitative admission, up to 60 days combined per calendar year, counting all types of therapies listed here (see definition of “Limited benefit”). You must pay the inpatient copay and your coinsurance for inpatient services. Outpatient habilitative services The plan covers medically necessary outpatient occupational, physical, and speech therapy services up to 60 visits combined per calendar year, counting all types of therapies listed here (see definition of “Limited benefit”). Rehabilitative Services The plan covers inpatient and outpatient services to improve or restore function lost due to issues such as: • An illness. • An acute injury. • Worsening or aggravation of a chronic injury. You must have a prescription for occupational, physical, and speech therapy services from a covered provider type (see the “Covered and noncovered provider types” section, such as a physician. Inpatient rehabilitation services Preauthorization is required for inpatient rehabilitation admissions. The plan covers therapy services when they are provided during inpatient rehabilitation admission, up to 60 days combined per calendar year, counting all types of therapies listed here (see definition of “Limited benefit”). You must pay the inpatient copay and your coinsurance for inpatient services. Outpatient rehabilitation services The plan covers medically necessary outpatient neurodevelopmental, occupational, physical, and speech therapy services up to 60 visits combined per calendar year, counting all types of therapies listed here (see definition of “Limited benefit”). 2024 UMP Select (PEBB) Certificate of Coverage 73