Part 5 – Covered Services (continued) IMPORTANT: Refer to the Schedule of Benefits for your plan option for the cost share amounts that you must pay for covered services and for the benefit limits that may apply to specific covered services. Once you reach your benefit limit for a specific covered service, no more benefits are provided by Blue Cross Blue Shield HMO Blue for those services or supplies. WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 69 or health center visit. For your coverage for these drugs, see “Prescription Drugs and Supplies.” No benefits are provided for the cost of these drugs when the drug is furnished by a non-pharmacy health care provider. For a list of these drugs, you can call the Blue Cross Blue Shield HMO Blue customer service office. Or, you can log on to the Blue Cross Blue Shield HMO Blue Web site at www.bluecrossma.org. (This exclusion does not apply when these covered drugs are furnished to you during a covered day surgical admission at a surgical day care unit of a hospital, ambulatory surgical facility, or hospital outpatient department.) Telehealth Services This health plan covers telehealth services that are furnished by a Blue Cross Blue Shield HMO Blue covered provider or by a Blue Cross Blue Shield HMO Blue designated telehealth vendor. Telehealth services are synchronous or asynchronous communications (audio, video, or other approved electronic media or telecommunications technology including, but not limited to: interactive audio-video technology; remote patient monitoring devices; audio-only telephone; and online adaptive interviews) between you and the health care provider. Your health care provider will work with you to determine if a telehealth visit is medically appropriate for your health care needs or if an in-person visit is required. These services are available for medically appropriate covered services, including services to diagnose and/or treat mental conditions. The cost share amount that you will pay depends on the health care provider that furnishes the covered service to you. (See below.) For covered telehealth services, you will not have to pay any more than you would normally pay for the same in-person covered service with your health care provider. In some cases, the cost share amount that you will pay for covered telehealth services may be less than you would pay for an in-person visit. Note: Any benefit limits that may apply for a specific covered service will still apply when the covered service is furnished as a telehealth service. The Schedule of Benefits for your plan option and/or any riders that apply to your coverage in this health plan describe any benefit limits that apply to your coverage. Telehealth Services with a Covered Provider When medically appropriate telehealth services are furnished by a Blue Cross Blue Shield HMO Blue covered provider, your cost share (such as deductible, copayment, and/or coinsurance) is the same amount as an in-person visit with that provider. Your Schedule of Benefits describes your cost share amount. (Also refer to riders—if there are any—that apply to your coverage in this health plan.) Your cost share for covered telehealth services may be lower than your in-person cost share. If this is the case, this will be described in a rider. Telehealth Services with a Designated Telehealth Vendor You may use a Blue Cross Blue Shield HMO Blue designated telehealth vendor when you need care for a minor illness or injury such as a cough, a sore throat, or a fever; or you need care for a chronic condition; or you need mental health and substance use care for conditions or symptoms such as anxiety and depression; or you have a general health and wellness concern.