Part 6 – Limitations and Exclusions (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 75 Services Furnished to Immediate Family No benefits are provided for a covered service that is furnished by a health care provider to themself or to a member of their immediate family. The only exception is for drugs that this health plan covers when they are used by a physician, dentist, or podiatrist while furnishing a covered service. “Immediate family” means any of the following members of a health care provider’s family:  Spouse or spousal equivalent.  Parent, child, brother, or sister (by birth or adoption).  Stepparent, stepchild, stepbrother, or stepsister.  Father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law. (For purposes of providing covered services, an in-law relationship does not exist between the provider and the spouse of their wife’s (or husband’s) brother or sister.)  Grandparent or grandchild. For the purposes of this exclusion, the immediate family members listed above will still be considered immediate family after the marriage which had created the relationship is ended by divorce or death.

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