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 65 provided for covered services that are consistent with the study protocol and with the standard of care for a person with the member’s condition; and, as long as the services would be covered if the member did not participate in the trial. But, no benefits are provided for an investigational drug or device, whether or not it has been approved for use in the trial. (This coverage does not apply if your health plan is a grandfathered health plan under the Affordable Care Act.) Radiation Therapy and Chemotherapy This health plan covers outpatient radiation and x-ray therapy and chemotherapy when it is furnished for you by a covered provider. This may include (but is not limited to): a physician; or a nurse practitioner; or a free-standing radiation therapy and chemotherapy facility; or a hospital; or a covered provider who has a recognized expertise in specialty pediatrics. This coverage includes:  Radiation therapy using isotopes, radium, radon, or other ionizing radiation.  X-ray therapy for cancer or when it is used in place of surgery.  Drug therapy for cancer (chemotherapy). Coverage for Orally-Administered Chemotherapy Drugs In most cases, this health plan will provide full coverage based on the allowed charge for in-network or out-of-network anticancer prescription drugs that are orally administered to kill or slow the growth of cancerous cells. The only exception is when you are enrolled in a high deductible health plan with a health savings account. In this case, your deductible will apply to these covered services. Otherwise, any cost share amounts will not apply for these covered services. Coverage for Self Injectable and Certain Other Drugs There are self injectable and certain other prescription drugs used for cancer treatment or treatment of cancer symptoms due to cancer treatment that are covered by this health plan only when these covered drugs are furnished by a covered pharmacy, even when a non-pharmacy health care provider administers the drug for you during a covered visit. For your coverage for these covered 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. Second Opinions This health plan covers an outpatient second opinion when it is furnished for you by a physician. This coverage includes a third opinion when the second opinion differs from the first. (See “Lab Tests, X-Rays, and Other Tests” for your coverage for related diagnostic tests.) Short-Term Rehabilitation Therapy This health plan covers medically necessary outpatient short-term rehabilitation therapy when it is furnished for you by a covered provider. This may include (but is not limited to): a physical therapist; or an occupational therapist; or a licensed speech-language pathologist; or a covered provider who has a