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 66 recognized expertise in specialty pediatrics. This coverage includes: physical therapy; speech/language therapy; occupational therapy; or an organized program of these combined services. This health plan provides coverage only until you reach your benefit limit. The Schedule of Benefits for your plan option describes the benefit limit that applies for these covered services. (Also refer to riders—if there are any— that apply to your coverage in this health plan.) Once you reach the benefit limit, no more benefits will be provided for these services. The benefit limit does not apply: for speech/language therapy; or when any of these services are furnished as part of a covered home health care program; or when any of these services are furnished to treat autism spectrum disorders. Whether or not your plan option has a benefit limit for these services, coverage is provided only for those services that are determined by Blue Cross Blue Shield HMO Blue to be medically necessary for you. This coverage is also provided when the short-term therapy is medically necessary habilitation therapy. Coverage for short-term habilitation therapy is most often included in the benefit limit for short-term rehabilitation therapy. But, the benefit limit for short-term habilitation therapy may be separate from the benefit limit for short-term rehabilitation therapy. If this is the case, the Schedule of Benefits for your plan option describes the separate benefit limits that apply for these covered services. (Also refer to riders—if there are any—that apply to your coverage in this health plan.) What Are Rehabilitation and Habilitation Services Rehabilitation services are those health care services that help a person keep, get back, or improve skills and functioning that have been lost or impaired because a person was sick, hurt, or disabled. Habilitation services are those health care services that help a person keep, learn, or improve skills and functioning for daily living. Speech, Hearing, and Language Disorder Treatment This health plan covers medically necessary services to diagnose and treat speech, hearing, and language disorders when the services are furnished for you by a covered provider. This may include (but is not limited to): a licensed audiologist; or a licensed speech-language pathologist; or a covered provider who has a recognized expertise in specialty pediatrics. This coverage includes: diagnostic tests, including hearing exams and tests; speech/language therapy; and medical care to diagnose or treat speech, hearing, and language disorders. A benefit limit that applies for short-term rehabilitation therapy does not apply for speech/language therapy. No benefits are provided when these services are furnished in a school-based setting. Surgery as an Outpatient This health plan covers outpatient surgical services when they are furnished for you by a covered provider. This may include (but is not limited to): a surgical day care unit of a hospital; or an ambulatory surgical facility; or a physician; or a nurse practitioner; or a covered provider who has a recognized expertise in specialty pediatrics. This coverage includes:  Routine circumcision.