Part 6 – Limitations and Exclusions (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 73 computers; computer software; dehumidifiers; dentures; elevators; foot orthotics; hearing aids (except for those that are described in Part 5); heating pads; hot water bottles; humidifiers; orthopedic and corrective shoes that are not part of a leg brace; raised toilet seats; and shoe (foot) inserts.  Special clothing, except for: gradient pressure support aids for lymphedema or venous disease; clothing needed to wear a covered device (for example, mastectomy bras and stump socks); and therapeutic/molded shoes and shoe inserts for a member with severe diabetic foot disease.  Self-monitoring devices, except for certain devices that Blue Cross Blue Shield HMO Blue decides would give a member having particular symptoms the ability to detect or stop the onset of a sudden life-threatening condition. Missed Appointments No benefits are provided for charges for appointments that you do not keep. Physicians and other health care providers may charge you if you do not keep your scheduled appointments. They may do so if you do not give them reasonable notice. You must pay for these costs. Appointments that you do not keep are not counted against any benefit limits that apply to your coverage in this health plan. Non-Covered Providers No benefits are provided for any services and supplies that are furnished by the kinds of health care providers that are not covered by this health plan. This Subscriber Certificate describes the kinds of health care providers that are covered by the health plan. (See “covered providers” in Part 2 of this Subscriber Certificate.) Non-Covered Services No benefits are provided for:  A service or supply that is not described as a covered service. Some examples of non-covered services are: private duty nursing; and reversal of sterilization.  A service or supply that is furnished along with a non-covered service.  A service or supply that does not conform to Blue Cross Blue Shield HMO Blue medical policies.  A service or supply that does not conform to Blue Cross Blue Shield HMO Blue medical technology assessment criteria.  A service or supply that is not considered by Blue Cross Blue Shield HMO Blue to be medically necessary for you. The only exceptions are for: certain routine or other preventive health care services or supplies; certain covered voluntary health care services or supplies; and donor suitability for bone marrow transplant.  A service or program, including a residential program, that is furnished in educational or vocational settings; or, services and/or programs that are not considered to be inpatient services, intermediate treatments, or outpatient services as described in this Subscriber Certificate. The only exception is for outpatient covered services to diagnose and/or treat mental conditions when these services are furnished by a covered provider along with one of these programs.  A program for which Blue Cross Blue Shield HMO Blue is not able to conduct concurrent review of continued medical necessity (see Part 4), including a program that has a pre-defined length of care or stay.  A service or supply that is furnished by a health care provider who has not been approved by Blue Cross Blue Shield HMO Blue for payment for the specific service or supply.  A service or supply that is furnished to someone other than the patient, except as described in this Subscriber Certificate for: hospice services; and the harvesting of a donor’s organ (or tissue) or stem cells when the recipient is a member. This coverage includes the surgical removal of the donor’s