Habilitative Services Exclusions  Activities that provide diversion or general motivation.  Custodial care or services for individualized education program development.  Daycare.  Exercise programs for healthy individuals.  Housing.  Recreational activities.  Respite care.  Services and devices delivered pursuant to federal Individuals with Disabilities Education Act of 2004 (IDEA) requirements.  Services solely for palliative purposes.  Social services.  Specialized job testing. 13. Hearing Instruments We cover Medically Necessary Services for the treatment of hearing loss as described in this “Hearing Instruments” section. Hearing instruments means any wearable prosthetic instrument or device designed for aiding, improving, compensating for, or correcting defective human hearing, and any parts, attachments, or accessories necessary for the device to function, excluding batteries, cords, and assistive listening devices. Hearing instruments include bone conduction hearing devices, as an alternative to conventional hearing aids, when Medically Necessary. Coverage includes the initial assessment, fitting, adjustment, auditory training, and ear molds as necessary to maintain optimal fit. We will cover these Services for Members who intend to obtain or have already obtained any hearing instrument, including an over-the-counter hearing instrument; however, we will not cover the over-the-counter hearing instrument itself. For minors under 18 years of age, the benefits described in this “Hearing Instruments” section are available only after the Member has received medical clearance within the preceding six months from:  An otolaryngologist for an initial evaluation of hearing loss; or  A licensed physician, which indicates there has not been a substantial change in clinical status since the initial evaluation by an otolaryngologist. We provide an allowance toward the price of a hearing instrument for each ear with hearing loss. The allowance amount is shown in the “Benefit Summary.” You do not have to use the allowances for both ears at the same time, but we will not provide the allowance for an ear if we have previously covered a hearing instrument for that ear within the same benefit period. Hearing Instruments Exclusions  Assistive listening devices (for example, FM systems, cell phone or telephone amplifiers, and personal amplifiers designed to improve your ability to hear in a specific listening situation).  Batteries, cords, cleaners, and moisture guards.  Over-the-counter (non-prescription) hearing instruments.  Repair of hearing instruments beyond the warranty period.  Replacement of lost or broken hearing aids if you have exhausted (used up) your allowance. EWCLGDED1983ACT0124 46 WAPEBB-CL-ACT