costs incurred during the hospitalization are the responsibility of the Enrollee. Follow-up care which is a direct result of the Emergency must be received from a Network Provider, unless Preauthorization is obtained for such follow-up care from a non-Network Provider. Gender Health Services Medically Necessary medical and surgical services for gender Hospital - Inpatient: After Deductible, Enrollee affirmation. Consultation and treatment require pays 10% Plan Coinsurance Preauthorization. Certain procedures are subject to age limits, please see our clinical criteria https://wa- Hospital - Outpatient: After Deductible, Enrollee provider.kaiserpermanente.org/static/pdf/hosting/clinical/crite pays 10% Plan Coinsurance ria/pdf/gender_reassignment_surgery.pdf for details. Outpatient Services: After Deductible, Enrollee Prescription drugs are covered the same as for any other pays 10% Plan Coinsurance condition (see Drugs – Outpatient Prescription for coverage). Counseling services are covered the same as for any other condition (see Mental Health and Wellness for coverage). Non-Emergency inpatient hospital services require Preauthorization. Exclusions: Cosmetic services and surgery not related to gender affirming treatment (i.e., face lift or calf implants); complications of non-Covered Services Hearing Examinations and Hearing Aids Routine hearing exams and hearing exams for hearing loss Hospital - Inpatient: After Deductible, Enrollee and evaluation and diagnostic testing for cochlear implants pays 10% Plan Coinsurance are covered only when provided at KFHPWA-approved facilities. Hospital - Outpatient: After Deductible, Enrollee pays 10% Plan Coinsurance Cochlear implants and surgically implanted Bone Anchored Hearing System (BAHS) when in accordance with KFHPWA Outpatient Services: After Deductible, Enrollee clinical criteria. pays 10% Plan Coinsurance Covered services for initial cochlear implants and surgically implanted BAHS include implant surgery, pre-implant testing, post-implant follow-up, speech therapy, programming and associated supplies (such as transmitter cable, and batteries). Replacement devices and associated supplies – see Devices, Equipment and Supplies Section. Hearing aids, externally worn bone conduction hearing After Deductible, Enrollee pays nothing, limited to devices, and non-surgical Bone Anchored Hearing System an Allowance of $3,000 maximum per ear during PEBB HMOHSA 2024 24