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This health plan covers inpatient or outpatient electric shock therapy furnished by a covered mental health provider to treat a mental condition. (No benefits are provided by this health plan for other services to diagnose and/or treat a mental condition.)

Note: Newborn hearing screening tests do not count toward the benefit limit.

Routine lab tests, including cholesterol screening and prostate-antigen (PSA) blood tests, when the tests are furnished as part of a covered routine physical exam.

Flu shots and Hepatitis B immunizations.

One visit each calendar year for ages 2 through 19.

One exam every three calendar years from age 25 through age 39.

Private duty nursing furnished by a registered nurse (RN) or licensed practical nurse (LPN) but only if the hospital's regular nursing staff cannot perform skilled nursing care due to the frequency and complexity of the services. Note: These services are limited to $3,000 for each member in each calendar year for inpatient and outpatient services combined (benefit limit does not apply for approved prolonged illness condition).

Immunizations (such as flu shots and travel immunizations).

Fitness Benefit - A member may take part of the fitness benefit. This health plan will reimburse up to a total of $150 each calendar year for fees paid for a health club membership or for fitness classes at a health club. (The member claiming all or part of the fitness benefit must have paid at least four months health club fees for that calendar year.)

Weight Loss Program Benefit - A member may take part of the weight loss program benefit. This health plan will reimburse up to a total of $150 each calendar year for fees paid for hospital-based weight loss programs or for non-hospital-based weight loss programs that are designated by Blue Cross Blue Shield.