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In addition, this health plan covers one set of frames and/or prescription lenses (or contact lenses instead) for each member every 24 months or every 12 months for an enrolled dependent child. For covered vision supplies, the member pays:

(These benefits may be reduced by any benefits that have already been provided for routine vision care services under a prior Blue Cross Blue Shield coverage in the same eligible time period.)

(These benefits may be reduced by any benefits that have already been provided for routine vision care services under a prior Blue Cross Blue Shield coverage in the same eligible time period.)

When durable medical equipment is furnished as part of covered home dialysis, home health care or hospice services, the benefit limit (if there is one) that would normally apply to durable medical equipment does not apply.

For a description of these benefits, refer to Prescription Drugs.

Enteral formulas for home use that are medically necessary to treat malabsorption caused by: Crohn's disease; chronic intestinal pseudo-obstruction; gastroesophageal reflux; gastrointestinal motility; ulcerative colitis; and inherited diseases of amino acids and organic acids.

Food products modified to be low protein that are medically necessary to treat inherited diseases of amino acids and organic acids for up to $2,500 for each member in each calendar year. The member may buy these food products directly from a distributor. (Any benefits already used in the same calendar year for low protein foods under a prior Blue Cross Blue Shield non-HMO coverage may reduce these benefits.)

The member's copayment is waived when the visit is only for immunizations and/or lab tests.

These self-referred benefits are limited to the following age-based schedule:

One visit each calendar year for ages 2 through 5.