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Note: The member's copayment does not apply for Medicare-covered diabetes monitoring and self-management training, glaucoma eye exam screenings, hearing tests, maternity services, medical nutrition therapy, smoking cessation counseling, and kidney disease education services.

Wellness Participation Program - Under a separate wellness participation program, when an eligible member participates in qualified fitness programs, Blue Cross Blue Shield, on behalf of the employer group, will reimburse up to $200 each calendar year for certain costs paid for health club membership fees, fitness classes taken at a qualified health club, or other fitness activities approved by employer group. Refer to Wellness Participation Program materials for more information.

Wellness Participation Program - under a separate wellness participation program, when an eligible member participates in qualified fitness programs and/or qualified weight loss programs, Blue Cross Blue Shield, on behalf of the employer group, will reimburse up to $150 each calendar year for certain costs paid by an eligible member for health club membership fees or fitness classes taken at a qualified health club; and up to a separate $300 each calendar year for costs paid for participating in hospital-based weight loss programs or non-hospital-based weight loss programs designated by Blue Cross Blue Shield. In addition, up to a separate $300 each calendar year for cost paid for mind and body wellness services from a licensed or certificated practitioner. This is the maximum reimbursement for any combination of fees incurred by eligible wellness participants enrolled under the same family plan. Refer to Wellness Participation Program materials for more information.

Methadone maintenance treatment for opioid dependence from an opioid treatment program provider.

For Medicare-approved Physician or other covered mental health provider services, Medex pays the Medicare Part B deductible and the Part B coinsurance. For services not covered by Medicare, full benefits after member pays Medex copay.

For Medicare-approved Physician or other covered mental health provider services, Medex pays the Medicare Part B deductible and the Part B coinsurance. For services not covered by Medicare, full benefits after member pays Medex copay.

Treatment of autism spectrum disorders, including (but not limited to) habilitative and rehabilitative care to develop, maintain and restore (to the maximum extent practicable) the functioning of the member. This care includes applied behavior analysis (ABA) furnished by or supervised by a psychologist or a licensed applied behavioral analyst. For these covered services, all cost share amounts are waived.

Telehealth services received from a Blue Cross and Blue Shield approved telehealth physician or practitioner using a telecommunications system. The telehealth provider will use an audio and video telecommunications system that permits a two-way, real-time communication. A member may see a telehealth provider online or by mobile device when care is needed for a minor illness or injury such as a cough, a sore throat, or a fever; or care is needed for a chronic condition; or help is needed for a general health and wellness concern. A referral or prior approval is not required. These are in-network benefits only, no out-of-network benefits are available for telehealth services.

Telehealth services received from a Blue Cross and Blue Shield approved telehealth physician or practitioner using a telecommunications system. The telehealth provider will use an audio and video telecommunications system that permits a two-way, real-time communication. A member may see a telehealth provider online or by mobile device when care is needed for a minor illness or injury such as a cough, a sore throat, or a fever; or care is needed for a chronic condition; or help is needed for a general health and wellness concern. A referral or prior approval is not required. These are in-network benefits only, no out-of-network benefits are available for telehealth services.

Telehealth services received from a Blue Cross and Blue Shield approved telehealth physician or practitioner using a telecommunications system. The telehealth provider will use an audio and video telecommunications system that permits a two-way, real-time communication. A member may see a telehealth provider online or by mobile device when care is needed for a minor illness or injury such as a cough, a sore throat, or a fever; or care is needed for a chronic condition; or help is needed for a general health and wellness concern. A referral or prior approval is not required. These are in-network benefits only, no out-of-network benefits are available for telehealth services.