18 Benefits • Home Health Care Visits from a Home Health Care Agency (Including intermittent skilled nursing services) 20% Coinsurance after Deductible • Home Dialysis 20% Coinsurance after Deductible • Home Infusion Therapy / Chemotherapy 20% Coinsurance after Deductible • Specialty Prescription Drugs for Infusion / Injection – Other than Chemotherapy 20% Coinsurance after Deductible • Other Home Health Care Services / Supplies 20% Coinsurance after Deductible • Private Duty Nursing (Including continuous complex skilled nursing services) 20% Coinsurance after Deductible Home Health Care Benefit Maximum Unlimited Home Infusion Therapy See “Home Health Care.” Hospice Care • Home Hospice Care 20% Coinsurance after Deductible • Bereavement 20% Coinsurance after Deductible • Inpatient Hospice 20% Coinsurance after Deductible • Outpatient Hospice 20% Coinsurance after Deductible • Respite Care 20% Coinsurance after Deductible Non-Participating Providers may also bill you for any charges over the Plan’s Maximum Allowed Amount. Human Organ and Tissue Transplant (Bone Marrow / Stem Cell) Services Please see the separate summary later in this section. Inpatient Services Facility Room & Board Charge: • Hospital / Acute Care Facility 20% Coinsurance after Deductible • Skilled Nursing Facility 20% Coinsurance after Deductible • Rehabilitation 20% Coinsurance after Deductible Skilled Nursing Facility/ Rehabilitation Services (Includes Services in an Outpatient Day Rehabilitation Program) Benefit Maximum Unlimited • Mental Health / Substance Use Disorder Facility 20% Coinsurance after Deductible