18 Benefits In - Network Out - of - Network • Home Dialysis 20% Coinsurance after Deductible 40% Coinsurance after Deductible • Home Infusion Therapy / Chemotherapy 20% Coinsurance after Deductible 40% Coinsurance after Deductible • Specialty Prescription Drugs for Infusion / Injection – Other than Chemotherapy 20% Coinsurance after Deductible 40% Coinsurance after Deductible • Other Home Health Care Services / Supplies 20% Coinsurance after Deductible 40% Coinsurance after Deductible • Private Duty Nursing (Including continuous complex skilled nursing services) 20% Coinsurance after Deductible 40% Coinsurance after Deductible Home Health Care Benefit Maximum 1 0 0 visits per Benefit Period In - and Out - of - Network combined . The limit includes and Therapy Services * (e.g., physical, speech, occupational , cardiac and pulmonary rehabilitation) given as part of the Home Care benefit. The limit does not apply to Home Infusion Therapy or Home Dialysis. * If Therapy Services are provided for a Mental Health or Substance Use Disorder condition (based on the primary diagnosis on the claim form) , benefits will be paid under the Mental Health and Substance Use Disorder benefits and the Home Health Care limit will not apply. Private Duty Nursing Benefit Maximum Limited to 82 visits per Benefit Period and 164 visits per lifetime , In - and Out - of - Network combined . Home Infusion Therapy See “Home Health Care.” Hospice Care • Home Hospice Care 0% Coinsurance after Deductible 0% Coinsurance after Deductible • Bereavement 0% Coinsurance after Deductible 0% Coinsurance after Deductible • Inpatient Hospice 0% Coinsurance after Deductible 0% Coinsurance after Deductible • Outpatient Hospice 0% Coinsurance after Deductible 0% Coinsurance after Deductible • Respite Care 0% Coinsurance after Deductible 0% Coinsurance after Deductible