19 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 Unlimited In - and Out - of - Network combined. The limit includes Private Duty Nursing and Therapy Services * (e.g., physical, speech, occupational, cardiac and pulmonary rehabilitation) given as part of the Home Care benefit. *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 w ill not apply. Home Infusion Therapy See “Home Health Care.” Hospice Care • Home Hospice Care 20% Coinsurance 4 0% Coinsurance • Bereavement 20% Coinsurance after Deductible 40% Coinsurance after Deductible • Inpatient Hospice 20% Coinsurance 40% Coinsurance • Outpatient Hospice 20% Coinsurance 40% Coinsurance • Respite Care 20% Coinsurance 40% Coinsurance Human Organ and Tissue Transplant (Bone Marrow / Stem Cell) Services Please see the separate summary later in this section. Infertility Services See “Maternity and Reproductive Health Services.”