17 Benefits In-Network Out-of-Network Habilitative Services Benefits are based on the setting in which Covered Services are received. See “Therapy Services” for details on Benefit Maximums. Home Health Care • Home Health Care Visits from a Home Health Care Agency (Including intermittent skilled nursing services) 20% Coinsurance after Deductible 40% Coinsurance after Deductible • 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 Home Health Care Benefit Maximum 100 visits per Benefit Period In- and Out-of-Network combined. The limit includes 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. Home Infusion Therapy See “Home Health Care.” Hospice Care • Home Hospice Care 20% Coinsurance after Deductible 20% Coinsurance after Deductible • Bereavement 20% Coinsurance after Deductible 20% Coinsurance after Deductible • Inpatient Hospice 20% Coinsurance after Deductible 20% Coinsurance after Deductible • Outpatient Hospice 20% Coinsurance after Deductible 20% Coinsurance after Deductible • Respite Care 20% Coinsurance after Deductible 20% Coinsurance after Deductible Out-of-Network Providers may also bill you for any charges over the Plan’s Maximum Allowed Amount.