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 50% Coinsurance after Deductible • Home Dialysis 20% Coinsurance after Deductible 50% Coinsurance after Deductible • Home Infusion Therapy / Chemotherapy 20% Coinsurance after Deductible 50% Coinsurance after Deductible • Specialty Prescription Drugs for Infusion / Injection – Other than Chemotherapy 20% Coinsurance after Deductible 50% Coinsurance after Deductible • Other Home Health Care Services / Supplies 20% Coinsurance after Deductible 50% 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 No Copayment, Deductible, or Coinsurance No Copayment, Deductible, or Coinsurance • Bereavement No Copayment, Deductible, or Coinsurance No Copayment, Deductible, or Coinsurance • Inpatient Hospice No Copayment, Deductible, or Coinsurance No Copayment, Deductible, or Coinsurance • Outpatient Hospice No Copayment, Deductible, or Coinsurance No Copayment, Deductible, or Coinsurance