53 You are eligible for hospice care if your Physician and the Hospice medical director certify that you are terminally ill and likely have less than twelve (12) months to live. You may access hospice care while participating in a clinical trial or continuing disease modifying therapy, as ordered by your treating Provider. Disease modifying therapy treats the underlying terminal illness. The services and supplies listed below are Covered Services when given by a Hospice for the palliative care of pain and other symptoms that are part of a terminal disease. Palliative care means care that controls pain and relieves symptoms, but is not meant to cure a terminal illness. Covered Services include: • Care from an interdisciplinary team with the development and maintenance of an appropriate plan of care. • Short-term Inpatient Hospital care when needed in periods of crisis or as respite care. • Skilled nursing services, home health aide services, and homemaker services given by or under the supervision of a registered nurse. • Social services and counseling services from a licensed social worker. • Nutritional support such as intravenous feeding and feeding tubes. • Physical therapy, occupational therapy, speech therapy, and respiratory therapy given by a licensed therapist. • Pharmaceuticals, medical equipment, and supplies needed for the palliative care of your condition, including oxygen and related respiratory therapy supplies. • Bereavement (grief) services, including a review of the needs of the bereaved family and the development of a care plan to meet those needs, both before and after the Member’s death. Bereavement services are available to the patient and those individuals who are closely linked to the patient, including the immediate family, the primary or designated caregiver and individuals with significant personal ties, for one year after the Member’s death. Your Doctor must agree to care by the Hospice and must be consulted in the development of the care plan. The Hospice must keep a written care plan on file and give it to us upon request. Benefits for services beyond those listed above that are given for disease modification or palliation, such as but not limited to chemotherapy and radiation therapy, are available to a Member in Hospice. These services are covered under other parts of this Plan. Human Organ and Tissue Transplant (Bone Marrow / Stem Cell) Services, Cellular and Gene Therapy Services Your Plan includes coverage for Medically Necessary human organ and tissue transplants as well as certain cellular and gene therapies. To be eligible for coverage, we must approve the benefits in advance through Precertification and services must be performed by an approved In-Network Provider to be covered at the In-Network level. Certain transplants (e.g., cornea) are covered like any other surgery, under the regular inpatient and outpatient benefits described elsewhere in this Booklet. In this section you will see some key terms, which are defined below: Covered Procedure As decided by us, a Covered Procedure includes: • Any Medically Necessary human solid organ, tissue, and stem cell / bone marrow transplants and infusions, and • Any Medically Necessary cellular or other gene therapies, and