Benefit Period, Covered Services will be covered as Inpatient Services, Outpatient Services, Home Visits, or Office Visits depending on where the service is performed. Inpatient Facility No Copayment, No Copayment, 50% Coinsurance Services Deductible, or Deductible, or after Deductible. Coinsurance Coinsurance • Precertification These charges will required NOT apply to your Out-of-Pocket Limit. Inpatient Professional No Copayment, No Copayment, 50% Coinsurance and Ancillary (non- Deductible, or Deductible, or after Deductible. Hospital) Services Coinsurance Coinsurance These charges will NOT apply to your Out-of-Pocket Limit. Outpatient Facility No Copayment, No Copayment, 50% Coinsurance Services Deductible, or Deductible, or after Deductible. Coinsurance Coinsurance These charges will • Precertification NOT apply to your required Out-of-Pocket Limit. Outpatient Facility No Copayment, No Copayment, 50% Coinsurance Professional and Deductible, or Deductible, or after Deductible. Ancillary (non- Coinsurance Coinsurance These charges will Hospital) Services NOT apply to your Out-of-Pocket Limit. Travel Expenses • Transportation and Covered, as approved by us, up to $10,000 per Benefit Period, In- and Out-of- Lodging Limit Network combined. Unrelated donor No Copayment, No Copayment, 50% Coinsurance searches from an Deductible, or Deductible, or after Deductible. authorized, licensed Coinsurance Coinsurance These charges will registry for bone NOT apply to your marrow/stem cell Out-of-Pocket Limit. transplants for a Covered Human Organ or Tissue Transplant Procedure • Donor Search Covered, as approved by us, up to $30,000 per transplant In- and Out-of- Limit Network combined. Live Donor Health Services 31