Noblesville Schools Medical Plan 40 Section 1: Covered Health Care Services • From a short-term acute care facility to the closest Network long-term acute care facility (LTAC), Network Inpatient Rehabilitation Facility, or other Network sub-acute facility where the required Covered Health Care Services can be delivered. For the purpose of this Benefit the following terms have the following meanings: ▪ "Long-term acute care facility (LTAC)" means a facility or Hospital that provides care to people with complex medical needs requiring long-term Hospital stay in an acute or critical setting. ▪ "Short-term acute care facility" means a facility or Hospital that provides care to people with medical needs requiring short-term Hospital stay in an acute or critical setting such as for recovery following a surgery, care following sudden Sickness, Injury, or flare-up of a chronic Sickness. ▪ "Sub-acute facility" means a facility that provides intermediate care on short-term or long- term basis. Cellular and Gene Therapy Cellular Therapy and Gene Therapy received on an inpatient or outpatient basis at a Hospital or on an outpatient basis at an Alternate Facility or in a Physician's office. Benefits for CAR-T therapy for malignancies are provided as described under Transplantation Services. Chronic Pain Management Benefits are provided for evidence based health care products and services, prescribed by a Covered Person's treating practitioner, intended to relieve chronic pain that has lasted for at least three (3) months. This includes: • Physical therapy. • Occupational therapy. • Chiropractic care. • Osteopathic manipulative treatment. • Athletic trainer services. As used in this section "chronic pain" means pain that: • Persists beyond the usual course of an acute disease or healing of an Injury; or. • May be associated with an acute or chronic pathologic process that causes continuous or intermittent pain for a period of months or years. Clinical Trials Routine patient care costs incurred while taking part in a qualifying clinical trial for the treatment of: • Cancer or other life-threatening disease or condition. For purposes of this Benefit, a life-threatening disease or condition is one which is likely to cause death unless the course of the disease or condition is interrupted. • Cardiovascular disease (cardiac/stroke) which is not life threatening, when the Claims Administrator determines the clinical trial meets the qualifying clinical trial criteria stated below. • Surgical musculoskeletal disorders of the spine, hip and knees, which are not life threatening, when the Claims Administrator determines the clinical trial meets the qualifying clinical trial criteria stated below.