The plan covers inpatient and outpatient services to improve or restore function lost due to:

• An acute injury or illness.
• Worsening or aggravation of a chronic injury.
• A congenital anomaly (such as cleft lip or palate).
• Conditions of developmental delay, including autism.

These services must be part of a formal written treatment plan developed with the provider who diagnosed or manages your condition and prescribed the therapy.

Inpatient Services

The plan covers rehabilitation therapy services provided during inpatient hospitalization up to 60 visits per calendar year (see definition of "Limited Benefit"). These services must be preauthorized by the plan. You must pay the hospital inpatient copayment and your coinsurance for inpatient services.

Outpatient Services

The plan covers outpatient physical, occupational, speech and neurodevelopmental therapy services up to 60 visits per calendar year , counting all types of therapies listed here (see definition of "Limited Benefit").

For the purposes of this benefit, developmental delay means a significant lag in achieving skills such as:

• Language (speech, reading, writing).
• Motor (crawling, walking, feeding oneself).
• Cognitive (thinking).
• Social (getting along with others).