Autism. Autism means a developmental neurological disorder, usually appearing in the first three years of life, which affects normal brain functions and is manifested by compulsive, ritualistic behavior and severely impaired social interaction and communication skills. This Contract shall provide benefits for the diagnosis of Autism in accordance with the conditions, limitations as to type and scope of treatment authorized for neurological disorders, exclusions, cost-sharing arrangements and Copayment requirements which exist in this Contract for neurological disorders. This Contract provides for habilitative or rehabilitative services and other counseling or therapy services necessary to develop, maintain, and restore the functioning of an individual with Autism Spectrum Disorder (ASD) who is twenty (20) years of age or under. BREAST CANCER PATIENT CARE Covered Services include Inpatient care following a mastectomy or lymph node dissection for an appropriate length of stay as determined by the attending Physician in consultation with the Member. Follow-up visits are also included and may be conducted at home or at the Physician’s office as determined by the attending Physician in consultation with the Member. Additional charges may apply. Mastectomy bras are covered, up to 3 per calendar year. BREAST RECONSTRUCTIVE CARE Covered Services include care following a mastectomy for reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complications, including lymphedemas. CLINICAL TRIAL PROGRAMS FOR TREATMENT OF CHILDREN’S CANCER
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