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Medically Necessary services provided by or under the direction of a Participating Physician in a Physician's office, a Participating Hospital or other Approved Health Care Facility when the reconstructive surgery is necessary: a. To correct congenital malformations and anomalies, when required to restore normal physiological functioning; or b. To restore normal physiological functioning following an accident, InJury, surgery, or as otherwise Medically Necessary. 5. Ambulance Service Emergency ambu}ance transportation by a profes- sional ambulance service to the nearest hospi- tal where Emergency care and treatment can be rendered. 7. Drug Abuse and Drug Addiction Detoxification The following Health Services are covered only when provided by, or authorized in advance by the Health Plan and its Psychiatric Primary Provider: a. Outpatient diagnosis and medical treat- ment for Drug Abuse Detoxification and services provided by or under the direc- tion of a Physician at the physician's office or other approved Health Care Facility or Program. b. Inpatient services and supplies on a semi- private accommodation basis for Drug Abuse Detoxification for that period of time deemed Medically Necessary by a Physician, in an Approved Health Care Facility or Program. Determination of the need for services of a spe- cialized facility, and referral to such facility in appropriate cases, are covered, but the spe- cialized facilities are not covered. B. Miscellaneous Health Services a. Health Plan will pay for the services and supplies provided by a licensed Home Health Agency, either at home orin the Hospital, where deemed Medically Necessary by the Participating Physician and authorized in advance by the Health Plan. SB-A2 -6- NONE $15 per visit 20% of Eligible Expenses for in- patient services. NONE