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<br />SB-A2 <br /> <br />14. <br /> <br />Prosthetic devices, medical equipment and appliances, even though <br />prescribed by a physician, including air conditioners, air filters, <br />humidifiers, dehumidifiers, and the repair, replacement or duplication as <br />specifically listed in this section under E.8.c. <br /> <br />15. <br /> <br />Sex change operations and reversal of elective sterilization procedures. <br /> <br />16. <br /> <br />Physical, occupational and speech therapy services not approved in advance <br />by Health Plan. <br /> <br />17. <br /> <br />As required in Section X of the Contract, Health Services not provided by <br />or under the direction of a single Coordinating Health Plan Physician or a <br />single Participating Pharmacy except in Emergency situations as provided <br />for in this section under C., "Emergency Health Services Rendered by Non- <br />Participating Providers". <br /> <br />18. <br /> <br />Health Services rendered by a provider who is a member of the Covered <br />Person's family, including spouse, brother, sister, parent, or child. <br /> <br />19. <br /> <br />Services in connection with Long-Term physica.l medicine and rehabilitative <br />services (including Long-Term physical and/or occupational therapy). <br /> <br />20. <br /> <br />Treatment for Drug Abuse and Drug Addiction (Detoxification, treatment of <br />medical complications, determination of need and referral to specialized <br />services are covered), <br /> <br />21. <br /> <br />Services <br />Rider. <br /> <br />in <br /> <br />connection <br /> <br />yith Long-Term speech therapy unless provided by <br /> <br />22. <br /> <br />Prescription Medications except as provided under E.2.b. of this section <br />or as provided in the Prescription Drug Rider. <br /> <br />23. <br /> <br />Specialty care not authorized by a Participating Primary Care Physician <br />and approved in advance by Health Plan. <br /> <br />10- <br />