Part 5 – Covered Services (continued) IMPORTANT: Refer to the Schedule of Benefits for your plan option for the cost share amounts that you must pay for covered services and for the benefit limits that may apply to specific covered services. Once you reach your benefit limit for a specific covered service, no more benefits are provided by Blue Cross Blue Shield HMO Blue for those services or supplies. WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 37 means an air ambulance that takes you to a hospital when your emergency medical condition requires that you use an air ambulance rather than a ground ambulance. If you need help, call 911. Or, call your local emergency phone number.  Other Ambulance. This includes medically necessary transport by an ambulance. For example, this may be an ambulance that is required to take you to or from the nearest hospital (or other covered health care facility) to receive care. It also includes an ambulance that is needed for a mental condition. No benefits are provided: for air ambulance transport for non-emergency medical conditions; for taxi or chair car service; to transport you to or from your medical appointments; to transport you to a non-covered provider; or for transport that is furnished solely for your convenience or for the convenience of your family or the health care provider (for example, this includes transport for the purposes of being closer to home or to have access to a health care provider for non-emergency care). Autism Spectrum Disorders Services This health plan covers medically necessary services to diagnose and treat autism spectrum disorders when the covered services are furnished by a covered provider. This may include (but is not limited to): a physician; a psychologist; or a licensed applied behavioral analyst. This coverage includes:  Assessments, evaluations (including neuropsychological evaluations), genetic testing, and/or other tests to determine if a member has an autism spectrum disorder.  Habilitative and rehabilitative care. This is care to develop, maintain, and restore, to the maximum extent practicable, the functioning of the member. This care includes, but is not limited to, applied behavior analysis that is furnished by or supervised by: a psychologist; a licensed applied behavioral analyst; or an early intervention provider.  Psychiatric and psychological care that is furnished by a covered provider such as: a physician who is a psychiatrist; or a psychologist.  Therapeutic care that is furnished by a covered provider. This may include (but is not limited to): a speech, occupational, or physical therapist; or a licensed independent clinical social worker. These covered services also include covered drugs and supplies that are furnished by a covered pharmacy when your prescription drug coverage is provided under this health plan. Your coverage for these covered services is provided to the same extent as coverage is provided for similar covered services to diagnose and treat a physical condition. When physical, speech/language, and/or occupational therapy is furnished as part of the treatment of an autism spectrum disorder, a benefit limit will not apply to these services. This coverage for autism spectrum disorders does not affect an obligation to provide services to an individual under an individualized family service plan, an individualized education program, or an individualized service plan. This means that, for services related to autism spectrum disorders, no benefits are provided for: services that are furnished by school personnel under an individualized education