$0 copay for aminimum of 4hours per 
day, up to amaximum of 80 hours per 
year for certain in-home support 
services to assist individuals with 
disabilities and/or medical conditions in 
performing activities of daily living 
(ADLs) and Instrumental Activities of 
Daily living (IADLs) within the home by a 
qualified aide. Amember must be 
receiving assistance with aminimum of 
one ADL to receive assistance with any 
IADL. 
Authorization may be required. Contact 
the plan for details.