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What Is Not Covered (Bridge plan Policy Exclusions)


(1) Any expense which You are not legally obligated to pay.

(2) Services which are not Medically Necessary or are not furnished by and under supervision of a Physician.

(3) Expenses for services and supplies for which You are entitled to benefits, services or reimbursement through the Veterans' Administration, Workers' Compensation insurance, any private health plan or from any other source except Medicaid.

(4) Expenses in excess of UCR.

(5) Intentional self-inflicted injuries while sane or insane.

(6) Treatment for alcoholism, drug addiction, allergies, and/or Mental or Nervous Disorders and all related symptoms and side effects.

(7) Rest cures, quarantine or isolation.

(8) Cosmetic surgery unless necessitated by an accidental Injury.

(9) Dental exams, dental x-rays and general dental care except as a result of an accidental Injury.

(10) Eye glasses or eye examinations.

(11) Hearing aids or hearing examinations.

(12) General or routine examinations.

(13) Injuries sustained from participation in Hazardous Sports and Activities.

(14) Injuries or Sicknesses due to War or any act of War whether declared or undeclared.

(15) Injuries or Sicknesses due to Terrorism or Act of Terrorism whether declared or undeclared.

(16) Injuries or Sicknesses due to an Act of Terrorism involving the use or release of any nuclear weapon or device or chemical or biological agent, regardless of any contributory cause(s).

(17) Injuries or Sicknesses sustained while committing a criminal or felonious act.

(18) Expenses incurred for or resulting from pain which is not supported by medical diagnosis.

(19) Outpatient drugs.

(20) Any elective surgery, including but not limited to complications of previous elective or cosmetic surgeries.

(21) Custodial Care.

(22) Expenses for supplies and services incurred outside of United States boundaries.

(23) Pre-existing conditions.

(24) Racing of any kind, all professional or semi-professional sports, and collegiate, sponsored, or interscholastic athletics.


Plan features listed here are high level, provided for your convenience and information purpose only. Please review the Evidence of Coverage and Plan Contract (Policy) for a detailed description of Coverage Benefits, Limitations and Exclusions. Must read the Policy Brochure and Plan Details for complete and accurate details. Only the Terms and Conditions of Coverage Benefits listed in the policy are binding.