General Exclusions and Limitations

Health and Dental Benefits will not be payable for charges in connection with the following:

  • Convalescent, custodial or rehabilitation services.
  • Services/supplies normally provided without cost or at nominal cost by the government health plan, or any plan or arrangement.
  • Participation in an insurrection, war, or hostile action.
  • Committing or attempting to commit a criminal act.
  • Self-inflicted injuries, suicide, or attempted suicide.
  • Cosmetic services or experimental procedures.
  • Conditions not detrimental to one’s health.
  • Missed appointments or completion of claim forms.
  • Replacement of lost or stolen prosthetic devices.