Collegiate Care Silver

Plan Detail

Plan Administrator: Trawick International | AM Best Rating: A "Excellent" | Underwriter: GBG Insurance Limited

Exclusions


PRE-EXISTING CONDITIONS

The “Pre-existing Condition Waiting Period” is 6 months. If you receive treatment or service for a Pre-Existing Condition: a) No benefits will be paid for such condition until the day after a 6 consecutive month period has passed from your effective date; and b) The plan will pay only for Covered Expenses incurred after such 6 consecutive month period.

No benefits will be paid for loss or expense caused by or resulting from:
  1. Suicide, attempted suicide (including drug overdose) self-destruction, attempted self- destruction or intentional self-inflicted Injury while sane or insane;
  2. War or any act of war, declared or undeclared;
  3. Injury sustained while in the service of the armed forces of any country;
  4. Voluntary, active participation in a riot or insurrection;
  5. Medical expenses resulting from a motor vehicle accident in excess of that which is payable under any other valid and collectible insurance;
  6. Treatment for an Injury or Sickness resulting from the Covered Person’s intoxication or use of illegal drugs or any drugs or medication that is intentionally not taken in the dosage recommended by the manufacturer or for the purpose prescribed by the Covered Person’s Physician;
  7. Commission or attempt to commit an assault or felony, or that occurs while being engaged in an illegal occupation;
  8. Eligible Expenses for which the Covered Person would not be responsible in the absence of the Policy;
  9. Treatment of acne;
  10. Charges which are in excess of Usual, Reasonable and Customary charges;
  11. Charges that are incurred outside of the Period of Insurance either prior to coverage commencing after coverage has terminated;
  12. Charges that are not Medically Necessary; charges provided at no cost to the Covered Person;
  13. Expenses incurred for treatment while in Your Home Country which exceed 30 days or $1000;
  14. Expenses incurred for an Accident or Sickness after the termination date of coverage;
  15. Regular health checkups, routine physical, immunizations or other examination where there are no objective indications or impairment in normal health;
  16. Injuries paid under Workers’ Compensation, Employer’s liability laws or similar occupational benefits or while engaging in an occupation for monetary gain from sources;
  17. Pre-existing conditions; however a Pre-Existing condition will be covered after the Covered Person has been continuously insured for 6 months under the same insurance plan;
  18. Unless covered herein, Pregnancy or childbirth, elective abortion, or any complications of any of these conditions;
  19. Dental care or treatment other than care, of sound Natural Teeth and gums, required for Injury resulting from an Accident while covered under the Policy, and rendered within 6 months of the Accident;
  20. Eyeglasses, contact lenses, hearing aids braces, appliances, or examinations or prescriptions therefore;
  21. Travel in or upon a snowmobile, a water jet ski, any two or three wheeled motor vehicle, other than a motorcycle registered for on-road travel, or any off road motorized vehicle not requiring licensing as a motor vehicle;
  22. Injury sustained while taking part in: mountaineering; hang gliding; parachuting; bungee jumping; racing by horse, motor vehicle or motorcycle; snowmobiling; motorcycle/motor scooter riding; scuba diving, involving underwater breathing apparatus; snorkeling; water skiing; snow skiing; spelunking; parasailing; white water rafting; surfing, and snowboarding; or other hazardous activities as determined by the insurance company;
  23. Practice or play in any amateur, club, intramural, interscholastic, intercollegiate, professional or semiprofessional sports, contest or competition;
  24. Rest cures or custodial care;
  25. Elective or Cosmetic surgery and Elective Treatment or treatment for congenital anomalies (except as specifically provided), except for reconstructive surgery on a diseased or injured part of the body. Correction of a deviated nasal septum is considered Cosmetic Surgery unless it results from a covered Injury or Sickness.