The following charges, treatments, care, services, supplies and/or conditions are excluded from coverage:

War, Terrorism, Biological, Chemical, Radioactive, Nuclear: Notwithstanding any provision to the contrary within this insurance or any endorsement or rider attached hereto, it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss, damage, cost or expense:
A. war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or
B. any act of terrorism. For the purpose of this insurance, an “act of terrorism” means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s) committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear; or
C. the use of any biological, chemical, radioactive or nuclear agent, material, device or weapon. However, this exclusion (C) shall not apply where the Insured Person is exposed to nuclear radioactive and/or radioactive material for the purpose of medical treatment.
This insurance also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to (A), (B) or (C) above. If Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance, the burden of proving the contrary shall be upon the Insured Person.
In the event any portion of this exclusion is found to be invalid or unenforceable, the remainder shall remain in full force and effect. The following charges, treatments, care, services, supplies and/or conditions are excluded from coverage hereunder:

1. Pre-existing Conditions – Charges resulting directly or indirectly from any Preexisting Condition, defined as a Condition (whether physical or mental, and regardless of the cause of the condition) for which medical advice, diagnosis, care or treatment was recommended or received during the 6 month period ending on the Enrollment Date, are excluded from this insurance until the earlier of the following dates:
• 365 days beginning on the Enrollment Date; or
• The date that the number of days beginning on the Enrollment Date, when added to the number of days of Creditable Coverage beginning on the first day following any Significant Break in Creditable Coverage and ending on the Enrollment Date applicable to the individual, exceeds 365 days; or
• With respect to individuals who are covered under this insurance as Late Enrollees, the date that the number of days beginning on the Enrollment Date, when added to the number of days of Creditable Coverage beginning on the first day following any Significant Break in Creditable Coverage and ending on the Enrollment Date applicable to the individual, exceeds 546 days.
2. Maternity and Newborn Care: Charges for pre-natal care, delivery, post-natal care, and care of Newborns, are excluded from this insurance until the Insured Person has maintained coverage hereunder continuously for 10 months; and
3. Charges for routine and Medically Necessary care of Newborns are excluded unless the Delivery of the Newborn is covered hereunder; and
4. Mental Health Disorders: Charges for treatment of Mental Health Disorders are excluded from this insurance; and
5. Wellness: Charges for Routine Physical Exams are excluded from this insurance; and
6. Charges which are not incurred by an Insured Person while insured hereunder; and
7. Charges for any benefit hereunder which are not presented to Underwriters for payment within 90 days of the date incurred (or as soon as is reasonably possible); and
8. Treatment, services or supplies which are not administered or ordered by a Physician; and
9. Treatment, services or supplies which are not Medically Necessary; and
10. Treatment, services or supplies provided at no cost to the Insured Person; and
11. Charges which exceed Usual, Reasonable and Customary; and
12. Telephone consultations or failure to keep a scheduled appointment; and
13. Surgeries, treatments, services or supplies which are Investigational, Experimental or for Research Purposes; and
14. While confined primarily to receive Custodial Care, Educational or Rehabilitative Care; and
15. Weight modification or surgical treatment of obesity, including wiring of the teeth and all forms of intestinal bypass Surgery; and
16. Modifications of the physical body in order to improve the psychological, mental or emotional well-being of the Insured Person such as sex-change Surgery; and
17. Surgeries, treatments, services or supplies for cosmetic or aesthetic reasons, except for reconstructive Surgery when such Surgery is directly related to and follows a Surgery which was covered hereunder; and
18. Treatment of Insured Persons who were HIV+ at their initial Effective Date of Coverage, whether or not the Insured Person had knowledge of his/her HIV status; and
19. Outpatient Prescription Drugs; and
20. Any drug, treatment or procedure that either promotes or prevents conception including but not limited to: artificial insemination, treatment for infertility or impotency, sterilization or reversal of sterilization; and
21. Any drug, treatment or procedure that either promotes, enhances or corrects impotency or sexual dysfunction; and
22. Willful and/or therapeutic termination of Pregnancy; and
23. Dental Treatment, except for Emergency Dental Treatment necessary to replace sound natural teeth lost or damaged in an Accident covered hereunder; and
24. Eyeglasses, contact lenses, hearing aids, hearing implants, eye refraction, visual therapy, or for any examination or fitting related to these devices; and
25. Eye surgery, such as radial keratotomy, when the primary purpose is to correct nearsightedness, farsightedness or astigmatism; and
26. Treatment of the temporomandibular joint; and
27. Routine care of Newborns after the first 31 days of life; and
28. Injury resulting from participation in the following activities:
    • Amateur Athletics, Contact Sports, and professional sports or athletic activities. Non-contact and non-organized/non-sanctioned amateur sports or athletic activities engaged in by the Insured Person solely for leisure, recreational, entertainment or fitness purposes are not excluded unless they are excluded by (b) through (j) of this provision; and
    • mountaineering where ropes or guides are normally used or at elevations of 4,500 meters or higher; and
    • aviation (except when traveling solely as a passenger in a commercial aircraft); and
    • hang gliding, sky diving, parachuting or bungee jumping; and
    • snow skiing or snowboarding, except for recreational downhill and/or cross country snow skiing or snowboarding (no cover provided whilst skiing away from prepared and marked in-bound territories and/or against the advice of the local ski school or local authoritative body); and
    • racing by any animal or motorized vehicle; and
    • spelunking; and
    • subaqua pursuits involving underwater breathing apparatus unless PADI/NAUI certified, accompanied by a certified instructor, and at depths of less than 10 meters; and
    • jet skiing; and
    • any other sport or athletic activity which is undertaken for thrill seeking and exposes the Insured Person to abnormal or extraordinary risk of Injury.
29. Injury sustained while under the influence of or due wholly or partly to the effects of intoxicating substances or drugs except drugs taken in accordance with Physician-prescribed treatment for eligible conditions; and
30. Willfully self-inflicted Injury or Illness; and
31. Voluntary testing for the following: HIV, seropositivity to the AIDS virus, AIDS related illnesses, ARC Syndrome, AIDS; and
32. Immunizations and Routine Physical Exams except for Newborns under the age of 31 days; and
33. Treatment by a chiropractor unless ordered in advance by a Physician; and
34. Charges resulting from or occurring during the commission of a violation of law by the Insured Person, including without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations; and
35. Treatment of Substance Abuse; and
36. Speech, vocational, occupational, biofeedback, acupuncture, recreational, sleep or music therapy; and
37. Any services or supplies performed or provided by a Relative of the Insured Person or any family Insured Person of the Insured Person or any person who ordinarily resides with the Insured Person; and
38. Orthoptics and visual eye training; and
39. Services or supplies which are not included as Eligible Expenses as described herein; and
40. The following care, treatment or supplies for the feet: orthopedic shoes, orthopedic prescription devices to be attached to or placed in shoes, treatment of weak, strained, flat, unstable or unbalanced feet, metatarsalgia or bunions, and treatment of corns, calluses or toenails; and
41. Care and treatment for hair loss including wigs, hair transplants or any drug that promises hair growth, whether or not prescribed by a Physician; and
42. Treatment of sleep disorders; and
43. Exercise programs, whether or not prescribed or recommended by a Physician; and
44. Treatment required as a result of complications or consequences of a treatment or condition not covered hereunder; and
45. Charges for travel or accommodations, except as provided for in the Local Ambulance and Transplant sections of this insurance; and
46. Treatment incurred as a result of exposure to non-medical nuclear radiation and/or radioactive material(s); and
47. Human Organ or Tissue Transplants or related services, except for Covered Transplants; and
48. Artificial or mechanical devices designed to replace human organs temporarily or permanently; and
49. Expenses to keep a donor alive for a transplant procedure, whether or not the transplant procedure is a Covered Transplant; and
50. Transplant benefits for more than one Covered Transplant during any 12 month period, except re-transplantation if during initial transplant procedure.
51. Charges for use of Emergency Room for treatment of an Illness unless the Insured Person is directly admitted to the Hospital as Inpatient for further treatment of that Illness or is located outside the United States at time of emergency treatment.

This is a summary of exclusions. For more details, or for a complete copy of the Master Policy, contact HCC Medical Insurance Services