Cancer Care PlusCancer and Dread Disease Insurance Financial Solutions, Treatment and Recovery THIS IS A CANCER - ONLY POLICY
According to the American Cancer Society:
- In the United States, men have about
a 1-in-2 lifetime risk of developing cancer; for women the risk is a little more
than 1-in-3.*
- Since 1990, over
18 million new cancer cases have been diagnosed.*
As advances in cancer treatment continue, more and more people will survive:
- Approximately 9.6 million Americans
with a history of cancer were alive in 2000.*
- The five-year relative
survival rate for all cancers combined is 63%.*
- The National Institutes
of Health estimated the overall costs for cancer in the year 2003 at $189.5 billion.
Although health insurance can help offset the costs of cancer treatment, you still
may have to cover deductibles and copayments on your own.
Additionally, cancer treatment can cause out-of-pocket expenses that aren’t
covered by traditional health insurance:
- Travel
- Food
- Lodging
- Long-distance calls
- Childcare
- Household help
Meanwhile, living expenses such as car payments, mortgages or rent, and utility
bills continue, whether or not you are able to work. If a family member has to stop
working to take care of you, the loss of income may be doubled. Central United Life
Insurance Company helps provide an important safety net in fighting the financial
consequences of cancer that result beyond traditional health insurance.
Central United Life pays benefits directly to you, unless assigned.
You use the cash however you decide.
* American Cancer Society
Cancer and Specified Disease Insurance Protection with optional critical
care rider available
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Plan A
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Plan B
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Plan C
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Plan D
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Cancer Screening Test
Payable for one annual cancer screening test, including but not limited to mammography
screening, pap smear (test only); CA125 (blood test for ovarian Cancer); PSA (blood
test for prostate Cancer); hemocult stool specimen; flexible sigmoidoscopy; CEA
(blood test for colon Cancer); colonoscopy; chest X-ray; thermography; or serum
protein electrophoresis. Payment based on benefit amount selected. Not payable if
received through any free-testing program or for any other cancer screening test
for which a charge is not made.
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Pays $50 per calendar year.
(MT only,
$100 per calendar year.)
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Pays your choice of $50 or $100 per calendar year.
(MT only,
$100 per calendar year.)
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Pays $100 per calendar year.
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Pays $100 per calendar year.
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First Occurrence Benefit (Rider)
Payable when a covered person is diagnosed with cancer for the first time. Payable
only once for each covered person and not payable for skin cancer. Not available
for ages 65 and above.
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Pays $1,000
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Pays $2,500
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Pays $5,000
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Pays $10,000
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Daily Hospital Confinement Benefit
Payable when a covered person is confined to the hospital for the treatment of cancer
or a dread disease. Payment is based on the daily benefit amount selected. Payable
for the first 70 days of each period of confinement.
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Pays $100
per day.
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Pays $150
per day.
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Pays $300
per day.
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Pays $150
per day.
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Surgical Benefit
Payable for surgeries performed in or out of the hospital to treat cancer or a specified
dread disease. Benefits for surgical procedures are calculated as a percentage of
the per-surgery maximum benefit amount selected.
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Pays maximum per surgery $2,500.
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Pays maximum per surgery $3,000.
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Pays maximum per surgery $4,000.
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Pays maximum per surgery $4,000.
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Radiation, Chemotherapy and Other Benefits
We will pay the actual charges for Teleradiotherapy, Radio-Active Isotopes Therapy,
Chemotherapy, Chemotherapy Enhancer Drugs, and Anti-Nausea and Immunotherapy drugs,
as indicated in the policy, for the treatment of cancer or a specified dread disease.
Benefits are based on the maximum monthly benefit amount selected. Actual Charges
means the amount(s) actually paid by or on behalf of the Covered Person and accepted
by the provider as full payment for the covered services provided. This benefit
is not payable if treatment is received in a government or charity hospital.
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Pays actual charges, maximum $2,500 per month.
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Pays actual charges, maximum $5,000 per month.
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Pays actual charges, maximum $7,500 per month.
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Pays actual charges, maximum $5,000 per month.
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The following defines the list of Dread Diseases covered under
the Policy:
• Addison’s Disease • Muscular Dystrophy • Tay-Sachs Disease
• Amyotrophic Lateral Sclerosis • Myasthenia Gravis
• Tetanus • Diphtheria • Niemann-Pick Disease • Toxic Epidermal
Necrolysis • Encephalitis • Osteomyelitis
• Toxic Shock Syndrome • Epilepsy • Poliomyelitis • Tuberculosis
• Legionnaire’s Disease • Reye’s Syndrome
• Tularemia • Lupus Erythematosus • Rheumatic Fever • Typhoid
Fever • Meningitis • Rocky Mountain Spotted Fever
• Whipple’s Disease • Multiple Sclerosis• Sickle-Cell Anemia
• Whooping Cough
Prescribed Drugs and Medicines
Actual charges for drugs and medicines prescribed while confined in a hospital.
Limited to the first 70 days for each period of confinement.
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Actual charges to a maximum of 20% of the Daily Hospital Confinement Benefit.
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Physician’s Attendance
If the regular physician visits during a confinement in the hospital.
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$50 per day
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Ambulance
For transfer of a covered person to or from a hospital for confinement as an inpatient.
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$250 per trip
3 trips per year
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Private Duty Nursing Service
When confined in a hospital and a private duty nursing service is retained.
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$150 per day
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Extended Benefits
Beginning on the 71st day of one continuous period of hospital confinement for cancer
or a dread disease. Payable in lieu of all other benefits payable for the same time
period.
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$1,000 per day
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Government or Charity Hospital
Pays a total benefit of $200 per day of treatment for outpatient Teleradiotherapy,
Radio-Active Isotopes Therapy, Chemotherapy, Chemotherapy Enhancer Drug, Anti-Nausea,
and Immunotherapy, as indicated in the policy, received in a government or charity
hospital. Paid in lieu of all other benefits except for transportation and lodging
benefits.
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$200 per day
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Extended Care Facility
Confinement must be recommended by the attending physician and begin within 14 days
of a covered hospital confinement. All days for which a Hospital Confinement benefit
is paid will be included in determining the maximum of 70 days for the Extended
Care Facility benefit.
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$100 for each day
of confinement to a
maximum of 70 days
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Hospice Care
For confinement in a hospice care center for care provided if a covered person has
diagnosed as terminally ill due to cancer or dread disease. Limited to a lifetime
maximum of 180 days for confinement in a hospice care center, or 30 days if hospice
services are provided in the covered person’s home.
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$100 per day
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Transportation and Lodging for Bone Marrow Donors
Paid for a donor who is either a covered person, or someone donating to a covered
person. When a covered person is the donor, this benefit is payable in lieu of any
other benefits payable under the policy.
• Actual charges to $2,500 for medical expenses directly relating to the services
provided to the donor during the transplant.
• Actual charges for round trip coach fare on a common carrier, or a personal
automobile allowance of 50 cents per mile if distance is more than 50 miles one-way.
Maximum 700 miles round trip.
• Actual charges to $75 per day for lodging and meal expenses incurred by the
donor.
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*Transportation for Non-Local Treatment Which Requires Hospital
Confinement
Actual charges for round trip coach fare, or a personal automobile allowance of
50 cents per mile if the distance is more than 50 miles one-way. Maximum 700 miles
round trip.
Prescribed treatment must not be available locally and must require hospital confinement.
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*Transportation and Lodging for Non-Local Treatment Which Does
Not Require Hospital Confinement
• Actual charges for round trip coach fare, or a personal automobile allowance
of 50 cents per mile if the distance is more than 50 miles one way, maximum 700
miles round trip. Maximum of $1,500 per calendar year.
• Actual charges to $50 per day for lodging and meal expenses. Payable only
for the days you receive treatment for cancer or dread disease for which a benefit
is payable.
Prescribed treatment must not be available locally and must not require hospital
confinement.
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*Adult Companion Transportation and Lodging
Payable only for an adult companion residing and traveling within the continental
United States.
• Actual charges for one adult companion to be near a covered person who is
hospital confined in a non-local hospital for covered treatments. Maximum $2,500
per confinement.
• Actual charges to $50 per day for lodging and meal expenses incurred. Limited
to the number of days of the covered person’s hospitalization.
• Actual charges of one round trip coach fare, or a personal automobile allowance
of 50 cents per mile, if the distance is more than 50 miles one way. Maximum 700
miles round trip.
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*Not payable for periodic checkups, cancer screening tests, or for treatments, services,
or procedures for which a benefit is not payable under this policy
Anesthesia
Pays for the procedure in which anesthesia is used. We will pay $50 for the administration
of anesthesia for each skin cancer operation.
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Pays 25% of the surgical benefit amount paid
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Additional Surgical Opinions
Pays for a second and third surgical opinion if the surgical opinions differ.
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$200 each opinion
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Artificial Limb and Prosthesis
Pays per prosthetic device or artificial limb and the
reconstructive procedure to affix or implant it. Benefits limited to only two of
the same type of prosthetic device or artificial limb. Not payable if a breast reconstruction
and breast prosthesis benefit is payable.
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Actual charges to $1,500
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Outpatient Surgery Benefit
Payable for outpatient surgery in a hospital or ambulatory
surgical center. Not payable for surgery in a physician’s office or clinic,
or for skin cancer treatment.
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Pays $375 per operations for drugs, medicines and lab tests.
Pays maximum of 150% of surgery shown in surgical benefits schedule.
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Skin Cancer
• If the diagnosis is made by a physician other than a pathologist, $150 for
removal of skin cancer to a maximum of $600 per calendar year.
• If the diagnosis is made by a pathologist, actual charges to the maximum
amount for such surgery shown in the surgical benefits schedule.
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Pays $150 per calendar year.
Maximum benefit $600.
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Breast Reconstruction/Breast Prosthesis
Actual Charges incurred for reconstructive surgery, and an external or internal
breast prosthesis and the surgeon’s fee for implantation following a mastectomy.
Lifetime maximum of $5,000. This benefit is in lieu of the surgical benefit provided
in this policy.
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Pays actual charges, lifetime maximum of $5,000.
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Bone Marrow Transplant for Cancer
Actual charges incurred for bone marrow transplants or other forms of stem cell
rescue and all related services and supplies. Lifetime maximum of $10,000. This
benefit is in lieu of any other benefit associated with the treatment, service,
or procedure underlying Bone Marrow Transplant, with the exception of the Transportation
and Lodging for Bone Marrow Donors benefit.
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Pays actual charges, lifetime maximum of $10,000.
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Experimental Treatment
Treatment must be received in the United States or its territories. This benefit
is in lieu of all other benefits payable for the treatment of cancer or dread disease.
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Pays actual charges, to a lifetime maximum of $10,000.
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Physical, Occupational or Speech Therapy
$50 for each 60-minute session for Physical, Occupational or Speech Therapy.
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$50 each session.
Lifetime maximum of $1,500.
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Outpatient Positive Diagnosis Test
For a diagnostic test that leads to a positive diagnosis within 90 days of such
test. Payable once per diagnosis.
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$250 for a diagnostic test
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Blood and Blood Plasma
For blood, blood plasma and platelets inserted into a covered person. Not payable
for blood which is donated or replaced.
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Pays actual charges, to a maximum of $5,000 per calendar year.
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Home Health Care Services
Payable when services are provided by a licensed home health care agency.
Benefit paid in lieu of all other policy benefits. Must be prescribed by a physician
and cannot be provided by a relative.
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Pays $60 per day at home services, 180 days max per calendar year.
Pays $150 per day at home private duty nursing, 15 days max per calendar year.
Pays $50 per day at home physician visits, 15 days max per calendar year.
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Hairpiece Benefit
One-time benefit for a hairpiece when hair loss is the result of cancer treatment.
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Pays $100
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Rental or Purchase of Durable Medical Equipment
For the rental or purchase of a respirator or similar
mechanical device; brace; crutches; hospital bed; or a wheel chair.
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Pays actual charges, maximum $1,000 per calendar year.
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Professional Mental Health Consultation
For a consultation with a licensed mental health professional when receiving treatment
for cancer or a dread disease. The licensed mental health professional may not be
a relative.
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$50 per session.
Lifetime maximum of $250.
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Tutor
Tutor session for an insured child under age 19, when the child is receiving treatment
for cancer or a dread disease.
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$25 per 60-minute.
Lifetime maximum of
50 sessions.
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Mammography Benefit
In MT only, pays actual charges for a mammography screening administered to a Covered
Person according to the schedule listed in the policy.
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Pays actual charges to a maximum of $70.
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Available at additional cost
Intensive Care Unit Rider -(Form Number ICUR
4000)
Benefits Reduce to ½ at age 70.
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Benefit for Intensive Care Unit.
If a Covered Person is confined in an Intensive Care Unit of a Hospital, we will
pay the ICU Daily Benefit Amount for each day of such confinement, not to exceed
30 days during any one period of confinement.
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Pays $600 per day
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Benefit for Step-Down Unit.
If a Covered Person is confined in a Step-Down Unit of a Hospital, we will pay for
each day of such confinement, not to exceed 30 days during any one period of confinement.
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Pays $300 per day
step down unit
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Critical Care Benefit Rider - (Form Number CCBR 4000)
Benefit for Heart Disease
A Heart Disease benefit will be paid for the actual charges incurred by a Covered
Person for the following due to Heart Disease: 1. pacemaker insertion; 2. angioplasty;
and 3. heart catheterization. This benefit is limited to a lifetime maximum.
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Pays Actual charges to lifetime max $2,500
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Benefit for Heart Attack/Stroke
A Heart Attack/Stroke benefit will be paid for the actual charges incurred by a
Covered Person.
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Pays Actual charges to lifetime max $5,000
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ELIGIBILITY - You and your covered spouse must
be ages 18 through 69 to apply for coverage. Unmarried, dependent children under
the age of 21 (in NM and TX, age 25 regardless of student status) may be covered.
Unmarried children under the age of 25 may also be covered if enrolled as a full-time
student in an accredited college or university, or marriage, whichever occurs first.
When the child reaches the limiting age, the child may “convert” to
an individual policy without evidence of insurability, subject to the “Conversion”
provision in the base policy.
LIMITATIONS 30-Day Waiting Period. If a
Covered Person has a Positive Diagnosis for Cancer or a Dread Disease during the
first thirty days after the Effective Date of this Policy, coverage for such Cancer
or Dread Disease will only apply to loss commencing after two years (in NH, six
months; in NC, twelve months) from the Effective Date of this Policy; or, at Your
option, You may elect to void this Policy from the beginning and receive a full
refund of premium. In AZ and MO, we will pay a reduced benefit of $40 for loss covered
by or resulting from such Positive Diagnosis during the first two years from the
Effective Date of this Policy; in MN, we will pay a reduced benefit of $40 for loss
covered by or resulting from any Cancer or Dread Disease during the first two years
from the Effective Date of this Policy.
WAIVER OF PREMIUM -If the Named Insured becomes
Totally Disabled for 60 days as a result of a Positive Diagnosis of Cancer or a
Dread Disease while this Policy is in force, We will waive the premiums that fall
due while he or she is Totally Disabled. The Total Disability must begin before
the policy anniversary following that person’s attainment of age 60. To be
eligible for this benefit, premiums must continue to be paid for 60 days after the
commencement of Total Disability. Upon approval of this benefit, waiver of premiums
will begin on the premium due date next following 60 days of continuous Total Disability.
This provision does not apply to Total Disability of the Insured Spouse or Insured
Child(ren).
GUARANTEED RENEWABLE FOR LIFE - Your policy
cannot be cancelled regardless of changes in health, the number of times benefits
are received or advancing age. The only way the policy can be cancelled is for failure
to pay premiums. The Company reserves the right to change the rates on all policies
of this class in the entire state.
10 DAY RIGHT TO EXAMINE POLICY - You have ten
(10) days to examine the policy. If you are not satisfied, you may return it to
us and have your premiums refunded.
EXCLUSIONS - Subject to the Time Limit on Certain
Defenses provision, We will not pay benefits for: 1.
Anything caused by or resulting from Injury;
2. Anything other than Cancer or a Dread Disease;
3. any sickness, illness, bodily infirmity or
incapacity that has been caused, complicated, worsened, or affected by Cancer or
a Dread Disease or as a result of Cancer or a Dread Disease treatment including
side effects from Cancer or a Dread Disease treatment except as specifically covered;
4. anything due to Cancer or a Dread Disease
for which a Positive Diagnosis was made, or treatment was received, (in NE, five
years; in NC, twelve months) prior to the Effective Date. In NC, a Pre-Existing
Condition for Insured Persons age 65 or older shall include only conditions excluded
by rider. In MT, any Cancer or Dread Disease during the first twelve months following
the Effective Date due to Cancer or a Dread Disease for which a Positive Diagnosis
was made, or treatment was received, 3 years prior to the Effective Date will not
be covered;
5. anything for which no charge was incurred
by the Covered Person (except as expressly provided herein);
6. (except in WI) any treatment, procedure,
or service which is not grounded in current, generally accepted medical practices,
except as specifically provided in the Experimental Treatment benefit or Bone Marrow
Transplant benefit (benefits for Experimental Treatment are limited to a lifetime
maximum of $10,000 and benefits for Bone Marrow Transplants are limited to a lifetime
maximum of $10,000);
7. any care and/or treatment received outside
the U.S. or its territories unless the Covered Person has traveled outside the United
States and/or its territories and treatment is received due to an Emergency Situation;
8.< (except in MO) any care, confinement and/or
treatment in a government or charity hospital except as specifically provided in
the Government or Charity Hospital benefit;
9. (except in AZ, MN, MO and MT) any Cancer
or Dread Disease during the first two years (in NH, six months; in NC, twelve months)
following the Effective Date in connection with a loss that was incurred during
the Waiting Period; 10. planning, clinical treatment
planning, clinical treatment management, medical radiation physics, dosimetry, blocks,
molds, treatment devices, special services, and similar services ancillary or related
to Teleradiotherapy or Radio-Active Isotopes Therapy; 11.side-effect
medications or treatments, supplies, saline or similar fluids, administration charges,
and other services or treatments ancillary or related to Chemotherapy (except as
expressly provided in the Chemotherapy Enhancer Drug benefit and Anti-Nausea benefit
provisions); or 12. side-effect medications
or treatments, supplies, saline or similar fluids, administration charges, and other
services or treatments ancillary or related to Chemotherapy Enhancer Drug, Anti-Nausea
medication, or Immunotherapy.
In MD, we will not pay any benefits otherwise covered under this Policy that are
in connection with or resulting from a Prohibited Referral.
We will reimburse you for the actual charges for the services provided. Actual charges
are the amounts paid by you or on your behalf and accepted by the provider for the
services provided.
The following limitations apply to the Critical Care Benefit
Rider and Intensive Care Unit Rider:
LIMITATIONS - Pre-Existing Conditions. These Riders
do not provide benefits for loss or losses due to Pre-Existing Conditions that are
incurred during the 12 months (in NM, 6 months) immediately prior to the Rider Date.
In addition, a loss caused by a Pre-Existing Condition will not be covered if: 1. (except in MD) the Pre-Existing
Condition was revealed in the application; or 2.
we have specifically excluded the Pre-Existing Condition by name or specific description.
However, a claim for a Pre-Existing Condition incurred after 2 years (in NM, 6 months;
in CA, 12 months) from the date these Riders become effective will be covered, unless
that condition is excluded by name or specific description effective on the date
of loss.
The benefits as specified in these Riders are payable in addition to all other indemnities
set forth in the Policy and/or attached Riders, if any.
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