Description / Exclusions / Application

The HCC Life Short Term Medical Plan does not cover:

• Expenses during the first 6 months after the effective date for (subject to all other coverage provisions, including the pre-existing condition limitation): a. Total or partial hysterectomy, unless it is medically necessary due to a diagnosis of carcinoma; b. Tonsillectomy; c. Adenoidectomy; d. Repair of deviated nasal septum or any type of surgery involving the sinus; e. Myringotomy; f. Tympanotomy; g. Herniorraphy; or h. Cholecystectomy
• Services related to pregnancy, except for complications of pregnancy, or conception
• Weight modification, cosmetic surgery, and treatment of varicose veins
• Dental, vision and hearing exams and treatment
• Routine physical exams, preventative care, and immunizations
• Substance abuse and alcoholism
• Speech, occupational, and sleep therapy as well as acupuncture and holistic care of any nature
• Organ or tissue transplants
• Spinal manipulation or adjustment
• Chronic fatigue or pain disorders
• Allergies, except for emergency treatment of allergic reactions
• Treatment of joints, spine, bones or connective tissue, unless related to a covered injury
• Over-the-counter medications and outpatient prescription drugs
• Charges that are not incurred during the coverage period
• Experimental or investigational services
• Services that are not medically necessary or which exceed usual and customary charges

Pre-existing Conditions

Charges resulting directly or indirectly from a condition for which you received medical treatment, diagnosis, care or advice within the 60 months immediately preceding your effective date are excluded. This exclusion does not apply to a newborn or newly adopted child who is added to coverage.

Waiting Period

If coverage was purchased within 3 days of the effective date, then in respect to sickness, you will only be entitled to receive benefits for sicknesses that begin, by occurrence of symptoms and/or receipt of treatment, at least 72 hours following the effective date.

This is a partial list of exclusions and limitations. Please see the Certificate of Insurance for detailed information about these and other plan exclusions and limitations. Benefits, provisions, limitations and exclusions may vary by state.