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1.
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Plastic/Cosmetic surgery, circumcision, eye examination, glasses and refraction
or surgical correction of nearsightedness (Radial Keratotomy or Lasik) and the use
or acquisition of external prosthetic appliances or devices such as artificial limbs,
hearing aids, aero chambers, equipment from nebulising, implanted pacemakers and
prescriptions thereof.
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2.
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Dental conditions including dental treatment or oral surgery except as necessitated
by Accidental Injuries to sound natural teeth occurring wholly during the Period
of Insurance.
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3.
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Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilization,
venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or
ARC (AIDS Related Complex) and HIV related diseases, and any communicable diseases
required quarantine by law.
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4.
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Any treatment or surgical operations for congenital abnormalities of deformities
including hereditary conditions.
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5.
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Pregnancy, child birth (including surgical delivery), miscarriage, abortion, prenatal
or postnatal care and surgical, mechanical or chemical contraceptive methods of
birth control or treatment pertaining to infertility. Erectile dysfunction and tests
or treatment related to impotence or sterilization.
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6.
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Consultation primarily for investigatory purposes, diagnosis, x-ray examination,
general physical or medical examinations, not incidental to treatment or diagnosis
of a covered Disability or any treatment which is not medically necessary and any
preventive treatments, preventive medicines or examinations carried out by a Physician,
and treatments specifically for weight reduction or gain.
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7.
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Suicide, attempted suicide or intentionally self-inflicted injury while sane or
insane.
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8.
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War or any act of war, declared or undeclared, criminal or terrorist activities,
active duty in any armed forces, direct participation in strikes, riots and civil
commotion or insurrection.
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9.
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Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear
waste from process of nuclear fission or from any nuclear weapons material.
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10. |
Investigation and treatment of sleep and snoring disorders, hormone replacement
therapy and alternative therapy such as treatment, medical services or supplies,
including but not limited to chiropractic services, acupuncture, acupressure, reflexology,
bonesetting, herbalist treatment, massage or aroma therapy or other alternative
treatment.
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11.
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Care or treatment for which payment is not required or to the extent which is payable
by any other insurance or indemnity covering the Insured Person and Disabilities
arising out of duties of employment or profession that is covered under a Workman’s
Compensation Insurance Contract.
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12. |
Psychotic, mental or nervous disorders, (including any neuroses and their physiological
or psychosomatic manifestations.)
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13.
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Sickness or Injury arising from racing of any kind (except foot racing), hazardous
sports such as but not limited to skydiving, water skiing, underwater activities
requiring breathing apparatus, winter sports, professional sports and illegal activities.
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14.
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Private flying other than as a fare-paying passenger in any commercial scheduled
airlines licensed to carry passengers over established routes.
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15.
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Long term medications for the following conditions are excluded: Arthritis, Asthma,
High Blood Pressure, Coronary Artery Disease, Cerebrovascular Disease, Cerebrovascular
Accident, Diabetes Mellitus, Epilepsy, Gout, Hyperlipidemia, Parkinson, Peptic Ulcer,
Psoriasis and Thyroid.
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16.
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Personal comfort and convenience items (e.g. soaps, shampoos, vitamin creams and
vitamin ointment) or services and similar incidental services and supplies, durable
medical equipment including supplement medication even though prescribed by a physician.
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17. |
Upper and lower jaw bone surgery (including that related to the temporomandibular
joint) except for direct treatment of acute traumatic injury or cancer. Orthognathic
surgery, jaw alignment, or treatment for the temporomandibular joint.
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18.
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Services and supplies for smoking cessation programs and the treatment of nicotine
addiction.
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19. |
Services rendered by a provider with the same legal residence as an Insured Person
or who is a member of a Insured Person’s family, including spouse, brother,
sister, parent or child.
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20. |
Education services such as speech improvement, diabetic classes and nutritional
services, or group support services, unless authorized by the Company.
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21. |
Out-Patient prescribed or non-prescribed medical supplies including elastic stockings,
ace bandages, gauze, syringes, diabetic test strips, and like products; over the
counter drugs and treatments.
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22. |
Any preventive vaccination or childhood immunization (unless specifically included
in the Schedule of Benefit).
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23.
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Topical skin testing at GP Clinic.
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24. |
General screening profiles at a GP clinic (unless specifically included in the Schedule
of Benefit).
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25. |
Growth hormone therapy.
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26.
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Out-Patient physical therapy, physiotherapy and/or rehabilitation therapy is not
covered and cannot be referred at general practitioner level. This service would
only be covered when referred by a specialist and treatment must be provided by
a registered physiotherapist. (applicable if specialist care is covered).
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