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Membership Guide 2008

3. What is not covered?

Important - please read

Personal exclusions

- please check your Membership Certificate to see if you have any personal exclusions or restrictions on your plan. The exclusions in this section apply in addition to and alongside any such personal exclusions and restrictions.

General note for all exclusions

For all exclusions in this section, and for any personal exclusions or restrictions shown on your Membership Certificate, please note that:

1. We do not pay for conditions which are directly related to excluded conditions or treatments.

2. We do not pay for any additional or increased costs arising from excluded conditions or treatments.

3. We do not pay for complications arising from excluded conditions or  treatments.

Example:
You have a personal exclusion for diabetes.

1. If your diabetes were to cause glaucoma, we would not pay for treatment for the glaucoma.
 
2. If while receiving treatment for another condition, you need to stay extra days in hospital because of your diabetes, we would not pay for thee extra days.
 
3. If complications arise from excluded treatment such as cosmetic or laser eye surgery, we will not pay to treat these complications.
 
Exceptions.
- this section describes some circumstances where exceptions can be made to exclusions or restrictions. Where this is the case, benefit is payable only up to the limits set out in your Table of benefits in Section 2.