DESCRIPTION OF BENEFIT

• Daily Hospital Confinement Benefit: Pays $500 for each day a covered person is confined to a hospital due to covered injury or sickness up to a maximum of 30 days per injury or sickness. Program works for your entire family.
   

• Again, the reimbursements will be paid to you no matter what hospital you choose. If you select a participating hospital, you will also have access to the hospital's contracted reduced rates. This will help you get the best value for your healthcare dollar.

Eligibility and Effective Dates: This insured benefit is effective on the first day of the month following the date your completed application for Membership is received and processed. Coverage for Legal Dependents you acquire after your coverage is effective will be effective on the date that your application for the additional dependent is approved except that coverage for adopted children, newborn children, foster children and children in your custody by a court order is effective for 31 days from the date of birth, date of adoption or placement. To continue coverage beyond 31 days for these children, you must provide notice of such children. For purposes of this benefit: an otherwise Legal Dependent child must also reside in your home for more than 6 months a year and chiefly rely on you for support and maintenance to be covered; and legal dependent includes a child past the age of 19 (25 if a full time student) who has a handicapped condition which renders the child incapable of self-sustaining employment and who is chiefly dependent on you or other care providers for lifetime care and supervision because of a handicapped condition that occurred before such age.

Pre-existing Conditions Limitation: Benefits are not provided for any loss caused by or resulting from a Pre-existing Condition until the earlier of: (1) the end of a continuous period of 12 months commencing on or after the covered person's effective date of coverage under this plan during all of which the covered person has received no medical advice or treatment in connection with such Pre-existing Condition; or (2) the end of an 18 month period commencing on the covered person's effective date of coverage under this plan. This provision does not apply to newborn or newly adopted children. Pre-existing Condition means a medical condition, injury or sickness, not excluded by name or specific description, for which medical advice, consultation, care diagnosis or treatment was recommended by, or received from, a doctor within 12 months immediately prior to the effective date of coverage for a covered person.

Exclusions and Limitations: Benefits will not be paid for charges or loss caused by, or resulting from, any of the following: suicide or any intentionally self-inflicted injury; any drug, narcotic, gas or fumes, or chemical substance voluntarily taken, administered, absorbed or inhaled unless prescribed by, and taken according to the directions of, a doctor (accidental ingestion of a poisonous substance is not excluded.); commission, or attempt to commit, a felony; participation in a riot or insurrection; driving under the influence of a controlled substance, unless administered on the advice of a doctor; driving while intoxicated as determined by the laws in the jurisdiction of the geographical area where the loss occurs; declared or undeclared war or act of war; nuclear reaction or the release of nuclear energy. However, this exclusion will not apply if the loss is sustained within 180 days of the initial incident and: the loss was caused by fire, heat, explosion or other physical trauma which was a result of the release of nuclear energy; and the covered person was within a 25-mile radius of the site of the release either: at the time of the release; or within 24-hours of the start of the release; or occurs while he is in the state where this plan was issued; or treatment of mental or nervous disorders, or alcohol or substance abuse.