The Consumer’s Choice/USA™ Medical Benefits (First-dollar Hospital Indemnity Benefit, Outpatient Physician Office Visit Benefit and other Outpatient Care and Surgical Care Benefits – underwritten by Companion Life Insurance Company) include the following exclusions and limitations:

With respect to all of the benefits provided under the Policy, no benefits will be payable as the result of:

1. suicide or any attempt thereat, while sane;
2. any intentionally self-inflicted injury or Sickness;
3. rest care or rehabilitative care and treatment;
4. cosmetic surgery or care or treatment solely for cosmetic purposes, or complications therefrom. This exclusion does not apply to cosmetic surgery resulting from a covered Accident if initial treatment of the Covered Person is begun within 12 months of the date of the Accident;
5. immunization shots and routine examinations such as: health exams; periodic check-ups; pre-marital exams; and routine physicals;
6. routine newborn care, including routine nursery charges;
7. voluntary abortion, except with respect to the Insured or covered Dependent spouse:
   1. where such person’s life would be endangered if the fetus were carried to term; or
   2. where medical complications have arisen from an abortion;
8. normal pregnancy, except for Complications of Pregnancy;
9. the treatment of:
   1. mental illness;
   2. functional or organic nervous disorder, regardless of cause;
   3. alcohol abuse;
   4. drug use, unless such drugs were taken on the advice of a Physician and taken as prescribed for more than 10 days in any Calendar Year, with respect to payment of the Daily In-Hospital Indemnity Benefit;
10. participation in a riot, civil commotion, civil disobedience, or unlawful assembly. This does not include a loss which occurs while acting in a lawful manner within the scope of authority;
11. committing, attempting to commit, or taking part in a felony or assault, or engaging in an illegal occupation;
12. participation in a contest of speed in power driven vehicles, parachuting, parasailing, bungee-jumping, or hang gliding;
13. air travel, except:
    1. as a fare-paying passenger on a commercial airline on a regularly scheduled route; or
    2. as a passenger for transportation only and not as a pilot or crew member;
14. any Accident occurring as a result of the Covered Person being intoxicated (where the blood alcohol content meets the legal presumption of intoxication under the law of the state where the Accident took place);
15. sex changes;
16. experimental treatments or surgery;
17. the reversal of tubal ligation and vasectomies;
18. artificial insemination, in vitro fertilization, and test tube fertilization, including any related testing, medications, or Physician’s services, unless required by law;
19. treatment of exogenous obesity or weight control;
20. an act of war, whether declared or undeclared, or while performing police duty as a member of any military or naval organization. This exclusion includes Accident sustained or Sickness contracted while in the service of any military, naval or air force of any country engaged in war. The Company will refund the pro rata unearned premium for any such period the Covered Person is not covered;
21. accident or sickness arising out of and in the course of any occupation for compensation, wage or profit. Expenses which are payable under Occupational Disease Law or similar law, whether or not application for such benefits have been made; or
22. Pre-Existing Conditions, except as described in the Schedule.

In addition to the Exclusions and Limitations for all coverages, the following are not covered under the Out-patient Physician Office Visit Indemnity Benefit and the Outpatient Diagnostic X-Ray and Laboratory Indemnity Benefit:

1. visits made, examinations given, or x-rays or laboratory tests performed as an in-patient while Confined to a Hospital;
2. routine eye examinations or fitting of glasses;
3. fi tting of hearing aids;
4. dental examinations or dental care other than expenses resulting from accidental injury; and
5. benefits which are provided under any other part of the Policy.

Please note: Any other America’s Health Care Consumer Association or America’s Health Care Benefit Plan insurance coverage, discount coverage programs, provider network access discount arrangements, or association membership benefits described herein, or elsewhere, are not affiliated with, nor endorsed by Companion Life.

Information included in this website regarding medical insurance plan benefits is for illustrative purposes to outline features, plan provisions, benefits and other information about the Consumer’s Choice/USA™ medical coverage. It is not intended to serve as legal interpretation of benefits, which are provided under the Master Policy issued to America’s Health Care Consumer Association. The exact provisions governing the insurance contract are contained in the Master Policy (Form MMP 2250) underwritten by Companion Life Insurance Company of Columbia, South Carolina. Some of the provisions, benefits, exclusions, or limitations may vary depending upon the insured person’s state of residence. Certain terms and restrictions apply. For complete details about the medical coverage provided through Consumer’s Choice/USA™ (a product of America’s Health Care Benefit Plan, LLC), please refer to the certificate of coverage (Form MMC 2260) underwritten by Companion Life Insurance Company. The administrator for the Companion Life coverage is Insurers Administrative Corporation (IAC) of Phoenix, Arizona.