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In addition to other limitations on benefits and exclusions, benefits are not
paid under any plan for a sickness or bodily injury resulting from:
- any act of war, declared or undeclared, or service in the military forces
of any country, including non-military units supporting such forces;
- participation in a riot, felony, or other illegal act or being under the
influence of alcohol, drugs or toxic substances unless administered by a
physician;
- suicide or attempted suicide, or self-inflicted bodily injury while sane
or insane;
No benefits are paid that
are provided:
- free of charge in lieu of this insurance;
- by a government-operated hospital unless the insured person is required to
pay;
- for treatment received outside the United States except for an emergency
while traveling for up to a maximum of 90 consecutive days.
Additionally, no benefits are paid for:
- sickness or bodily injury that arises out of, or as a result of, any work
if the insured person is required to be covered under Worker's Compensation or
similar legislation.
Other Exclusions include:
- normal pregnancy and delivery;
- routine physical examinations and "well baby" care of a dependent child
unless CeltiCare Plus option is chosen. "Well-baby" care is defined as
charges not related to a sickness or bodily injury;
- treatment or surgical procedure relating to fertility, including diagnosis
or treatment of infertility;
- birth control (except where state mandated);
- tubal ligations and vasectomies while hospital confined are not covered.
The reversal of a tubal ligation or vasectomy is not covered at any time;
- treatment for weight loss (unless covered by Healthy Lifestyle Program),
and exogenous obesity;
- gender reassignment (sex change or reassignment);
- eye refractions, fitting of glasses or hearing aids, glasses, contact
lenses, radial keratotomy, or hearing aids;
- treatment or medication that is experimental or investigational;
- custodial care;
- treatment of drug addiction or chemical dependency;
- myringotomy or dilation and curettage and surgical treatment of tonsils,
adenoids or hernia within first 6 months of coverage unless due to emergency
| Important Note: The
information contained on this web page and the other linked pages is not
intended to provide full details of Celtic plans and may change at the
discretion of Celtic Insurance Company. Benefits and Plan details may vary
by state. Complete terms of coverage are outlined in the individual
Certificate Booklets and set forth in the applicable insurance Policy and
Trust agreement. In applying for coverage, the primary insured agrees to
be bound by the Certificate. The benefits described in these pages and any
accompanying literature are the standard benefits offered by Celtic. Policy
provisions vary in some states. |
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Pierre Granger CLU
Group & Individual plans available
Website Address
http://www.assurance-reseau.com
E-Mail:
pierre@floridahealthinsurance.com
PH: (954) 328-6750 Fax: (954) 893-7916
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