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 narcotics unless taken as prescribed 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 a medical 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, elective or repeat Cesarean section;
• 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 or surgery for exogenous and endogenous or morbid obesity;
• gender reassignment (sex change or reassignment);
• eye refractions, vision therapy, glasses or fitting of glasses, contact lenses, surgical or non-surgical treatment to correct refractive eye disorders, or any treatment or procedure to correct vision loss;
• hearing aids, exams or fittings, surgical or non-surgical treatment or procedure to correct hearing loss;
• 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;
• newborn nursery charges, unless required by state law.