
Inpatient Care
- ✓Hospital room and board
- ✓Nursing care and medications
- ✓Surgical procedures
- ✓Emergency treatments
- ✓Intensive care unit (ICU)
Outpatient Care
- ✓Doctor consultations
- ✓Diagnostic tests (X-rays, blood tests)
- ✓Prescription medications
- ✓Physical therapy
- ✓Specialist consultations
Preventive Care
- ✓Annual health checkups
- ✓Vaccinations
- ✓Cancer screenings
- ✓Blood pressure monitoring
- ✓Cholesterol testing
Specialized Care
- ✓Maternity and prenatal care
- ✓Emergency ambulance services
- ✓Mental health services
- ✓Rehabilitation services
- ✓Chronic disease management
💄
Cosmetic Procedures
Reason: Not medically necessary
- ✕Facelifts and cosmetic surgery
- ✕Liposuction
- ✕Rhinoplasty (unless medical)
- ✕Breast augmentation
- ✕Botox for cosmetic purposes
⚠️
Pre-existing Conditions
Reason: Must be declared during enrollment
- ✕Diabetes complications (if undeclared)
- ✕Heart disease treatments
- ✕Cancer treatments (if pre-existing)
- ✕Chronic kidney disease
- ✕Mental health conditions (if pre-existing)
⚡
High-Risk Activities
Reason: Voluntary exposure to danger
- ✕Extreme sports injuries
- ✕Self-inflicted injuries
- ✕Substance abuse treatment
- ✕Injuries from illegal activities
- ✕War or terrorism-related injuries
🧪
Experimental Treatments
Reason: Not proven or widely accepted
- ✕Experimental cancer treatments
- ✕Unproven surgical procedures
- ✕Alternative medicine (varies by plan)
- ✕Stem cell therapy (cosmetic)
- ✕Gene therapy