We will pay this benefit for Covered Expenses up to the Maximum Benefit shown on the Certificate Schedule and subject to any limits shown below. Covered Expenses must be incurred by an Insured Person for an Injury or Illness on a Covered Trip, provided initial treatment was received during a Covered Trip. The first expense must be incurred within forty-eight (48) hours of the date of the onset of the Injury or Illness, or, if the Pre-Existing Condition Limitation is waived, the Injury or Illness must re-occur while the Insured Person is covered for Injury or Illness. Except as may be indicated elsewhere in the Certificate, this coverage is secondary to any Other Plan the Insured Person may have. Coverage continues until the Insured’s Covered Trip ends.
“Covered Expenses” means the Necessary and Reasonable Expenses for medical, surgical and Emergency dental services, treatments and supplies incurred during a Covered Trip. Covered Expenses also includes professional nursing, Hospital charges, X-ray, and ambulance services.
We will not pay for:
- hernia, however caused;
- services or treatment given by any person employed by, a Family Member of, or retained by the Insured Person;
- experimental procedures;
- cosmetic surgery or procedures;
- medical expenses for which the Insured Person is entitled to benefits under any worker’s compensation act;
- any surgical or medical treatment which can reasonably be delayed until the Insured Person’s return to his or her usual place of domicile;
- any treatment or medication which at the time of departure is known to be required to be continued during a Covered Trip;
- the cost of dentures, dental appliances, false limbs, hearing aids, cochlear implants, contact or corneal lenses or spectacles (prescription or otherwise);
- any repatriation costs not authorized by Us;
- the additional cost of a single or private room at a Hospital, except when the Physician treating the Insured Person considers it Necessary.