We will not provide benefits for any of the following:
- Expenses duplicated by Medicare
- Expenses not covered by Medicare
- Services and supplies provided by a provider not recognized by Medicare—any services or supplies provided by a physician, hospital, skilled nursing facility, or any other provider that is not recognized as payable under the Medicare Act, except as specifically covered under the policy for foreign travel. This includes services provided by a provider who has opted out of Medicare, and who must by federal law, enter into an agreement with you regarding your liability for the care that provider gives you.
- Third party liability—services and supplies for treatment of illness or injury for which a third party is responsible.
Dental exclusions
In addition to the exclusions listed above, we will not provide benefits for any of the following conditions, including any direct complications or consequences that arise from them:
- Non-covered dental services—any procedure, treatment, supply, or service not specifically listed as a covered dental service.
- Not dentally appropriate—services that are not considered dentally appropriate.