Medico Insurance Company Disclosures

Exclusions and limitations (may vary by state)

No benefits will be paid for any expense not identified and included as a covered loss under the policy. You will be fully responsible for payment of any expense that is not a covered loss. We will not pay benefits for:

1. Any loss that occurs while this policy is not in force.
2. Services or supplies not covered under this policy or not included in your plan of care.
3. Treatment of complications of a non-covered loss.
4. Any treatment for loss that: 
   1. Is not medically necessary.
   2. Is not prescribed by a physician as necessary to treat a sickness or injury.
   3. Is determined to be experimental or investigational.
   4. Is received without charge or legal obligation to pay.
   5. Would not routinely be paid in the absence of insurance.
   6. Is received from any family member.
5. Any suicide attempt, while sane or insane, or any intentionally self-inflicted injury.
6. Alcoholism, drug addiction, or their complications, unless addiction resulted from narcotics prescribed by a physician.
7. Injuries received or caused directly or indirectly while under the influence of a controlled substance, unless prescribed by a physician, or by intoxication as defined by the laws and jurisdiction of the geographic area in which the loss or cause of loss was incurred.
8. Loss to which a contributing cause was your commission of or attempt to commit a felony or being engaged in an illegal occupation.
9. Loss that occurs outside the territorial limits of the United States.
10. Any loss resulting from war, declared or undeclared, or actively serving in the armed forces or their auxiliary units, including any country’s National Guard or Army Reserve or their equivalent.
11. Any loss resulting from any device for aerial navigation, except as a fare-paying passenger.

STCI-008 Rev. 05/20

05/01/20