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WAIT I HQ PERIODS Hospital, surgical or medical services for: " Ai any condition, disease or ailment which existed on or before the effective date of membership; B. hernias, tuberculous conditions, nervous or mental conditions, including alcoholism, drug addiction, and other manifestations thereof; C. any elective surgery; will not be covered until six months from the effective date. STUOERT CONTRACT DOES ROT COVER A. In-patient care required primarily for diagnostic purposes; in-patient care which could lust as well be given In the home, doctor's office, or out-patient facility; C. medical services in home or physician's office; D. rest cures or domiciliary care In a hospital; E. care rendered for any condition of pregnancy; F. care rendered in connection with any accident sustained while practicing for or participating in intercollegiate athletics; 8. dental treatment; M. care provided for under Federal, State or local laws, including Workmen's Compensation Laws; I. services provided by any other Blue Cross-Blue Shield Plan, whether you are enrolled individually or as a participant under a family contract; <1. surgery for cosmetic purposes; K. x-ray examinations not incidental to the diagnosis of hospitalized disabilities; x-ray examinations of out-patients (except initial x-ray examinations of accident cases and except x-rqy examinations made within 30 days prior to hospital admission); | L. ambulance service; M. blood, bloodplasma and blood derivatives.
STUDENTS AND PARENTS: „
SET FULL INFORMA TION! Phas» send me Information about tha Slut Cross-Blua Shield Studant Contract. Nama__ Address-- CHy___State. BLUE CROSS-BLUE SHIELD MO Prlaceas Asm* Street Frederlckabarg, Va. I U.
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