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WAITING PERIODS Hospital, surgical or medical services for: A. 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. STUDENT CONTRACT DOES ROT COVER A. In-patient care required primarily for diagnostic purposes; B. in-patient care which could Just 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; C. care rendered for any condition of pregnancy; F. care rendered in connection with any accident sustained while practicing for or participating in Intercollegiate athletics; 6. dental treatment;, H. care provided for under Federal, State or local laws, Including Worhmen'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; *. J. 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-ray examinations made within 30 days prior to hospital admission); L. ambulance service; M. blood, blood plasma and blood derivatives.
STUDENTS AND PARENTS:
BET FULL INFORMATIONI j Ptease send me Information Studant Contract. about tha Blua Cross-Blot Shhtd Addrass_ -C«y_ .State. BLUE CROSS-BLUE SHIELD HO Princess Aim Street Prsdericksbaia, Vs. I r i ,i i i i i i i i i i i i i i i .j
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