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WAITIMQ PERIODS Hospital, surgical or madlcal 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. STUDEMT COHTQACT DOES MOT COVED A. In-patient care required primarily for diagnostic purposes; B. in-patient care which could |ust 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; 6. dental treatment; H. 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; 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.
66.6%