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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 NOT 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; 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; G. 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.
STUDENTS AND PARENTS:
GET FULL INFORMATION! Please send me information about the Blue Cross - Blue Shield Student Contract. (29) I Name_I
[ Address_City_State_ I jI BLUE CROSS-BLUE SHIELD | 908 Princess Anne Street Fredericksburg, Virginia 22401 I
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