Orange County NC Website
34 <br /> SECTION, VII <br /> EXCLUSIONS <br /> 1. Any Accidental Injury or sickness, if any benefits, settlement, <br /> award damages are received or payable, (or could reasonably be <br /> expected to be received or payable if a claim were made) from: a <br /> claim under Worker's Compensation, Employer's Liability, or <br /> Occupational Disease Law, or Medicare. <br /> 2. Health Services for the Treatment of Mental. Health Conditions, <br /> except Crisis Intervention and Evaluation services. (Please see <br /> Section IV). <br /> 3. Medication, supplies, and equipment given for a charge to a Member <br /> by a hospital to take home (such as, but not limited to: <br /> disposable oxygen equipment, dressing kits, and disposable <br /> monitoring supplies) . <br /> 4. Any Health Services rendered after Termination of Coverage (Please <br /> see Section VIII). <br /> 5. Prosthetic and orthotic devices and durable medical equipment <br /> except as explicitly provided under this Contract. (Please see <br /> Section IV) . <br /> 6. Any dental care or oral surgery, including but not limited to care <br /> or surgery for an injury which occurred while the covered <br /> individual is in the act of chewing or for damage to or breakage <br /> of an appliance (such as, but limited to, a bridge or denture <br /> being cleaned or otherwise not in normal mouth usage at the time <br /> of the accident) except: for the treatment of sound natural teeth <br /> needed as a result of an Accidental Injury, when said injury <br /> occurred while a Member of the Plan and the care is received <br /> within thirty (30) days from the date of the Accidental Injury. <br /> 29 <br />