LIMITATION IN SERVICES. MediCard is not responsible for the following:
a. Delay or failure to render services due to major disasters, brownouts or epidemics affecting facilities or personnel.
b. Unusual circumstances such as complete or partial destruction of facilities, war, riots, disability of a significant number of MediCard personnel or similar events which result in delay to provide services.
c. Conditions for which a MEMBER has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists.
d. Sudden change of hospital policies.
LIMITATION IN SERVICES. MediCard is not responsible for the following:
a. Delay or failure to render services due to major disasters and natural calamities, brownouts or epidemics affecting facilities or personnel.
b. Unusual circumstances such as complete or partial destruction of facilities, war, riots, disability of a significant number of MediCard personnel or similar events which result in delay to provide services.
c. Conditions for which a MEMBER has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists.
d. Sudden change of hospital policies.
e. Failure of the patient to get the proper treatment if deemed not covered by MediCard SEC 12.4 EXCLUSIONS FROM OUT-PATIENT EMERGENCY CARE SERVICES:
a. Hospitalization and treatment outside the Philippines are not covered.
b. Cost of medical services, medicine and other expenses incurred as a result of a MEMBER’s decision to avail of such medical services, treatment or procedure, not prescribed or contrary to what has been prescribed by the attending MediCard provider, or without MediCard’s express written report shall not be covered by MediCard.
c. All other cases not specifically mentioned under Emergency Care Benefits will not be covered by MediCard.
d. Plastic and reconstructive surgery for cosmetic purposes and for physical congenital deformities and abnormalities.
e. Slipped disc, herniated disc, scoliosis, spinal stenosis and spondylosis.
f. Experimental medical procedures, acupuncture, acupressure, reflexology and chiropractics.
g. Purchase or lease of durable medical equipment, oxygen dispensing equipment and other medical supplies.
h. Corrective appliances, artificial aids and prosthetic devices.
i. Human blood products like platelets, packed RBC, plasma, gamma globulin, etc. and its processing.
j. Psychiatric and psychological illnesses including neurotic and psychotic behavior disorders.
k. Treatment for alcoholic intoxication and drug addiction or overdose reaction to use of prohibited drugs including illnesses directly related to it and other injuries attributed as a result of it.
l. Rehabilitation treatment and physical therapies.
m. Hazardous job-related illnesses and/or injuries.
n. Injuries or illnesses resulting from participation in war-like or combat operations, riots, insurrection, rebellion, strikes, domestic violence and other civil disturbances.
o. Treatment of self-inflicted injuries or injuries attributable to the ...