Exclusions

This section describes those services and supplies that are not covered under the Federal Long Term Care Insurance Program (FLTCIP).

The FLTCIP does not pay benefits for any of the following:

1. illness, treatment or medical condition arising out of:
• your participation in a felony, riot or insurrection; or
• your attempted suicide, while sane or insane; or
• injuries you intentionally inflict on yourself; or
2. care or treatment for alcoholism or drug addiction; or
3. care or treatment provided in a government facility, including a Department of Defense or Department of Veterans Affairs facility, unless otherwise required by law; or
4. care you receive while in a Hospital, except in a unit specifically designated as a Nursing Home or Hospice facility; or
5. any service or supply to the extent the expense for it is reimbursable under Medicare, or would be so reimbursable except for the application of a deductible, coinsurance or copayment amount. (This exclusion will not apply in those instances where Medicare is determined to be the secondary payor under applicable law); or
6. services or supplies for which you are not obligated to pay in the absence of insurance; or
7. services provided by any person who normally lived in your home at the time you became eligible for benefits.

Your coverage does not have a war exclusion

Your coverage does not have a war exclusion. As a result, benefits may be payable under the FLTCIP for conditions due to war or acts of war, declared or undeclared, or service in the armed forces or auxiliary units.

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