Exclusions

Like most long term care insurance plans, the Federal Long Term care Insurance Program (FLTCIP) does not pay benefits for any of the following:

• 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
     
• care or treatment for alcoholism or drug addiction; or
   
• 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
   
• care you receive while in a hospital, except in a unit specifically designated as a nursing home or hospice facility; or
   
• 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 co-payment amount. (This exclusion will not apply in those instances where Medicare is determined to be the secondary payor under applicable law); or
   
• services or supplies for which you are not obligated to pay in the absence of insurance; or
   
• services provided by any person who normally lived in your home at the time you became eligible for benefits.