United Teacher Associates Insurance Company Cancer Treatment Limitations and Exclusions
AL, IN, KS, KY, NE, NV, OH 

LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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AK


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy.  Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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AR
LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness. However, benefits will be paid for any other condition or disease that is directly caused or aggravated by either cancer or the treatment of cancer;
  2. Injuries;
  3. Care and treatment received outside the United States;
  4. Treatment not approved by a Physician as medically necessary;
  5. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  6. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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CA

LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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CO

LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which medical charges are incurred, medical treatment or consultation is received, or prescription drugs are taken within the twelve (12) months prior to the Effective Date of the policy.  Benefits for a Pre-Existing Condition will be excluded for twelve (12) months from the Effective Date of the policy.

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GA


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Benefits for Cancer Treatment or diagnosis made during the Waiting period will be excluded for two (2) years from the Effective Date of this policy.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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HI


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy.  Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.  

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IA

LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the five (5) year period prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for twelve (12) months from the Effective Date of the policy.

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ID

LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. PRE-EXISTING CONDITION - Benefits for a Pre-Existing Condition will be excluded for 12 months from the Effective Date of the policy unless the Pre-Existing Condition is specifically excluded.
PRE-EXISTING CONDITION means a Cancer or covered disease for which medical advice, diagnosis, care or treatment was recommended or received from a physician within the six (6) month period preceding the effective date of the policy.

Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

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LA


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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MI


Limitations and Exclusions

The policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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MO


LIMITATIONS AND EXCLUSIONS

The policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy.  Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.  

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MS


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given within twelve (12) months prior to the Effective Date of the policy.  Benefits for a Pre-Existing Condition will be excluded for twelve (12) months from the Effective Date of the policy.

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NC

LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given within the twelve (12) months prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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NM


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advise or treatment if given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy. Benefits provided for under this policy will not be paid for any diagnosis resulting from a Pre-Existing condition regardless of when such diagnosis is made.

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OK


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.

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SD

LIMITATIONS AND EXCLUSIONS

The policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
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TN


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will only be a considered a covered condition after the second policy anniversary. If a Diagnosis of Cancer is made during the Waiting Period, after two (2) years from the Effective Date of the policy, benefits will be paid for loss incurred commencing after the expiration of such two-year period, even if the original Diagnosis of Cancer was made during the Waiting Period.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given prior to the Effective Date of the policy. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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TX


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States, when care and treatment has not been funded by the National Cancer Institute or when the care and treatment are not subjects of ongoing clinical studies by the United States Food and Drug Administration for the treatment of cancer;
  5. Treatment not approved by a Doctor as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given, within the five (5) years prior to the Effective Date of the policy. No benefits will be payable during the first twelve (12) months that coverage is in force for a Pre-Existing Condition if the Effective Date is prior to your sixty-fifth (65th) birthday.

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WA


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

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WI


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or becauseof Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received for Cancer within the Waiting Period will not be covered.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given, or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy.  

Any Pre-Existing Condition not disclosed on the application will be excluded for two (2) years from the effective date of coverage.

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WV


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer.  It does not cover:

    1.    Any other disease or sickness;
    2.    Injuries;
    3.    Care and treatment received outside the United States;
    4.    Treatment not approved by a Physician as medically necessary;
    5.    Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
    6.    Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.

Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy.  Benefits for a Pre-Existing Condition will be excluded for twelve (12) months from the Effective Date of the policy.  

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WY


LIMITATIONS AND EXCLUSIONS

After a 30 day waiting period, the policy pays only for loss resulting from Cancer. It does not cover:
  1. Any other disease or sickness;
  2. Injuries;
  3. Any disease or incapacity that has been caused, complicated, worsened, or effected by Cancer or because of Cancer treatment;
  4. Care and treatment received outside the United States;
  5. Treatment not approved by a Physician as medically necessary;
  6. Experimental treatment by any program that does not qualify as experimental treatment as defined in the policy; or
  7. Hospital confinement or expenses incurred before the Effective Date of coverage despite the date of positive diagnosis.
Any advice or treatment received within the Waiting Period which leads to the diagnosis of Cancer or Cancer first diagnosed during the Waiting Period will not be a covered condition.

PRE-EXISTING CONDITION means a Cancer or covered disease for which diagnosis, advice or treatment is given or for which signs or symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment, prior to the Effective Date of the policy.  Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy.

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