General Exclusions

1. Viral and bacterial illnesses that are complications of or contracted due to a compromised or impaired immune system. The following are examples but not limited to:
   • Patients with malnutrition
   • Patients with uncontrolled diabetes mellitus
   • Recipients of organ transplant
   • Patients with hematologic malignancies
   • Patients undergoing radiation, chemotherapy and immunosuppressive therapy
   • Patients with HIV / AIDS infection
   • Patients with foreign objects/implants such as venous or urinary catheters.
   • Patients with auto-immune diseases such as Systemic Lupus Erythematous (SLE), Rheumatoid Arthritis, Multiple Sclerosis, Guillain-Barre syndrome
2. Viral infections like:
   • Hepatitis B, C, D & E
   • Herpes infections like Epstein-Barr and Cytomegalovirus
3. Accidents and viral / bacterial illnesses that are secondary to or contracted due to having a degenerative disease such as but not limited to Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Parkinson’s disease.
4. Conditions secondary to all pregnancy and fertility-related illnesses / treatments.
5. Lithiasis/stones of the gallbladder and genito-urinary system.
6. Sexually transmitted infections such as but not limited to syphilis, gonorrhea, chlamydia, human papillomavirus infection, HIV/AIDS.
7. Pre-existing conditions except Hepatitis A.
8. Chronic viral and bacterial illnesses.
9. Congenital illnesses acquired through viral and bacterial infections.
10. Care by non-accredited Physician and/or in a non-accredited hospital.
11. All dental related conditions and services.
12. Complications from sterilization of either sex or reversal of such, artificial insemination, sex transformations, and circumcision
13. Rest cures, custodial, domiciliary, or convalescent care.
14. Complications arising from cosmetic surgery, dental/oral surgery and dermatological procedures for the purpose of beautification, including reconstructive surgery to treat a dysfunctional defect due to a disease or accident
15. Psychiatric disorders, psychosomatic illnesses, hyperventilation syndrome, stress related conditions, adjustment disorders, alcoholism and its complications or conditions related to substance or drug abuse, addiction and intoxication.
16. Medical and/or surgical procedures which are not generally accepted as standard treatment by the medical profession like acupuncture.
17. Procurement or use of corrective appliances, artificial aids and durable equipment, and orthopedic prosthesis and implants.
18. Surcharges resulting from additional personal (luxuries/accommodation) request or service including special nursing services.
19. Injuries or illnesses due to military, paramilitary, police service, high risk activities, or suffered under conditions of war, self-inflicted, caused by attempt at suicide or incurred as a result of or while participating in a crime or acts involving the violation of law, administrative order or ordinances.
20. Professional sports and high-risk sports.
21. Outpatient/Take home medicines.
22. Valvular Heart Disease and/or Rheumatic Heart Disease.