What Is Not Covered

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	Long Term Care Insurance Plan

	The Plan at a Glance

	Participating in the Plan

	How the Plan Works

	What Is Not Covered

	Filing a Claim

	Glossary

What Is Not Covered

Exclusions

Are there any Exclusions under this Plan?

The Long Term Care Insurance Plan does not provide benefits for any of the following:

care specifically provided for detoxification of or rehabilitation for alcohol or drug abuse (chemical dependency), except drug abuse sustained at the hands of or while being treated by a Physician for an injury or sickness

any service or supply received outside the United States or its territories (except for insureds who are eligible to receive benefits outside the United States)

illness, treatment or medical condition arising out of any of the following:

war or act of war (whether declared or undeclared)

participation in a felony, riot or insurrection (unless the insured is acting in self-defense)

service in the armed forces or auxiliary units

attempted suicide (while sane or insane) or intentionally self-inflicted injury

aviation (this applies only to non-fare paying passengers)

treatment provided in a government facility, unless otherwise required by law

any care provided while in a hospital, except for confinement in a distinct part of a hospital that is licensed as a nursing home or hospice

any service provided by your immediate family, unless the service is a covered service from an informal caregiver (such as a friend, neighbor, or family member)

any service or supply to the extent that such expenses are reimbursable under Medicare, or would be reimbursable but for the application of a deductible or coinsurance or copayment amount. This exclusion will not apply in those instances where Medicare is determined to be secondary payer under applicable law

service for which no charge is normally made in the absence of insurance

Alternate plan of service provision

What if the service I want is not covered?

This Plan has an "Alternate plan of service provision." This provision means that a MetLife care manager can authorize benefits for qualified long-term care services not specifically covered under the Plan. Services must be qualified, must meet the needs of the covered person, and be a cost effective alternative.