This is a scheduled benefit plan. All covered expenses have a limit as noted and can vary from plan to plan. It is NOT AVAILABLE to any individual who has been residing within the United States for more than 365 days prior to their Effective Date; or to US Citizens and does not provide coverage in Israel, Lebanon, Ukraine, Belarus, or Russia. It does not cover Hockey League play.
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  1. There are certain restrictions, exclusions and limitations that apply to all services and coverages. Plan benefits, limits and provisions may vary. NSM-0224AO (7/23)
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