Medical Plan

General List of Exclusions Gulf Operations

P.O. Box 371916, Dubai, United Arab Emirates
www.metlife-gulf.com

This document provides a general list of items that are not included in your medical coverage.
For the complete list, please refer to your policy terms and conditions.

1. Registration Fee including the fee which providers charge for registering a new patient or preparation of identification card

2. Cost of Medical Reports, CD, prints

3. Co-payment, and /or co-insurance or any other deductible

4. General Health check-ups, check-ups for employment, travel, licensing, immigration, or insurance purposes

5. Alternative medicine; Podiatrist services, Homeopathy, Ayurveda and Acupuncture

6. Dietician services

7. Allergy tests

8. Speech therapy and occupational therapy

9. Non-prescription or over-the-counter drugs

10. Medical supplies (durable medical items) and first aid, including but not limited to antiseptics, arch supports, mouthwash, toothpaste,

skin care products, diapers, nasal wash, eye wash, ear wash, lozenges

11. Drugs prescribed for non-medical or cosmetic purposes including but not limited to medicated shampoos and soaps, moisturizing,

disinfectant/cleansing lotions, elastic stockings, etc.

12. Vitamins unless prescribed to treat a diagnosed significant vitamin deficiency syndrome & Dietary supplements and other nutritional or

herbal services

13. Expenses incurred on account of the following items which include but are not limited to:

a) Health care services, treatments, and associated expenses for alopecia, baldness, hair loss, dandruff or wigs; and hirsutism

b) Birth control measures, contraceptive measures, tubal ligation & reversal, intrauterine device removal or insertion

c) Treatment of infertility, including but not limited to ovulation induction, invitro-fertilization (IVF), hormone treatment for the purpose

of regulating reproduction; and Sexual disorders, including but not limited to treatment of erectile dysfunction, and sexually

transmitted diseases

d) Preventive treatment, immunization, and vaccinations

MET/MD-GLX/CLM/09-14

e) Ritual practices such as circumcision and ear piercing

MetLife

14. Medically non-approved experimental, research, investigational healthcare services, treatments, devices and pharmacological regimens

American Life Insurance Company is a MetLife, Inc. Company