Note: These exclusions should not in any way prevent any member from undergoing whatever treatment or procedures deemed necessary by attending physician.

1. Long-term rehabilitation and psychiatric care and/or psychological illnesses and conditions including neurotic and psychotic behavior disorders; anxiety disorders.exclusions
2. Developmental disorders including functional disorders of the mind, such as but not limited to Attention-Deficit Disorder (ADD) or Attention-Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorders, Bipolar Disorders, Central Auditory Processing Disorder (CAPD), Cerebral Palsy, Down Syndrome, Neural Tube Defects, and Mental Retardation.
3. Congenital, genetic and hereditary diseases and their complications affecting functions of individuals.
4. Sexually transmitted diseases including genital warts.
5. Injuries resulting from direct participation in riots, strikes, and other civil disturbances.
6. Infectious diseases (i.e. Avian Flu, Meningococcemia, etc.) that are declared epidemic or pandemic by the Department of Health, World Health Organization or any recognized health authority.
7. Aesthetic, cosmetic and reconstructive surgery or any consultation or treatment for any beautification purposes except if necessary to treat a functional defect due to accidental injury within the initial confinement.
8. Maternity care and all other conditions, including pre and post natal consultations, related to and/or resulting from pregnancy and/or delivery which affect the conditions of the principal Member and the unborn child.
9. Circumcision (except for treatment of urological conditions), sex transformation, diagnosis, treatment and procedures related to fertility or infertility, artificial insemination, sterilization or reversal of such procedures and their complications.
10. Experimental medical procedures and its complications.
11. Acupuncture, acupressure, chirotheraphy and other forms of alternative medicine and their complications.
12. Routine physical examinations required for obtaining or continuing employment, requirement in school, insurance, government licensing, health permit and other similar purposes.
13. All screening tests
14. Treatment for injury and its complications resulting from self-inflicted injuries including infections as a result of tattoos, piercing of the ear or in any body part, whether self-inflicted or done by a third party or attempted suicide or self-destruction, whether sane or insane.
15. Treatment of any injury received wherein there is negligence, unauthorized use of prohibited or regulated drugs, alcoholic liquor intake, direct or indirect participation in the commission of a crime whether consummated or not, violation of a law or ordinance or unnecessary exposure to imminent danger, knowingly or unknowingly, or hazard to health, by the Member.
16. Treatment of injuries or illnesses caused directly or indirectly by engaging in any professional sport or hazardous activity such as but not limited to scuba diving, surfing, water skiing, mountain climbing, rock climbing, mountaineering, parachuting, airsoft, drag racing, paintballing, wakeboarding and bungee jumping.
17. Treatment of injuries or illnesses resulting from war and any combat-related activities while in military service.
18. Treatment for Chronic Dermatoses
19. Services obtained for non-emergency conditions from physicians and hospitals in any of the following circumstances:
    1. non-Affiliated Physicians in non-Affiliated Hospitals or non-Affiliated Clinics
    2. non-Affiliated Physicians in Affiliated Hospitals or Affiliated Clinics
    3. Affiliated Physicians in non-Affiliated Hospitals or non-affiliated Clinics or other healthcare facility.
20. Additional hospital charges and physician's professional fees resulting from:
    1. room-upgrading beyond twenty-four (24) hours during Emergency Conditions;
    2. extension of hospital stay despite release of discharge order from Member's Attending Physician;
    3. fees of the assistant surgeons for surgeries with less than 250 RUV units / resident doctors who assisted the Attending Physician in the process of rendering the medical services shall not be chargeable to the Member and/or COOPHEALTH except for hospitals that do not have resident physicians to assist during surgeries subject to the prior approval of COOPHEALTH;
    4. use of extra bed, TV, electric fan, DVD/ VCD, and other similar items unless such appliances and items are necessarily and ordinarily included in the Member's Room and Board Accommodation;
    5. extra food; toilet articles like face towel, soap, toothbrush and the like;
    6. difference in Room and Board Accommodation, the incremental rate differences for professional fees, diagnostic and laboratory examinations, and other ancillary medical services brought about by obtaining a room and board accommodation higher than the Member's Room and Board Accommodation limit;
    7. services of a private or a special nurse;
    8. all other items not medically necessary in the medical management of the Member.
21. Routine physical examinations required for obtaining or continuing employment, requirement in school, insurance/travel or government licensing, health permit and other similar purposes.
22. Custodial, Domiciliary, Convalescent and lntermediate care.
23. Medical certificates.
24. Professional fees of medico-legal officer/s.
25. All expenses incurred in the process of organ donation and transplantation if the Member is the donor, and its complications.
26. Benefits covered by PhilHealth and all other government funded healthcare entitlements as provided for by law.
27. Cost of the medical services and professional fees in excess of the MBL.
28. Purchase or lease of any Durable Medical Equipment, oxygen dispensing equipment, and oxygen except during covered in-patient care.