NFL Collective Bargaining Agreement

Article 61
Long Term Care Insurance Plan

Section 3
Limitations

Benefits will continue to not be paid for confinement, treatment, services or care; (i) resulting from alcoholism, drug addiction, or chemical dependency, unless as a result of medication prescribed by a physician; (ii) arising out of suicide (while sane or insane), attempted suicide, or intentionally self-inflicted injury; (iii) provided in a government facility (unless otherwise required by law), services for which benefits are payable under Medicare, or would be payable except for application of a deductible or coinsurance amount, or other governmental programs (except Medicaid), and services for which no charge is normally made in the absence of insurance; (iv) received outside the United States; (v) for which benefits are payable under any state or federal workers’ compensation, employer’s liability of occupational disease law; (vi) that are not included in a participant’s plan of care; or (vii) that are prohibited by federal law.