What are the complete definitions of the covered conditions?

Life-threatening cancer: A tumor characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue as confirmed by histological examination of tissue samples.

Heart attack (myocardial infarction): The death of a portion of the heart muscle due to atherosclerotic heart disease. The diagnosis must be based on all of the following criteria occurring at the same time:

• New episode of typical chest pain or equivalent symptoms; and
• Resulting from the blockage of one or more coronary arteries; and
• New electrocardiographic changes indicative of myocardial infarction; and
• Biochemical evidence of myocardial necrosis including elevated cardiac enzymes and/or troponin.

Stroke: A cerebrovascular incident causing infarction of your brain tissue, due to intracranial hemorrhage, thrombosis or embolism, producing a new measurable permanent clinical neurological deficit persisting for at least thirty (30) days following the occurrence of the stroke.

Coronary artery bypass surgery: You have undergone heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts.

Kidney failure: End stage renal disease, due to whatever cause or causes, as a result of which you are undergoing peritoneal dialysis or hemodialysis on a regular basis or have received a transplanted human kidney.

Major organ transplant: You have undergone transplantation of a human heart, liver, lung or kidney due to irreversible failure of such organ, or you have received transplanted human bone marrow.

Blindness: Total and permanent loss of sight in both eyes, as confirmed by a doctor who is a certified ophthalmologist. The corrected visual acuity must be worse than 20/200 in both eyes, or the field of vision must be less than 20 degrees in both eyes.

Deafness: Total, permanent and profound loss of hearing in both ears, with an auditory threshold of 90 decibels or greater within the speech threshold of 500 to 3,000 cycles per second, as confirmed by a doctor who is a certified otolaryngologist, and such loss of hearing cannot be corrected by any hearing aid, implant or device.

Multiple sclerosis: The unequivocal diagnosis of definite multiple sclerosis by a doctor who is a certified neurologist. The diagnosis must be based on well-defined neurological abnormalities on physical examination persisting for a continuous period of at least one hundred and eighty (180) days and confirmed by imaging techniques.

Paralysis: Complete and permanent loss of use of two or more limbs for a continuous period of ninety days following the precipitating event, during which time there has been no sign of improvement.

Coma: A state of unconsciousness, with no reaction to external stimuli or response to internal needs, continuing for at least four (4) days.

Burns: Third degree burns covering at least 20% of the surface area of the body. The diagnosis must be confirmed by a certified plastic surgeon.

Loss of speech: Total and irreversible loss of the ability to speak as the result of physical injury or disease which loss continues for a continuous period of at least one hundred and eighty (180) days.

Loss of limbs: The irreversible severance of two or more limbs at or above a point that is proximal to the wrist or ankle joint as the result of an accident or medically required amputation.

Motor neuron disease: You receive an unequivocal diagnosis, by a doctor who is a certified neurologist, that you have one of the following: amyotrophic lateral sclerosis (A.L.S. or Lou Gehrig’s disease), primary lateral sclerosis, progressive spinal muscular atrophy, progressive bulbar palsy, or pseudo bulbar palsy, and limited to these entities. The diagnosis must be accompanied by typical progressive neurological findings on physical examination for at least one hundred and eighty (180) days.

Aortic surgery: The undergoing of surgery for disease of the thoracic or abdominal aorta, requiring excision of the diseased segment of the aorta and replacement of it with a graft.

Alzheimer’s disease: The definite diagnosis of Alzheimer’s disease, by a doctor who is a certified neurologist, with progressive degeneration of the brain, memory and the ability to reason and perceive. You must exhibit the loss of intellectual capacity involving impairment of memory and judgment, which results in such a significant reduction of mental and social functioning as to require continuous daily supervision.

Parkinson’s disease: The diagnosis, by a doctor who is a certified neurologist, of primary idiopathic Parkinson’s disease, characterized by two or more of the following clinical manifestations:

• Muscle rigidity
• Tremor
• Bradykinesia (abnormal slowness of movement, sluggishness of physical and mental responses)