What Is a Health Insurance Exclusion?
Updated March 28, 2015.
A health insurance exclusion is something your health plan won’t pay for even if you need it to get or stay healthy. That health care service is excluded from your health insurance coverage benefits.
Each health plan will have its own list of health insurance exclusions. However, according to a 2014 HealthPocket study, the most common exclusions in individual and family health insurance are:
- Cosmetic Surgery
- Adult Dental Services
- Weight Loss Programs
- Acupuncture
The opposite of health insurance exclusions are covered benefits: things your health plan will pay for. Health insurance sold in the United States must include the 10 essential health benefits mandated by the Affordable Care Act as covered benefits. Comprehensive health plans sold in the United States aren’t allowed to exclude any of the essential health benefits from coverage.
5 Surprising Things Not Covered By Health Insurance
I Have Health Insurance. Why Do I Still Have to Pay for Health Care?
Why Your Health Insurance Won’t Pay for Your Health Care
