What is Exclusion in Health Insurance?

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Exclusions in health insurance refer to services, treatments, or conditions that are not covered by a specific insurance plan. The policy contract usually includes a list of exclusions. If you have health insurance, you should be aware of what is not covered so that you can plan and budget accordingly.

A health insurance policy may include a variety of exclusions. Some common include:

• Pre-existing conditions: Pre-existing medical conditions are typically excluded from most health insurance policies. A pre-existing condition is defined as any condition for which you received treatment or a diagnosis within a specific time period prior to enrolling in the health insurance policy. The waiting period varies by insurer, but it is typically between 6 and 12 months.
  
• Elective procedures: Many health insurance policies do not cover elective procedures like cosmetic surgery. Any procedure that is not medically necessary to treat a disease or condition is considered elective.
  
• Experimental treatments: Health insurance policies will also typically exclude coverage for experimental treatments, which are defined as any treatments that have not yet been widely accepted as safe and effective by the medical community.

It is important to note that some services excluded in some plans may be included in other plans. It is therefore important to compare plans side-be-side to know which one benefits you.

If your health insurance policy excludes services that you might want, you can always opt-in for additional coverage.

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