What Are Exclusions And Limitations?

Exclusions and limitations are medical services or benefits that will not be paid for or may be paid on a limited basis. Some examples are: experimental medical treatments, self­inflicted injuries, on­the­job injuries covered by Worker`s Compensation, cosmetic surgery, eye or dental care, and services that are not medically necessary. Most policies have reduced or no benefits for mental illness or substance abuse treatment. Read your outline of coverage or benefits handbook to see what benefits your insurer will NOT pay for.

The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.

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