What is an excluded service?

An excluded service is a type of healthcare service or procedure that is not covered by a health insurance policy. In California, health insurance policies typically exclude services that are not medically necessary, experimental or investigational services, services that are not part of a covered benefit plan, or services for which an insured is not eligible. Excluded services may include cosmetic surgery, bariatric surgery, orthodontic services, moving expenses, routine physicals, hearing aids, and some types of vision services. It is important for individuals to carefully review their health insurance policy so that they understand what services are covered and which services are excluded. Health insurance plans may also include exclusions for pre-existing medical conditions or for certain types of illnesses and injuries. It is important to be aware of any exclusions when choosing a health insurance plan so that it adequately covers the healthcare needs of the individual or family.

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