What is a plan exclusion?

A plan exclusion is when a health insurance plan or policy does not cover certain types of care. This usually means that the insured person will be responsible for the full cost of the care that has been excluded from their plan. In California, health insurance plans and policies are regulated by state law and must provide basic coverage for certain types of care. However, even with these minimum requirements, some policies may still exclude certain types of care, such as coverage for experimental treatments or alternative therapies. Plan exclusions can also apply to specific conditions, such as pre-existing conditions or mental health. This means that even though the policy may cover care for a certain condition, it may not cover any treatments related to that condition. In addition, some plans may have exclusions that cover specific drugs or medical devices. When considering a health insurance plan, it is important to carefully review what it covers and what is excluded in order to make sure that you get the coverage that you need.

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