What is a plan exclusion?

A plan exclusion is a type of limitation or restriction included in a health insurance policy that states that certain services, treatments, or products are not covered. This means that if the policyholder receives any of the excluded services, they will not be reimbursed by the plan. In Washington, state law requires health insurance policies to list the exclusions when they are sold. Exclusions can vary both in how comprehensive they are and what is excluded. Some health plans may have a few exclusions, such as cosmetic or unnecessary procedures, while others may have many exclusions, such as lab tests or certain types of surgery. It is important for someone to take the time to read over their health insurance policy so they understand exactly what is and isn’t covered. A plan exclusion is a good example of something that may not be included. Someone who is considering getting a health plan should have a thorough understanding of the exclusions listed on the plan so that they can make an informed decision about their health care coverage.

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