Eligible Expenses

Updated: 09 June 2023

What Does Eligible Expenses Mean?

Eligible expenses, in the context of insurance, are expenses defined in a health insurance plan as eligible for coverage. These expenses must meet the conditions required of the individual or group to ensure their eligibility for coverage.

Insuranceopedia Explains Eligible Expenses

For expenses to be eligible for reimbursement, they should meet the following conditions:

  • The expenses must be for health services or a product used in for the treatment of a medical condition.
  • The expenses must be incurred by the insured, the spouse or the eligible dependent.
  • The expenses must be incurred before the run-out period stipulated in the plan.
  • The expenses must be incurred during the eligibility period of coverage.

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