Exclusions in Medical Benefits

Published: | Updated: September 17, 2017

Definition - What does Exclusions in Medical Benefits mean?

Exclusions in medical benefits are things that will not be covered by a health insurance policy. These exclusions could be things like illnesses, treatments, prescriptions, or things that would otherwise be covered. Typically, health insurance companies make exclusions if they view the particular thing too risky for coverage.

Insuranceopedia explains Exclusions in Medical Benefits

In the past, it was common for pre-existing conditions to be excluded from medical benefits. However, it is now illegal for health insurance companies to exclude coverage for pre-existing conditions. This means that a person who has cancer and who buys a health insurance policy cannot have his cancer treatments blocked from coverage just because he had cancer before he purchased the policy. However, even though pre-existing conditions are no longer excluded from medical benefits, exclusions still exist.

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