Exclusions From Medical Benefits Exemption
Definition of "Exclusions from medical benefits exemption"
Found under the "Exceptions and Exclusions Section for All Medical Benefits" in many health insurance policies that exclude:
- complications arising from elective, nontherapeutic voluntary abortion.
- necessary cosmetic surgery for the immediate repair of a nonoccupational disease, illness, accident, or injury.
- custom-built orthopedic shoes, wedges, or arch supports.
- speech therapy ordered by a physician to restore partial or complete loss of speech resulting from stroke, cancer, radiation laryngitis, orcerebral palsy.
- services, supplies, or treatment in connection with or related to endogenous obesity or obesity resulting from external causes thatthe physician certifies is associated with a serious or life-threatening disorder.
Popular Insurance Terms
Automatic reinsurance that requires an insurer to transfer (cede) and the reinsurer to accept the part of every risk that exceeds the insurer's predetermined retention limit. The reinsurer ...
Provision in an insurance policy that permits an insured to cancel the policy and recoup the excess of the paid premiums above the customary short rate for the expired time. The clause also ...
Model state law of the NAIC setting minimum standards with which insurance products must comply if they are to qualify under the definition of a long-term care (LTC) insurance policy. These ...
Act that seals a contract and is noncancellable. surety bonds and fidelity bonds resemble insurance contracts in many ways. However, the surety, which is often an insurance company, cannot ...
Employee benefit plan that includes benefits to be received from Social Security when determining the allowable benefit amount to be received by that employee or beneficiary. ...
Joint profit sharing and money purchase plan that is appropriate for businesses that desire the funding flexibility of the profit sharing plan and the higher tax-deductible (25% vs. 15%) ...
Coverage for a practicing physician, surgeon, or dentist, when bodily injury, personal injury, and/or property damage is incurred by a patient and the patient sues for injuries and/or ...
Many different, unofficial, and voluntary nonlitigation processes employed by insurance companies to resolve contractual disputes with their insureds. Examples would include nonbinding ...
Retirement plan for an individual based on a single contract with a benefit based on current earnings, as if they will remain static until normal retirement age. As the earnings of the plan ...
Have a question or comment?
We're here to help.