What's not covered
This section does not address UnitedHealthcare StudentResources
policies specifically (each one of these has its own list of exclusions and limitations).
However, this is a generic overview of items typically not covered.
Remember, HMO benefits are generally more comprehensive than those of traditional
Fee-for-Service plans. No health plan, however, will cover every single medical
expense. Here are some common exclusions in coverage:
- No matter how much you want that nose job, very few plans will cover it -- or any
other elective cosmetic surgery, for that matter. Exceptions occur when the procedure
is needed to correct damage caused by accidental injury, but check your plan to
- Some Fee-for-Service plans do not cover routine medical checkups. Women should take
careful note of which plans cover annual gynecological exams -- pap smears and mammograms,
- Women should also note that some individual plans will cover complications of pregnancy
but won't cover normal pregnancy or childbirth.
- Want to try acupuncture for your hypertension? Your plan might not cover it. Procedures
that are considered experimental or non-traditional are usually not covered.
- Believe it or not, mental health coverage is not offered in many health plans. Others
offer limited coverage for acute conditions only.
- Procedures the health plan determines are not medically necessary.
Insurers will definitely not pay duplicate benefits. You and your spouse may be
covered under different health insurance plans, but under what is called a "coordination
of benefits" provision, the total you can receive under both plans for a covered
medical expense can never exceed 100% of the allowable cost. So while you won't
be able to pull a fast one, you can rest assured that this provision benefits everyone
in the long run. How? By helping to keep overall insurance costs down.