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 make sure!
  • 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, for example.
  • 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.

Other exclusions

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.