What does excluded mean medical?
Asked by: Beth Kirlin | Last update: May 10, 2025Score: 4.1/5 (59 votes)
What does "excluded" mean on medical insurance?
In a nutshell, an exclusion is a condition or instance that is not covered by your insurance plan. Just as each plan has a list of items that the insurance company will cover, they also have a list of items they will not.
What is exclusion in medical terms?
Medical Definition
exclusion. noun. ex·clu·sion iks-ˈklü-zhən. : surgical separation of part of an organ from the rest without excision.
What is an exclusion in insurance?
An exclusion is a provision within an insurance policy that eliminates coverage for certain acts, property, types of damage or locations. Things that are excluded are not covered by the plan, and excluded costs don't count towards the plan's total out-of-pocket maximum.
What is an excluded condition?
A diagnosis of exclusion or by exclusion (per exclusionem) is a diagnosis of a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from history, examination or testing.
Excludes 1 vs. Excludes 2
What does excluded mean in medical terms?
1. Shutting off or removing from the main part. 2. In medical insurance programs, a list of specific hazards, perils, or conditions for which the policy will not provide benefits or coverage payments.
What is medical condition exclusion?
A pre-existing condition exclusion period limits the number of benefits that an insurer has to provide for specific medical conditions and does not apply to medical benefits afforded by a health insurance policy for other types of care.
What does being excluded from insurance mean?
Excluded drivers are not covered by an auto insurance policy, even if they have permission to use the vehicle. If an excluded driver causes an accident, the accident is treated as if the driver had no insurance at all.
What is an exclusion list in healthcare?
Mandatory exclusions: OIG is required by law to exclude from participation in all Federal health care programs individuals and entities convicted of the following types of criminal offenses: Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare, Medicaid, ...
What is the difference between exclusion and excluded?
If someone is excluded, on the other hand, it means that someone has been deliberately and painfully left out. Exclusion is more neutral. The department store that advertises a big sale often states at the bottom of the ad that "some exclusions apply," meaning the discounts don't apply to all items.
What is meant by excluded?
verb. to keep out; prevent from entering. to reject or not consider; leave out.
What does exclude mean health?
Health care services that your health insurance or plan doesn't pay for or cover.
What is exclusion conditions?
Exclusion Conditions means, as of any date of determination, the satisfaction of all of the following conditions on such date: (i) no Termination Event or Unmatured Termination Event has occurred and is continuing, or would result from the proposed designation of such Obligor as a Excluded Obligor, (ii) after giving ...
Does excluded mean removed?
: to remove from participation, consideration, or inclusion (as in insurance coverage)
What does excluding mean in insurance?
An insurance exclusion specifies which events your policy won't cover, essentially narrowing the scope of coverage. These exclusions help insurers avoid risks they find too high or unpredictable. Sometimes, your policy only lists the perils it covers, meaning everything else is automatically excluded.
Does excluded mean exempt?
“Exempted” means you are relieved or excused from an obligation. “Excluded” means you are prohibited from participating.
What is exclude in medical terms?
The term diagnosis of exclusion (per exclusionem) refers to a medical condition whose presence cannot be established with complete confidence from examination or testing. Diagnosis is therefore by elimination of other reasonable possibilities.
What does exclusion mean in health insurance?
Insurance exclusions are provisions in an insurance policy specifying risks that are not covered. Whether the policy is written for home, renters, health, automobile or business insurance, exclusions allow the insurance company to define when your coverage applies – and when it does not.
What does exclude list mean?
An exclusions list is a list—set up by a financial institution—of customers who are to be exempted from ongoing due diligence screening. This is usually because these customers' activities have a history of being flagged as false positives, or of otherwise not exhibiting anything suspicious.
What does it mean when you get excluded?
Sometimes, a school will issue an exclusion for a child, which means that they cannot attend the school. This can be fixed term, which is generally for a few days, or permanent which means they cannot return to the school and a new school should be found.
What does excluded benefit mean?
Excluded Benefits means vacation days or vacation pay, sick days or sick leave, maternity leave or other leaves of absence, termination or severance pay, pension benefits, ERISA coverage and similar contributions, and payroll taxes, worker's compensation and benefits in excess of the percentage limitation provided in ...
What is an example of an exclusion in insurance?
Policy exclusions create a balance between coverage for fortuitous losses (losses you couldn't have reasonably prepared for) and the need to remain solvent in order to pay those claims. For example, a homeowners insurance policy doesn't include flood insurance.
What does "excluded" mean on insurance?
An excluded driver is a person in your household who has been explicitly excluded from coverage under your car insurance policy. Their name will show as "excluded" on your policy, and they won't be insured to drive any vehicles on your policy.
What does it mean if a medication is a plan exclusion?
Formulary exclusions are drugs that a PBM chooses not to be included in coverage. Usually, a PBM will contract with multiple insurance providers to manage their prescription benefits. A provider can choose not to follow their PBM's formulary exclusion list if they wish to cover a drug.