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National General Insurance Company

Help Center»Benefits»Exclusions

Exclusions

Virtually all health insurance policies have exclusions that are listed in the insurance contract. It is important that a member know those exclusions. Below is a list of some of the more common short-term medical exclusions (for a complete listing read your specific insurance contract):

  • Pre-existing conditions
  • Prescription drugs (unless otherwise noted)
  • Routine prenatal care
  • Alcoholism
  • Substance abuse
  • Medically unnecessary procedures
  • Charge exceeding usual and customary amounts the insurer will pay for a procedure/treatment
  • Surgical treatment of obesity
  • Contraception or sexual dysfunction treatment
  • Routine vision, hearing, and dental
  • Injuries from extreme sports and activities
  • Injuries from interscholastic or intercollegiate sports
  • Injuries from substance abuse
  • Self-inflicted injury or sickness
  • Sexually transmitted diseases
  • Preventative care (unless otherwise noted)
  • Speech or vocational training/therapy
  • Hair loss
  • Sleep disorders
  • Organ/tissue transplants (unless otherwise noted)
  • Treatment for acne or moles
  • Acquired Immune Deficiency Syndrome (AIDS)
  • Hormone therapy
  • Joint replacement