Also "exclusions." Specific conditions or circumstances that are not covered for benefits under a health plan. These are listed in detail in the plan documents, and sometimes more generally in marketing or other plan materials. Check uncovered services/exclusions carefully before enrolling in a plan. Ask the plan or your employer for a copy of the plan document.
Services received for an unexpected illness or injury that is not life threatening but requires immediate outpatient medical care that cannot be postponed. An urgent situation requires prompt medical attention to avoid complications and unnecessary suffering or severe pain.
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