TMJ and CMD, Contraceptives, and Sexual Dysfunction
Get Legal Help Today
Secured with SHA-256 Encryption
UPDATED: Feb 24, 2015
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes and legal advice should be easy. This doesn’t influence our content. Our opinions are our own.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
What follows is a breakdown of specific exclusions from coverage found in a typical individual health insurance policy.
(Typical wording*): Limitations, Exclusions and Non-Waiver (cont.)
|
TMJ/CMD: Under the policy above, any treatment for TMJ (temporomandibular joint disorder) or CMD (craniomandibular disorder) and any of the expenses related thereto are excluded from coverage. In other words, the expenses for TMJ disorder and CMD disorder are out-of-pocket. However, not all insurance policies have specific exclusion clauses. Some will cover a certain dollar amount.
Contraceptives: This health insurance policy does not cover any form of contraceptives, regardless of their intended use.
In order to be subject to consideration for coverage, prescription drugs must be dispensed by pharmacists on an outpatient basis under orders by a provider who is acting within the scope of his or her license to treat an injury or sickness. If your health care provider dispenses the drug, its cost is not eligible for coverage under the policy.
Allergy shots administered on an outpatient basis, which most are, are excluded from coverage.
Consistent with the exclusion of the expenses of cosmetic surgery, so too are the expenses for products used for cosmetics purposes.
*Wording may vary from contract to contract and from state to state.