Coverage exclusions
What's Not Covered
Some services, most of them elective, are not covered by most plans. Here are a few:
- Cosmetic services, except for surgery with the primary purpose of restoring function lost or impaired because of illness or injury, a birth defect, or breast reconstruction after a mastectomy
- Elective abortions
- Artificial insemination, in vitro fertilization or any related fertility or infertility transfer procedure (NOTE: Some Wellmark employer plans do cover these procedures.)
- Massage therapy
- Investigational or experimental treatment
- Acupuncture
- Weight reduction programs
- Routine foot care
- Long-term care
- Non-emergency care when traveling outside the U.S.
- Private-duty nursing
- Services not determined to be medically necessary
For a complete list, always review the specific exclusions outlined in your plan's coverage manual or myWellmark.
