Common not covered services

Since HealthJoy is not an insurance company and operates independently from your insurance carrier, we do not cover any services. However, we’re here to help you navigate your options. While our access to specific coverage details is limited to the information provided by your employer, we can reach out to your insurance provider to find the answers you need.

Still, even though insurance coverage can vary widely depending on the plan, there are several services that are commonly excluded or not covered by many health insurance plans.

Here are some typical exclusions:

1. Cosmetic Procedures:
- Cosmetic Surgery: Procedures intended to improve appearance rather than health, such as facelift surgery, breast augmentation, and liposuction.
- Botox Injections: For cosmetic purposes, not related to medical conditions like chronic migraines or excessive sweating.

2. Experimental and Investigational Treatments:
- Unapproved Therapies: Treatments not yet approved by the FDA or not considered standard practice, including some clinical trial treatments.
- New Technologies: Cutting-edge or experimental procedures that haven’t gained widespread acceptance.

3. Alternative and Complementary Medicine:
- Massage Therapy: For conditions not considered medically necessary.
- Naturopathy: Treatments provided by naturopathic doctors.
- Dry needling: The lack of standardized training leads to the treatment being investigational.

4. Long-Term and Custodial Care:
- Assisted Living: Services for non-medical personal care and supervision.
- Home Health Aides: Non-medical home care assistance.

5. Personal or Lifestyle Services:
- Weight Loss Programs: Non-medical weight management services, including commercial weight loss programs.
- Smoking Cessation Programs: Often not covered unless they include prescription medications or counseling.
- Sexual Enhancement Drugs: Medications for sexual performance or enhancement not related to a diagnosed medical condition.

6. Non-Essential or Convenience Services:
- Luxury Hospital Rooms: Private rooms or additional amenities beyond basic care.
- Travel Vaccinations: Certain vaccines needed for international travel.

7. Non-Prescription Over-the-Counter Items:
- Over-the-Counter Medications: Items like pain relievers, cold medicine, and vitamins.
- Health and Wellness Products: Supplements and other non-prescription health aids.

8. Non-Medically Necessary Procedures:
- Elective Surgeries: Procedures chosen by the patient for convenience or preference that are not deemed medically necessary.
- Whole Body Imaging: There is no evidence that the scans are a good screening tool, and no medical societies recommend whole-body scans.

9. Certain Mental Health and Substance Use Services:
- Marriage and Family Therapy: Often not covered unless there is a clear medical necessity.
- Rehabilitation for Substance Use Disorders: Long-term residential treatment for substance abuse disorders or residing in halfway houses are generally not covered

Always review your specific insurance policy to understand what is and isn’t covered, as some plans may have unique exclusions or offer partial coverage for services that are generally excluded. If in doubt, contacting your insurance provider directly can help clarify coverage details.