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[Health Insurance] 13, Common Exclusions and Limitations
Published 2 weeks, 6 days ago
Description
This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams.
In this episode you will learn:
- The primary purpose of exclusions is to manage risk, prevent adverse selection, and maintain affordable premiums.
- Under the ACA, pre-existing conditions cannot be excluded or charged higher premiums in compliant health plans.
- A waiting period for employer-sponsored health benefits cannot exceed 90 days from the date of eligibility.
- Injuries sustained at work are exclusively covered by Workers' Compensation, not by health insurance.
- A key distinction tested is between elective cosmetic surgery (excluded) and medically necessary reconstructive surgery (covered).
For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep