Exclusions are specific services, treatments, or circumstances that are not covered under your Soda benefits plan. Think of them as the boundaries of your coverage - they help define what your plan will and won't reimburse.
Why do exclusions exist?
Exclusions help keep your benefits plan sustainable and affordable for everyone. They ensure that Soda plans focus on essential healthcare needs while maintaining fair and predictable costs for both employers and employees.
Common types of exclusions in plans:
While specific exclusions vary by plan, they typically include things like cosmetic procedures (such as teeth whitening or aesthetic treatments), experimental or investigational treatments, and services that aren't medically necessary.
Pre-existing conditions may also have specific exclusion periods or limitations depending on your company's plan design.
What if I'm unsure whether something is excluded?
If you're not sure whether a particular treatment or service is covered, it's always best to check before proceeding. You can use our AI Chatbot to ask for more details or check with your HR administrator - we're here to help you make informed decisions about your healthcare.