Services Not Covered

The BU Health Savings Plan does not provide coverage for:

  • Health care services that are not medically necessary
  • Health care services that are considered experimental
  • Health care services that are considered obsolete and no longer medically justified
  • Health care services furnished to someone other than the member
  • Cosmetic procedures, except when medically necessary
  • Commercial diet plans or weight loss programs
  • Transsexual surgery, including related procedures and treatments and reversal of such procedures
  • Dental services, including periodontal, restorative, and orthodontic services
  • Eyeglasses, contact lenses, and fittings. This exclusion does not apply to eyeglasses and contact lenses that are required due to cataract surgery, covered corneal transplants, and keratoconus.
  • Refractive eye surgery
  • Ambulance services unless necessitated by an emergency or medical necessity or authorized by Blue Cross Blue Shield for transfer from one facility to another
  • Osteopathic manipulation, electrolysis, routine foot care, biofeedback, pain management programs, massage therapy,and acupuncture
  • Sensory integrative praxis test; testing for central auditory processing
  • Blood and blood products
  • Physical examinations for insurance, licensing, or employment
  • Rest or custodial care, personal comfort or convenience items
  • Reversal or attempted reversal of voluntary sterilization (including procedures necessary for conception following voluntary sterilization)
  • Infertility services for members who are not medically infertile
  • Cost for any services for which the member is entitled to treatment at government expense or under Workers’ Compensation or occupational disability
  • Care for military service-connected disabilities for which the member is legally entitled to treatment or services
  • Court-ordered examinations and services (unless deemed medically necessary  by the plan)
  • Services incurred after termination of coverage under the plan
  • Charges in excess of the plan maximum amount or other limit
  • Services incurred prior to the effective date of coverage
  • Services for which no charges would have been made in the absence of coverage under this plan
  • Hearing aids
  • Orthotics
  • Nicotine gum
  • Services for any person who is not covered under the plan when the services are rendered
  • Custodial or domiciling care to assist a member in the activities of daily living or provide room and board, training in personal hygiene and other forms of self-care; personal care in the home except when medically necessary as part of a treatment plan for a medical condition
  • Private duty nursing
  • Temporomandibular joint dysfunction treatment limited to medical services only
  • Educational services (including problems of school performance) or testing for developmental, educational, or behavioral problems except as medically necessary under an early intervention program
  • Any claim submitted more than one year from the date the service was rendered
  • Non-durable medical equipment, unless used as part of the treatment at a medical facility or as part of approved home health care services
  • Services or supplies given to you by anyone related to you by blood, marriage, or adoption, or who ordinarily lives with you
  • Non-covered services
  • The portion of the charge for a service or supply in excess of the usual, customary, and reasonable (UCR) charge
  • Equipment for environmental control or general household use, such as air filters, air conditioners, air purifiers, liquidizers, bath seats, bed pans, dehumidifiers, dentures, elevators, heating pads, hot water bottles, and humidifiers
  • Missed appointments
  • Private room unless medically necessary
  • Surrogate pregnancy (any form of surrogacy)
  • Services not specifically described on this site
  • Services not within the scope of the physician’s, provider’s, or hospital’s licensure
  • Weight loss programs or charges for weight reduction except when extreme obesity adversely affects another medical condition and treatment is medically necessary  as determined by the plan

For a comprehensive list of services and conditions not covered by the BU Health Savings Plan, please refer to the description for the BU Health Savings Plan available from the Benefits Section of Human Resources