Allergy kits: Allergy kits are usually prescribed by a provider because the patient is prone to severe allergic reactions that could be harmful to a patient's health or, in some cases, even life-threatening. They are generally prescribed because of the real threat the allergic reaction poses to the health of the patient and because it is not possible to predict when the reaction might occur. For this reason, it would seem appropriate for the cost of these prescribed kits, assuming the medication is otherwise FDA approved for treatment, to be covered under a health insurance policy. When used, it is clear that the kit becomes medically necessary.

And that is the question – maybe the kit will never be used. The exclusion does not say the cost of the kit will not be covered when used. It says it will not be covered when it is purchased for a future event. In other words, it will not be covered before it is actually used.

Protect your prescription drugs! If they are lost or damaged, you will have to pay for replacing them out of your own pocket. This is an understandable exclusion because it would be so difficult to prove or disprove why you need a replacement for a prescription already filled AND because there are health and safety reasons why you are not allowed to obtain more prescription drugs than your qualified health care provider thinks you need.

Abortificant: An abortificant is broadly defined as anything that will terminate a pregnancy. But it is also commonly used in a narrower sense to refer to the use of natural elements such as herbs and high doses of vitamins to terminate a pregnancy. In any case, the cost of anything that is used to effectuate the termination of a pregnancy is not covered by this sample policy.

Drugs that are not FDA-approved are not covered.

Nor are prescription drugs that are produced, extracted or derived from blood or blood products or from synthetic blood products.

If your doctor prescribes a drug that you can get at your local pharmacy without a prescription, do not bother to submit it to the insurance company. It will not be covered.

If you are purchasing prescription drugs for use by someone else, not only are you violating the law, the insurance company will not provide coverage for their cost – nor will the insurance company provide coverage for any known abuse of prescription drugs.

*Wording may vary from contract to contract and from state to state.