What’s NOT Covered

Although Experimental CarePlus and Expanded CarePlus cover a wide range of experimental and investigational services, and treatments and services that extend beyond your base medical program coverage, there are items which are not covered as part of your CarePlus benefits or have unique requirements for coverage, and include:

• For those who contribute to a Health Savings Account (HSA), you must meet your annual deductible under your base medical program before charges can be considered under CarePlus*.
• Certain covered services are only appropriate for specified conditions, otherwise they may be covered by your base medical program.
  For example:
  • Traditional CarePlus covers stem cell transplants for certain cancer and non-cancer indications, but does not cover stem cell injections for treatment of arthritis.
  • Traditional CarePlus covers partial or total joint replacement surgery for treatment of mandibular disorders, but does not cover other more mainstream joint replacement surgeries that are covered under your base medical program such as a hip or knee replacement.
• For a very small group of services (i.e. hearing aids), charges cannot be considered under CarePlus until the deductible, coinsurance, copayment, or visit limit maximum required under your base medical program has been satisfied.
  For example, CarePlus will reimburse up to $4,000 toward the purchase of hearing aid(s) for routine hearing loss during a rolling 36-month period. CarePlus only considers any remaining charges after your base medical program deductible, coinsurance or copayment has been met. These deductible, coinsurance or copayment amounts are not eligible expenses under CarePlus.
• Any item which is listed in the “What is Not Covered” section of the AT&T CarePlus Summary Program Description including services obtained prior to your effective date in CarePlus, or charges payable under Workers’ Compensation or similar laws.

*If you are enrolled in a Consumer-Driven Health Program and participate in an HSA you will not be able to receive payment for expenses under CarePlus until you meet your applicable annual deductible under your base medical program. Covered expenses under CarePlus will count toward your base medical program annual deductible and annual out of pocket maximum.