What do "noncovered" charges generally refer to?

Noncovered charges generally refer to services that are not included in the patient's insurance plan. When patients have health insurance, their plans specify which services are covered and under what circumstances. If a particular service or treatment is not part of the covered benefits outlined in the insurance policy, those charges become the responsibility of the patient. This means that even if the physician provides the service, the insurance will not provide payment for it, leading to a "noncovered" designation.

For example, certain elective procedures or treatments might be excluded from an insurance plan, making them noncovered charges. Thus, the patient would need to pay for these services out-of-pocket.

While out-of-network charges may lead to higher costs due to reduced coverage, they still can be partially covered by insurance, unlike noncovered services. Routine monthly fees may not be considered charges for specific services at all, and payments made in error do not accurately fit the definition of noncovered charges. Therefore, the definition of noncovered charges aligns directly with services not included in the patient’s insurance plan.