Health Benefit Plan Law and Legal Definition

A health benefit plan refers to a health insurance plan offered by a health insurance company that provides a set of covered services and a provider network for health care. A health benefit plan does not include medicare supplement, benefits for long-term care, dental care, vision care, home health care, community-based care, disability income insurance, liability insurance, coverage for on-site medical clinics, workers' compensation or similar insurance, or automobile medical payment insurance. It also excludes specified disease, hospital confinement indemnity, and limited benefit health insurance if such types of coverage are provided under separate polices or certificates.