ActuateCare Exclusionary Policy

Effective Date: 07/01/2025 

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This Exclusionary Policy lists services and situations not covered by ActuateCare products. 

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Virtual Urgent Care – Exclusions 

• Life-threatening or emergency conditions (call 911) 

• Workers’ compensation cases 

• Ongoing chronic disease management 

• Ongoing mental health therapy or counseling 

• Specialty medical care requiring referral 

• Pregnancy-related care or childbirth 

• Diagnostic imaging or in-person testing 

• Prescribing of controlled substances beyond allowable emergency refills 

• Pediatric patients under age 3

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Virtual Primary Care – Exclusions 

• Life-threatening or emergency conditions (call 911) 

• In-person diagnostic or physical exams 

• Workers’ compensation cases 

• Complex specialty care 

• Obstetrics and prenatal care 

• Injections or procedures 

• Prescribing certain controlled substances 

• Pediatric patients under age 2 

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Behavioral Health – Exclusions 

• Inpatient psychiatric hospitalization 

• Emergency crisis intervention (call 988 or 911) 

• Substance abuse detox or inpatient rehabilitation 

• Age restrictions as determined by partner policy 

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Pharmacy Benefits – Exclusions 

• Medications excluded from the partner’s formulary 

• Controlled substances if not covered by partner 

• Medications prohibited by law in certain states 

• Pediatric patients under age 2 if restricted by partner policy 

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Contact Us 

ActuateCare, LLC 
info@actuatecare.com 
888-683-2620