Health Insurance Articles

Finding Out What Exclusions Mean For Your Child Health Insurance Policy

2010-03-22

Every family needs a good health care plan, one tailored to their needs that can provide for them if any member of the household takes ill. Many health insurance companies offer robust family plans which will have high annual payout limits and include things like private hospital rooms and recurring treatment allotments. However, no plan is perfect and every health plan will have at least one or two items listed as "exclusions." These exclusions are items or treatments that will not be paid for by the insurance company, no matter the situation. Many parents are unaware how these exclusions can affect both themselves and their children.

One of the most common exclusions in health care coverage is that for behavioral disorders. This includes such common childhood ailments as attention deficit hyperactivity disorder (ADHD), or dyslexia. Counseling, medication and treatment plans for both these and many other disorders will often be entirely uncovered by a health plan. In addition, health plans do not often cover home care. While it is thought of mainly as affecting older patients, it can seriously impact a family which has a child that is too chronically ill to attend school, but cannot afford to have one parent stay at home.

Even using health care coverage for items that it does pay for, such as a hospital visit, can end up costing extra due to exclusions. For example, although a typical plan will cover a hospital stay, it will not cover use of the hospital's television, an extra pillow being requested, or even a band-aid. While these are minor charges, they can add up over the long term if the care is continuing. Also commonly excluded are cosmetic treatments, and this category of procedures now includes circumcision. As well, this could include operations such as ear pinning, which is a minor day surgery that can significantly improve a child's quality of life. Lastly, two large exclusions which many families are unaware of are dental and vision care. Health care providers do not typically include either of these types of care in any health insurance quote, as they assume that such care will be provided by an employer or other outside source. All children need regular dentist checkups, and glasses or contacts are an expensive proposition.

This is simply a partial list of some of the exclusions found in most health care plans. To be absolutely certain what is covered, and to what extent, be sure to speak to an insurance agent, and ask specifically about exclusions. Often, these will not be listed prominently on documentation provided by the insurance company, but it is better to know what is and isn't covered before owing a large and unexpected amount.