Health Insurance Articles
How Ancillary Services Are Covered By A Health Insurance Policy
2011-08-22
Ancillary services are often used by your primary care physicians, general doctors and even dentists as a way of ensuring that you get the full coverage that you need. There are more ancillary service providers than there are doctors, so it's important to understand what they offer and how your health insurance will cover their services.
Ancillary services are divided into three categories. These are diagnostic, therapeutic and custodial. Your health insurance plan probably defines these separately so that you have a clear definition of what is and is not covered, how many of them or for how long.
If you have an HMO and you visit your doctor for a broken leg, your doctor is going to send you for X-rays. That X-ray office is an ancillary provider that falls under the diagnostic category. The service will be covered by your insurance, because your primary care physician sent you there. If you require going into a nursing home because of the injury, you will likely be covered because it falls under custodial, but the definitions of your plan will probably tell you how many days you will be covered for, as there is usually a limit.
As you visit your doctors, regardless of whether you have an HMO, PPO or HSA, then you will likely be referred to ancillary services whether you were aware of it or not. Most of the time, these are covered by your health insurance policy, at least in part. When your doctor knows that you have insurance, they will likely check your explanation of benefits to make sure that you do have the coverage.
Some diagnostic labs are covered by insurance companies while others are not. Doctors are usually pretty good about sending you to the right labs so that your insurance will cover it. The same goes for therapy and custody. If your health insurance won't cover where the doctor is sending you as part of your diagnosis or therapy, they will tell you.
When the expenses are out of pocket, you have the ability to refuse the treatment. If you have different types of medical insurance, such as Medicare supplemental insurance, you can choose different plans that will provide you with more coverage for ancillary services. This will ensure that you are paying as little out of pocket as possible.
Whenever you choose to switch providers or even switch plans, it's a good idea to find out what ancillary services your health insurance company will and will not cover so that you don't get any surprises after you've been diagnosed with something. Being prepared and asking the right questions can make all the difference.
