Health Insurance Articles
Three Things Health Insurance Is Not Meant To Cover For Patients
2010-12-07
Just because you have health insurance does not necessarily mean that you are covered for everything. There are a great many services and procedures that you might consider part of your regular health care but are included in your health coverage plan. The smart thing to do is to understand exactly what your health insurance will pay for and even more important; what it will not.
Virtually all health insurance policies include standard or basic health coverage protection that includes hospital services, doctor's care, specific and limited prescription drug benefits and other fundamental health services. These plans carry a lifetime maximum and an annual deductible of up to $1,000. Your contribution towards covered services can range from 20% to 40%. There are available options and additional coverage, like dental and vision care, that can be added to your health insurance. Every addition to the coverage package increases the cost of your policy in terms of increased premiums, higher deductibles or a combination of both. Regardless of one's specific desires, there are certain services and procedures that are not meant to be covered by health insurance and are not included in health coverage plans. Three more common of these are briefly described here.
Private nursing and in-home care is excluded. These services are not available as part of your plan. It is a common misconception that they can be added to coverage but that is not the case. You may not be able to find these exclusions listed in just those terms on your health insurance plan but you can be certain that they are. Ask for the explanation details if you are not sure.
Cosmetic surgery is not meant to be a covered procedure but there are mitigating circumstances that should be understood. Most important is the fact that not all cosmetic surgery is the same. In general terms, cosmetic surgery refers to the augmentation or reshaping of normal physical features for purely aesthetic reasons. Breast implant and rhinoplasty fall into this category. If the cosmetic surgery is necessary to correct abnormal structures that are the result of trauma, disease or congenital defect, it is classified as reconstructive surgery and in such cases it is often covered by health insurance plans.
Most insurance plans are not meant to cover behavioral disorders or treatment for learning disabilities. Even more serious conditions are not included in coverage in part because the conditions are ongoing, can last for many years and often cost the insurance company more than it can recover in premiums.
Know what cannot be added to your health coverage plan and what can. You may be surprised to learn what health insurance will not cover.
