All too many people assume that once they have a medical health insurance plan they are covered for all eventualities but this is not the case and most healthcare plans will exclude a range of treatments. Many people also think that once they have paid their premium that their medical bills are covered. Once again this is not the case and you will almost always be expected to meet a proportion of your medical costs.
The first important point to understand is that there are different forms of health insurance and that each provides cover for different forms of treatment. A traditional indemnity plan for example will not normally cover preventative treatment, such as annual check-ups and immunization, although this is usually covered under an HMO plan.
This situation is beginning to change and an increasing number of insurance companies are realizing that they can save money if they concentrate their attention on encouraging policyholders to stay healthy in the first place. As a result more and more plans are now covering preventative medicine and some even go so far as to offer discounts for the use of such things as health clubs and programs which help people to stop smoking.
Today most plans cover annual check-ups, annual eye checks, routine medical care, immunization, pre-natal care, well baby visits, urgent and emergency care and hospital care, including x-rays, blood tests and other laboratory work.
The precise mix of treatment covered however will vary between plans and so it is important that you check your plan document carefully to see just what is insured. Equally, you must read through the plan carefully to see what treatment is specifically excluded. Most health insurance plans will clearly specify any excluded treatments which will typically include such things as dental and eye care (except for routine annual eye checks), as well as a sometimes lengthy list of treatments for anything from acupuncture to weight loss.
Another thing that you need to look at carefully is the cover provided for prescription medicines. A growing number of insurance companies are excluding payment for prescription medicines from their plans as the cost of medicines continues to rise rapidly. Where cover is excluded it is often possible to arrange cover through a separate plan, as indeed is the case with dental and eye treatment.
Health insurance plans are complex legal documents in which the detail really is to be found in the ‘small print’. Simply purchasing a plan and assuming that you are covered for all medical events is likely to result in your being told, “Sorry, your health insurance plan does not cover you for that” when it come time to make a claim.
