Understanding what health insurance does and does not cover

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Insurance doesn’t cover everything

Health insurance is often a controversial issue. From criticism of for-profit insurance companies to new laws that are having a dramatic impact on how health care works, it can be difficult to understand exactly what is and is not covered by a typical insurance policy. Without an understanding of what insurance companies do and do not cover, you could be placing yourself at serious financial risk.

health insurance coverageIt should be noted that no single insurance company provides coverage for all diseases. While insurers in the U.S. are required to provide coverage for those with pre-existing medical conditions, chronic issues such as diabetes and asthma may only receive a minimal amount of coverage. Cancer is something that many insurance companies will cover as part of their typical insurance offerings but can still leave many with high out-of-pocket expenses . As such, cancer insurance exists as auxiliary coverage and is designed to tackle the very specific issues that are associated with cancer.

Some medical care is not covered by typical insurance policies

General health insurance policies often provide coverage for medical testing. Procedures including cancer screenings, blood tests, and similar examinations are often covered by an insurance policy. Specialty or experimental procedures, however, as well as certain types of treatment may not be covered by insurance policies. Dental work, weight loss programs, hospice care, disability and cosmetic surgery are not typically covered by general insurance plans, but there are supplemental insurance policies that do provide coverage for such procedures.

Many health insurance policies do not provide coverage for certain types of medication. While some insurers do offer coverage for general medication, specialty medications and those that are still classified as “experimental” are not usually covered by an insurance policy. Some pharmacies do offer financial aid and payment plans that can help mitigate the cost of specialty medication.

Understanding what health insurance does and does not cover could make a major difference in how much money you actually pay for your medical care. The best way to understand what coverage you are purchasing is to read the actual policy and speak with your insurance agent so that you understand the stipulations of your policy.

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