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What does health insurance cover?
Your exact level of cover will depend on the provider and type of policy you choose. But most life insurance policies will generally offer similar types of protection and come with common exclusions.
- Hospitalization
- Pediatric services
- Prescription drugs
- Emergency services
- Ambulatory patient services
- Hearing Aids
- Fertility treatments
- Travel Vaccinations
- Nursing Home Care
- Cosmetic procedures
Partners Include
What happens if...
my doctor recommends care that isn’t covered?
Most of the things your doctor recommends will be covered by your plan, but some may not. When you have a test or treatment that isn’t covered, or you get a prescription filled for a drug that isn’t covered, your insurance company won’t pay the bill. This is often called “denying the claim.” You can still obtain the treatment your doctor recommended, but you will have to pay for it yourself.
I want to get vaccinated for travel?
Getting shots before your exotic foreign vacation? Your health insurance might not pay for your travel vaccinations. While all non-grandfathered health insurance plans cover vaccines routinely recommended for preventative care in the U.S., vaccines for tropical diseases that aren’t a problem where you live are probably not covered by your health insurance plan.
I hurt myself doing somethng illegal?
Your health insurance might not pay for healthcare costs you racked up doing something illegal. Known as an illegal act exclusion, if your health insurance policy has one, it means you won’t be covered for healthcare costs caused by your participation in an illegal act.
I have a pre-existing illness?
Suicide is not generally covered in the first two years of a life insurance policy but it is covered after that. This two-year period is known as a suicide clause. If a suicide happens more than two years after getting a life insurance policy, the life insurance policy will pay out death benefit to the policy’s beneficiaries. While beneficiaries are not entitled to death benefits if a suicide occurs during a policy’s first two years, they may receive a refund of the premiums that were paid into the policy before the death. The exclusion for suicides includes instances of doctor-assisted suicide. Five states allow assisted suicide: California, Colorado, Oregon, Washington and Vermont.
I want to go to a nursing home?
Neither Medicare nor private health insurance companies pay for long-term care. You’ll have to pay for your nursing home, assisted living facility, or custodial home health care yourself if you don’t have long-term care insurance or qualify for Medicaid coverage (the majority of nursing home residents do qualify for Medicaid,5 which pays for custodial care once a person has depleted nearly all of their assets).
My Claim Gets Denied?
Covered persons can contest a denial by an insurance company. Each insurance company is required to provide an insured person with the procedure required to appeal. In addition, if the appeals process results in another denial, the insured consumer can appeal to the state insurance commissioner for a review of the case. The process can be somewhat lengthy but is often without cost to the insured person.9
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Frequently Asked Questions
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A number of factors contribute to how much home insurance coverage you need. The first is the cost per square foot to rebuild or repair a home in your region. Your insurance agent should be able to provide you with this information
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