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What Does Your Health Insurance Plan Cover?

Meredith Miller | Published: June 14, 2018

Heart shaped pills

After a lengthy and most likely frustrating search, you finally found the most affordable health insurance available in your area. Health insurance plans can greatly reduce the stress associated with most medical bills. Now that your health insurance has kicked in, you decide it's time to schedule that consultation for the latest cosmetic procedure that you've been putting off. After meeting with the doctor and setting up a follow-up appointment, they begin to talk pricing. You brush it off and say your health insurance will cover it. You may be in for a rude awakening.

Keep reading for a comprehensive breakdown of what you will get if you purchase health insurance plans. Sometimes the most affordable health insurance plans in your area may not provide the extensive coverage that you were hoping for.

What Your Health Insurance Covers

Health insurance covers a vast assortment of services that you receive from medical professionals in various situations. Insurance provides health coverage for wellness doctor's visits as well as sick visits when you have to diagnose a problem. Your health plan covers a certain number of vaccinations if you want them as well.

More often than not, even with the most affordable health insurance plan, your prescriptions will be covered, or at least partly covered. You also may have benefits on your affordable health insurance that cover tests such as X-rays, blood tests, urine tests and so forth. Additionally, some policies may also cover things like vision and dental services, but they are separate services most of the time. If you find a healthcare plan that includes all of those things, you've struck gold in the medical world. The goal is to find a plan that you can use to stay healthy at all times.

What Your Health Insurance Doesn’t Cover

Health insurance companies have the right to refuse payment for things that they do not believe are medically essential, but your coverage will likely be outlined in your policy. There are a number of situations and items that health insurance does not cover. One thing that health coverage does not pay is for injuries and illnesses that occur while the insured party is involved in a criminal activity. Covering such incidents and illnesses would be an ethical issue, and many insurance companies do not want to get involved. Health insurance also does not cover vaccines that you get just because you want to travel abroad. It's surprising that it does not cover those, yet it's absolutely true.

Affordable health insurance does not cover cosmetic surgery. It generally doesn't cover procedures that are not absolutely necessary for the insured person's health or wellness. Other items that such insurance may not cover are nursing home services, acupuncture, weight loss surgery, and certain medications. That's why it's imperative for you to check and make sure that you're covered for the benefits that you desire.

How Do You Know What Your Health Insurance Covers?

The way that you know what your health insurance covers is by reading plan details before you purchase a specific plan. You will be able to view a breakdown of all the features that your new insurance policy will have. You can also contact the insurance company if you have already purchased a policy and ask the customer service representatives to break down the different benefits you have and the services that your plan covers.

It's also a good idea to search for a health insurance policy through a broker or agent, as they are professionals in the field. When you work with an agent or broker, the first thing you will do is discuss what you need to be covered, and they will begin the search based on the criteria you specify. Make sure not to leave any detail out.

What Are Essential Health Benefits?

There are 10 benefits that professionals refer to as "essential" health benefits which can be found here. Today, even the cheapest health insurance plans need to cover the 10 essential benefits in order to be considered qualifying health plans. Those essential health benefits and services include:

  • Emergency Services
  • Preventative Services
  • Pediatric Care
  • Pregnancy Care
  • Substance Abuse
  • Prescription Medications
  • Rehabilitation Services
  • Lab Tests
  • Inpatient Care
  • Outpatient Care

Do All Health Insurance Plans Cover Essential Health Benefits?

All healthcare policies are supposed to cover the 10 essential health benefits, according to Obamacare. If they do not cover those essential health benefits, the providers may have to face penalties, and you may face a tax penalty if you are enrolled in an unqualified plan. It's imperative that you conduct thorough research and ask questions when you're looking for health insurance plans. It may be best to have a licensed agent help you with your search for health insurance plans to make sure you get exactly what you need at a price point within your budget.

Now that you better understand the mechanics of affordable health insurance, you can obtain a health coverage policy for yourself, and First Quote Health is here to help. First Quote Health specializes in finding you agents licensed in your area at no cost to you. Get started with your search today, and find an affordable health insurance plan the covers all your needs.