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Are you covered? The top 10
treatments that
your health plan
may not pay
for | Think that your every health care need is
covered by your insurance plan? It may not be so. Taking
the time to read all the material associated with your
health care package may keep you from being surprised
later.
Here are the top 10 treatments that your health
insurance plan may not cover:
- Maternity expenses. Pre-natal and delivery
expenses may not be covered in all plans. If you are
planning on having a child, be sure to check your
current health care plan to find out what it will pay
for. If your company offers several choices for health
care, you may need to switch to a plan that covers
these expenses.
- Eye doctors. Routine visits for an eye exam, even
if you go to an ophthalmologist, typically are not
covered unless you have a medical condition, such as
glaucoma. Low-cost vision insurance can help pay for
eye exam costs, glasses and contact lenses. Surgery to
improve eyesight is generally not covered by health
care insurance.
- Treatment for drug addiction or alcoholism. If
treatment is included in your plan, what is covered
can vary greatly. Some plans will cover in-patient
treatment but not out-patient programs.
- Nursing home or home health care. With shorter
hospital stays a goal in saving health care costs,
even patients too young to retire may require a stay
in a long-term facility or home health care. Find out
what your plan will cover and for how long.
- Cosmetic surgery. You most likely are on your own
if a facelift or liposuction is in order.
- Treatment for weight loss. Prescription
medication, surgery, dietitians and exercise trainers
may be what the doctor ordered, but check with your
plan to find out what costs you will be responsible
for.
- Mental health. Trips to the therapist may be
limited, or may not be covered at all. Some plans
restrict therapy to a particular group of counselors,
or offer an Employee Assistance Program. In-patient
psychiatric treatment may be covered in some
instances, but not always.
- Any treatment related to an accident. If you are
hurt on the job or in an auto accident, your health
care provider may not cover you.
- Preventative care. Your annual physical or flu
shot may not be covered. Most plans that have a
network of health care providers cover at least some
of these expenses, but be sure to check, especially if
your physician is out-of-network.
- Chiropractic, acupuncture or other types of
alternative care. Read your plan closely or call your
human resources department to determine if you will be
covered. A chiropractic visit for a sore back may be
covered, but not a visit to cure asthma.
So you’ve determined that your current health care
plan does not cover treatment you need. What can you do?
If your company offers a more expensive health care plan
that covers the services you need, consider switching to
it. You may be able to purchase supplemental coverage,
such as vision insurance, to help defray the costs.
Another option is a Medical Spending Account (MSA),
which allows your employer to deduct a pre-tax amount of
your pay for medical expenses that aren’t covered by
your plan.
If your benefits guide isn’t clear about whether a
particular treatment is covered, don’t assume that it
is. Call your benefits administrator to find
out.
© 2004 by Roger
Lacocoa, Affordable Health Insurance
Quotes.
~~~~~~~~~ About the author:
Roger Lacocoa is a professional
consultant with Affordable Health Insurance
Quotes, specializing in the areas
of health, life and disability
insurance.
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