What Does Health Insurance Cover? – 7 Areas

What Does Health Insurance Cover? – 7 Areas are listed and discussed in this article. You will find it informative.

What percentage does health insurance cover

What Does Health Insurance Cover? - 7 Areas
What Does Health Insurance Cover? – Photo Source: https://www.quora.com

One of the basics of every individual is Health insurance because having a good one is very important as it would help you to access prompt medical services when you need them and at the price that you can afford.

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The more knowledge that a person has about health insurance will help them make better choices when they want to sign up for it.

In this article, we will be considering a few things that health insurance covers. These are things that you should look out for when you consider buying an insurance plan from an insurer.

1. Already existing conditions:

Ever since the passage of the Affordable Care Act, one can rest assured that the insurance plans that he buys have total coverage for his pre-existing conditions.

Before, now, insurance companies usually refuse to add up pre-existing conditions to their insurance package, thereby causing a lot of issues for the insured after purchase.

Most times, people buy insurance because of their pre-existing conditions and get so surprised to realize that the insurance companies do not cover the same conditions that they bought the policy for.

2. Prescriptions

Most insurance plans are expected to cover up or offer coverage for prescription drugs however, the kind of medications that are covered may differ and are subject to the insurer’s choice or discretion.

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When buying an insurance policy, it is of utmost necessity to check out the approved medications by that insurer probably on their website or any other places that they may make it available.

However, as part of the document sent to you by your insurer, the list of approved medications should be enclosed in it. It is also not out of place to call your insurer in order to find out the drugs that are on the list and those that are not.

3. Hospital and doctor visits:

Visits to your specialist, primary physician, or any other medical provider are one of the core things that health insurance must cover.

When you get health care services at the hospital, your insurance plans should cover it even if it is a minor emergency or a major case like surgery, or even outpatient care, overnight stay, or procedures.

4. Doctor’s Visits

Health insurance covers the cost of visits to see your primary physician, specialists, and other medical providers. It also covers when you get health care services at a hospital, whether for emergency care or surgeries, outpatient care, procedures, or overnight stays.

The insurance policy might require that you should be responsible for the deductible of the plan, coinsurance cost, and the copayment but as long as you stay in-network and the situation you are faced with demands medical attention, the insurance plan should be able to fund a greater part of the cost once you get to your plan’s deductible.

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5. Essential health benefits

With the Affordable Care Act in motion, there is a guarantee that insurance plans on the healthcare marketplace should offer essential health benefits which include but are not limited to; Emergency services, Pregnancy, maternity, and newborn care, Hospitalization, Prescription drugs, Pediatric services, which includes oral and vision care (adult dental and vision, however, are not compulsory), Ambulatory patient services, wellness, and Preventive services which may include shots and screening services as well as lingering disease management, Mental health, and substance which are used disorder services, including behavioral health treatment.

6. Preventive services

It is expected that every insurance plan covers some preventive services in regard to your health without charging you a dime for it.

What this means is that you cannot be charged a coinsurance or a copay. The preventive services can be subdivided into three categories which include children, all adults, and women.

7. Birth control and breastfeeding services

In cases where there is a need for insurance companies to foot costs for breastfeeding or birth control, it is part of their obligation to do the same in order to contribute to the well-being of both the child of the insured and the insured.

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These are some of the basic things that any health insurance should cover. They are not limited to these.

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