It can be easy to assume that once you’ve done the responsible thing and secured health insurance, that any injury or medical issue you’ll face moving forward will fall under your coverage plan. Unfortunately, this may not be the case. Indeed, there are a number of circumstances that can prevent individuals from using their insurance to pay for legitimate medical needs. Here, we’ll outline three issues that health insurance may not cover –– so that you can plan accordingly for the future.
A Quick Word on Health Insurance
Before we begin, it’s important to note that health insurance plans are not identical. In fact, what they cover and what they don’t can vary wildly based on an individual’s age, well-being, marital status, and healthcare provider. Given that fact, it’s important for people to always check their own insurance policy first in order to determine what’s covered and what isn’t.
Visiting the dentist may not seem vital to a person’s overall well-being, but the reality is that oral health is often overlooked. The bad news is that dental procedures are not covered under most standard healthcare plans. The silver lining here is that most employers will offer health/dental coverage as a package deal.
Injuries Sustained from Illegal Activities
How a person sustains an injury can have a big impact on whether or not insurance will cover the costs associated with treating it. Specifically, some insurance policies contain an illegal act exclusion, which means that insurance companies can waive responsibility to pay for medical costs associated with injuries incurred as a result of illegal activities. So, for instance, if you break your leg while robbing a bank, you’d have to pay for any treatment on your leg yourself.
Preventative Tests and Treatments
Health insurance will cover a good number of preventative tests and treatments. However, certain tests are not covered in most health insurance policies. One common example of this is travel-based vaccines. Individuals who need to get vaccinated to visit another country will have to pay for those vaccines out of pocket. In addition, most preventative tests require some form of reasonable cause to administer. In other words, the doctor or patient must have a good reason beyond a “checkup” to request the test. Unfortunately, some issues like STDs can remain asymptomatic for long periods of time, and many people don’t understand their nature. (It’s unlikely very many people even know the difference between bacterial vs viral STDs –– let alone which STDs pose a serious health risk.) And while many people choose to visit independent clinics for regular STD testing, few insurance providers cover this service.
The Bottom Line
No two people share the same healthcare needs, so it’s imperative for everyone to understand what their insurance does and does not cover. (And they should also strive to understand the difference between health, disability, and life insurance!) Taking some time out now to figure that out can save you huge amounts of stress –– and money –– down the line.