If there’s one thing that we have come to realize over the past couple of years of being a global pandemic, it’s that healthcare in most parts of the world sucks. Conversations around medical expenses and healthcare insurance have been around forever, but they have been in the forefront of everyone’s mind during this time. People are constantly worried about a sudden medical expense that they cannot afford, especially since other factors like job loss and poor business have also piled onto that burden.
Health insurance can help lift some of that weight off a person’s shoulder as they do not have to worry about not being able to afford a number of medical expenses from emergency, surgery, or critical illness that may befall themselves or their family.
Employer-funded or government-sponsored healthcare are the most common types, although you can choose to go with a private insurance provider as well. Whatever it is, make sure to get the best plan that you are able to afford. However, keep in mind that there are some conditions that even the best of health insurance policies does not cover. So, you may have to decide whether it is worth going that extra mile based on your specific situation.
Here are 5 things that your health insurance probably doesn’t cover:
Any healthcare policy provider will ask you to disclose all your pre-existing health conditions along with your application. This information is used to devise a plan for your unique situation, including the coverage and extra charges if they apply.
You cannot hide any pre-existing conditions from your insurance provider because they will do their own background check anyways. If they were to find you lied about or hid a medical condition you have, it could lead to circumstances ranging from having to pay for a very expensive plan, having your policy canceled, or even being blacklisted!
Still, even if you are prepared to pay premium prices, your policy probably will not cover the cost of pre-existing conditions, although there are a few private health insurance providers who may let you get cover if you are willing to shell out some extra dough. Make sure to ask your policy provider about them before signing your name on the plan presented to you!
This may come as a surprise to you, but most health insurance plans do not cover abortions, infertility-related treatments, or even pregnancy! While you can still get health insurance if you are already pregnant, medical expenses related to it are not covered because it will be considered a “pre-existing condition”.
Needless to say, insurance companies won’t cover the cost of abortions either. Infertility treatments are also excluded under most policies, although health insurers may be required to pay for treatments and doctor visits that lead up to such a diagnosis.
However, you can get a maternity insurance plan, which would cover the cost of delivery, be it normal or cesarean, pre-and post-delivery hospitalization charges, doctor charges, and certain other costs related to newborn care. Maternity coverage can be obtained as an add-on to your basic individual or family health insurance plan. Some maternity plans may also cover abortions and/or infertility treatments.
While vaccines are typically covered under most health insurance plans, those related to travel are often considered non-essential, and therefore, not covered. So, your insurance provider may consider the flu or tetanus shot necessary for your health, but at the same time, consider any number of vaccines you may need to take before traveling “optional” or “elective”.
This is not ideal because doctors may recommend you to take certain vaccines before traveling to certain parts of the world. These are usually more than one, and usually pretty expensive!
Cosmetic And Non-Essential Surgeries
Health insurance is a basic necessity meant to keep people from being unable to get medical care during emergencies, surgeries, and other situations where a condition may take someone’s life or alter the quality of it to any extent. When all is said and done, cosmetic and non-essential surgeries aren’t really a priority. This is one of the major reasons that most health insurance companies do not cover the cost of such procedures under their plans. It also doesn’t help that the demand for cosmetic surgeries has been steadily going up in the last two decades.
This is worrisome from the customer’s point of view because cosmetic surgeries have been drastically growing in popularity. According to data from the ASPS, cosmetic surgeries among women is up 538% since 1997. Men have also been getting some of the action because there has been a 325% increase in male cosmetic surgeries during that same time period!
Liposuction, breast augmentation, eyelid surgery, plastic surgery, and facelifts are among the most common types of cosmetic surgery that health insurance providers refuse to cover. However, there are certain instances where some of these may be considered essential, in which case a person can petition their health insurance provider to get coverage. For instance, a person who has been disfigured due to an accident may need reconstructive plastic surgery, or a morbidly obese person may need abdominoplasty or “tummy tuck” in order to reduce weight quickly and save their life.
It’s safe to say that health insurance providers take their sweet time catching up to the advancements in the medical community. This means that it takes quite a bit of time for them to get around to including new drugs or treatments in their coverage plans.
Insurance providers consider the benefit of any drug or medical procedure before they approve the coverage of it. This means that they take into consideration studies and research that prove their efficacy. The burden is on medical companies to prove that a new test, drug, or other product is worth the cost to improve mortality or morbidity rates of patients – to put it simply, that they can save costs, save lives, or improve the quality of life.
Since it takes government-provided insurance policies a bit of time to get around to covering them, most private insurance providers also follow suit and wait for more data before jumping on board.
There may be no one-size-fits-all policy that we can tell you is the best. Different policy providers offer different levels of coverage and charges vary based on a number of factors. It is up to you to research all the plans available in your area and pick the one that best suits your healthcare needs. You can do this by listing out all your options and filtering out ones that both fit your budget and offer the care you require. Make sure to check all the network hospitals and doctors that your insurance provider covers before signing on with them!