What is Included And Excluded in Health Insurance Plans
Reader’s Question:
I understand very little about health insurance policies, and I constantly feel in the dark. I do not even have a clear idea of what might not be included, and this worries me. I’ve just always thought that health care insurance policies would save me from exorbitant medical expenses! Can you explain some of the limitations of a health insurance policy? I live in Louisiana.
Joy
New Orleans, LA
If you think that your health care plan includes every medical cost you might have in the future, you’re up for a surprise. Mostly, a very good health insurance plan means that you will only need to pay for a minimal amount, but certainly there are limitations to what is covered. Here are some exclusions to your health care policy.
First of these are pre-existing conditions. Many health insurance companies are reluctant to shoulder the cost of those medical conditions that you already had before you bought the health insurance policy. Insurers generally have an exclusion period of about 6 months; The state of Louisiana allows this period to be as long as one year. This means you cannot get coverage for pre-existing conditions within the first 6 or 12 months, depending on your contract.
Another is drug abuse. This exclusion assumes that you have inflicted the problem upon yourself. So, in the same way, attempts at committing suicide are excluded. So is alcoholism.
Mental illness–especially if it has already manifested before the start of your contract– will not be covered, as well. So, your psychiatric care will not be paid for by the health insurance company. The same goes for any treatment for learning and behavioral problems.
Cosmetic surgery is not vital to life or living, so looking more beautiful is something you will have to spend for on your own. Most medical procedures considered to be preventive are part of the exclusions, too. So are dental and eye care.
Of course, the best advice I could give is for you to make sure that you read your contract with any insurer very carefully and ask your health insurance company the questions that boggle you.
Tags: Health Care, health insurance, insurance
What does all that medical health insurance jargon mean?
Say you’re going to be traveling to a country where English isn’t the official language. If you want to be understood and to understand, and don’t want to be completely confused while you’re over there, the least you want to do is learn a few key phrases, right? You might not be able to become fluent in the language over night–that only comes with experience–but to a certain degree you can at least be able to get by and not be lost in a such a foreign place.
The same basic principle applies to medical health insurance. These medical health insurance policies often come full of crazy jargon that is not explained and that you don’t understand, and so it makes choosing a health insurance plan difficult because you don’t understand what it means. There are many kinds of medical health insurance, such as:
- FFS, which means indemnity fee for service.
- HMO, which means health maintenance organization
- POS, which means point of service
- PPO, which means preferred provider organization
All of these plans is very unique and individual, and you should consider all of its features before you make a decision on what kind of medical health insurance plan that you want. The last three are considered to be more managed, and the care for yourself and your family is more organized, although it is also more restrictive.
Cheers,
Fashun Guadarrama.
Traveling health insurance
Reader question:
I live in Kentucky but I’ll be going to England next summer for a student program. Do I need international traveling health insurance while I am there?
Miranda
Absolutely!
Health insurance is always a necessity, in whatever part of the world you are. Outrageous medical bills are among the leading cause of debt in American society, and debt leads to bad credit and poor opportunities, which also leads to more difficulty in getting medical health insurance in the future. It’s especially important to be insured when you’re going to a strange place that you are not familiar with, where you might meet up with unknown dangers. That isn’t to say that England is a scary place, but accidents tend to happen on trips when you are in unfamiliar surroundings. You don’t want to be caught unprepared.
Not only is the lack of familiarity a problem, but getting the care you need once in England could cost you a lot of money, which is why I want to stress the important of international traveling health insurance. If you have medical health insurance within the country, almost all of the time that will not be accepted abroad. Government programs like medicaid and Social Security go the same way. If you go out of the country, you have to have other plans. Consider that a medical evacuation out the foreign country and to the United States often costs upwards of $50,000.
Some medical health insurance policies do carry a international traveling health insurance coverage, but if yours doesn’t, you should think about getting temporary health insurance for the duration of the time you will be out of the country. A lot of medical health insurance plans exist that specifically cover people who are traveling, so it shouldn’t be too hard.
One way that you can get a hold of some international traveling health insurance is through your travel agent. They often can help lead you in the right direction towards what you will need. If you get this kind of insurance, it can bring coverage for things even as expensive as medical evacuation to the U.S.
The key to finding a great international traveling health insurance policy is to look around among the companies that exist and compare quotes. You want to get a good deal, but remember that it is very important to get good coverage while you’re abroad, because while you’re that far from Kentucky, you won’t have anything to fall back on.
Cheers,
Fashun Guadarrama.