Five Things Your Health Insurance May Not Cover for You

Insurance can serve as a safety net for people who have doubts about their purchases and properties. However, all insurance policies come with a comprehensive list of prohibitions that can leave policyholders dumbfounded when the unexpected occurs. By being informed of what is and is not covered, clients can understand when to purchase extra insurance that may be needed. After doing enough research on the different kind of policies available, below are the most common exclusions we have encountered.

Breaking the Law

Your medical bills may not be covered by your health insurance when you are caught doing an illegal act. It is commonly called as illegal act exclusion. If your health insurance has this policy, it means you will not get covered for your medical bills that you have incurred while engaging in illegal actions. If you get burned while grilling at the family barbecue party then that will probably be covered by your insurance. Get burned while using cocaine? Then expect that medical bill coming right to you. Several states restrict these inclusions, while most states prohibit insurance companies from implementing insurance exclusions based on if the client is under the influence of alcohol or drugs.

Travel Vaccinations

If you are getting vaccinations before going to an exotic, overseas vacation, your health insurance may not be paying for your shots. While most health insurance companies cover preventive care vaccination, shots dedicated for tropical illnesses that are not encountered where you currently live will possibly not be covered by your health insurance. If you need a vaccine for chickenpox, the bill will definitely be covered by your health insurance. However, if you need a vaccine for yellow fever because you will be traveling to the Amazon River Basin, take measures now to ensure that you can cover the costs of these vaccinations.

Permanent Nursing-Home Services

It is ironic that the American healthcare system covers neither Medicare nor other insurance policies to help in paying for nursing homes. Medicare and others might provide short-term coverage in several professional nursing facilities just for rehabilitation purposes, however, they will not pay for a long-term or permanent care. For this, you will need another insurance care policy which is usually very costly. Medicaid is the only one offering an insurance plan that will pay for a fraction of long-termed nursing home care. However, it is required that you declare bankruptcy first.

Experimental Therapies

The United States is endowed with the most ingenious and well-funded technological researchers on the planet, who are consistently developing new therapies for acute illnesses, such as Alzheimer’s disease and cancer. However, if you are not lucky to be selected for a clinical trial, you will have to pay for your own non-FDA certified therapies. In some cases, you and your medical practitioner can request your insurance company to cover a preliminary therapy, if it is more cost-efficient than the usual treatment given in hospitals. This may result in lower expenses for the insurance provider in the long run.

Hearing Aids

Loss of hearing is one of the most common disabilities in the US, with almost 50 million Americans having some degree of hearing loss, usually in people aged 65 and above. Yet again, Medicare, the federal safety net program that is supposed to be the primary medical safety net for older people in the US, does not cover the bills when acquiring hearing aids. Other insurance companies and employers only provide ear exams, but do not cover hearing aids. This is due to the fact that hearing aids are regarded as elective. Arkansas, Rhode Island, New Hampshire and Connecticut are the only states that require insurance policies to cover hearing aids for both children and adults.

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  • These are all facts! It is important to know this before doing something that may not be cover with your insurance. Almost all insurance have always an exception to the rules and these are the particulars.

  • Great blog! It’s so important to be aware of the potential gaps in our health insurance coverage, and this article does an excellent job of highlighting five key areas that may not be covered. From cosmetic procedures to mental health services, it’s crucial to understand the limitations of our health insurance plans to avoid unexpected costs. The practical tips and insights shared in this article are invaluable for anyone navigating the complexities of health insurance coverage. Well done!