A Few Services That are Not Covered in Health Insurance

HBI Blog / A Few Services That are Not Covered in Health Insurance

It is a monumental task to navigate through various health insurance plans. Health insurance plans are among the most confusing “subscription” you can buy. Unlike anything else in the world, when you sign up for health insurance you know (almost) nothing. You don’t know if your monthly premium will hike up (in some cases overnight), what services are covered and what services will be out of pocket costs, there is no way to figure out a set amount for the same procedure as it varies from town to town, insurance plans to insurance plan and the list of confusing details go on and on… It is common to face such scenarios where a doctor requests a service, the patient goes through it, and then, finds out that the service is not included in their insurance.

We wanted to provide a list of most commonly “non-covered” services and procedures here, but, very quickly, we realized that this list varies between insurance companies, insurance plans offered by the same company and worse based on your age, city and state.

A Few Services That are Not Covered in Health Insurance

However, we still attempted to provide you with a few services/procedures that are almost always never covered by an insurance plan.

Cosmetic Procedures

Health insurance plans often exclude services that can improve someone’s exterior appearance. Plastic surgery of cosmetic nature and some other dermatological procedures are some of those services. However, the interesting thing is, the price transparency for these procedures is greater than others. For example, a customer, who wants to undergo laser hair removal treatment, can call several providers, or search on Health Beyond Insurance and can immediately get a price quote.

Fertility Treatment

Fertility treatment costs are usually not covered by medical insurance. Patients/customers are required to pay for all the tests that are required for a complete infertility diagnosis. The laws of fertility treatment can vary from one state to another. As of August 2020, fertility insurance coverage laws have been passed by 19 states, of which 13 include IVF coverage. Moreover, 10 states have amended fertility preservation laws for medically-induced infertility.

“Off-label” Prescribed Drugs

Prescription drugs are those that are tested and then approved for some specific disorders. However, there are certain times when a doctor might prescribe such drugs for disorders that are not listed on the “label”. In such cases, there are chances that the insurance company will deny paying for such medications.

New/Experimental Treatments

It takes time for a health insurance company to include the latest treatment technology on its list. If the technology fails to demonstrate an added benefit for the increased cost, it might take even more time. Mostly, the companies wait for more data to ensure that it will be safe to include in their list of services.

Apart from the above services, several others are not covered by health insurance. The list varies from one insurance company to another. Therefore, before choosing insurance, go through it and make some calls, if necessary, to get a complete insight on what’s included and what’s not.

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