Insurance offers financial protection against unforeseen risks that could lead to significant expenses. For example, auto insurance covers costs for car accidents and other damages, while life insurance provides peace of mind and financial security. Health insurance protects against unexpected medical expenses, including doctor appointments and prescription drugs. However, understanding how health insurance works can be complicated, with varying costs depending on the policy and specific services.
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Whether you're considering purchasing an individual plan, or are already enrolled in a health plan through work or the Affordable Care Act marketplace, it's important to learn what is covered and not covered by your specific policy. Your health plan's summary of benefits and coverage itemizes the types of care and services that are or are not covered, as well as any annual out-of-pocket maximums. You can also find out if you need to meet a deductible before your plan begins to pay for care and how much coinsurance is required.
For example, some health plans cover preventive visits at no cost to you, like annual check-ups, certain types of cancer screenings and vaccinations. However, other services may only be covered if you receive them from in-network providers or facilities. In addition, your plan may require you to get pre-approval for some services or ask your doctor to obtain it before they provide them (prior authorization or prior approval).
Homeowner’s insurance protects your house and other structures on your property from damage caused by fire, smoke, storms, theft, vandalism and more. In addition, it typically covers other items in your home, such as your personal belongings and appliances. In contrast, renter’s insurance usually only covers your possessions.
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What’s Not Covered
Many people are unaware that not every medical expense is covered by their insurance policy. There are several types of services that most plans exclude, including cosmetic procedures, vein removal, off-label drug use and new technologies. Understanding these rules and knowing what to do if your doctor recommends a service that your insurance company will not cover can help you make more informed healthcare decisions.