In the UK alone, around 7 million people are covered by health insurance. Even more so are covered in the United States. Most of these people are covered by their company. However, very few of these people have actually reviewed their policy and understand what is or is not covered.
If you think that health insurance pays for all health costs, you’re mistaken. Health insurance usually only provides protection for short-term and curable health problems. Usually, health insurance allows you to see consultants, doctors, get surgery, or be treated. However, before you buy a health insurance plan you need to research the health bills that are not covered by your health insurance plan.
This article does not relate to any specific policy and individual health insurance plans are different. That’s why you should be sure to check your policy documents. After reading this article, you’ll know what to be on the lookout for!
If a condition is curable and is not a long-term problem, insurance companies classify it as “acute” and usually cover such problems. However, if a problem is not curable or will require long-term treatment, then it is classified as “chronic”, and you usually won’t be covered. Drawing a fine line between “acute” and “chronic” usually leads to difficulties between the insurance company and the policy holder.
It is agreed that problems such as diabetes and asthma are chronic conditions, since they likely last for your entire life; therefore, these are not covered by insurance. However, when a doctor considers one’s illness to be curable but it quickly deteriorates and it becomes incurable, it is defined by insurance companies as chronic, as it has become chronic during treatment. These problems usually arise in different stages of cancer.
Insurance companies usually do not pay for long-term treatments. Be sure to check your policy information to see how your insurance provider defines a long-term condition. Many times, if use of a single drug extends for a year or so, the insurer will only pay for the first ten months.
Most insurance plans only pay for the treatment and cure of conditions after the arise, not for treatments that may prevent a sickness. once again, how your insurance provider defines this can cause problems. For example, the drug Herceptin can be considered as a cure or preventative. Herceptin is used in the early stages of breast cancer, and can halve the chance of cancer returning for woman. However, it can be considered as a cure or preventative. Insurance companies and policy-holders can have problems in such a case.
Hopefully, this article has been helpful to reviewing your health insurance plan. Always contact your insurer when you have any doubt about whether your medical bill is covered.