Insurance Quote Hero

Health insurance is there for our protection and coverage for medical expenses. But just like any other insurances, there are also some limitations and exclusions as to what is the coverage of your policy. In a way, this is for the protection of the insurance companies that they don’t have to pay for unnecessary expenses that will result to lesser profit for the company. Remember at the end of the day, insurance companies are still business that needs to earn profit to be able to continue operation and provide more coverage. Here are some of the typical limitation and exclusion of your health insurance:

• Pre-existing conditions- many health insurance will provide a six month to a year waiting periods for pre-existing conditions in cases like lapse of insurance coverage that’s more than 63 days. Lets ay for example that you have diabetes, once you leave your job and would still be unemployed after some time then you would have to purchase an individual insurance. This is to avoid the waiting period and still be covered until your next policy.
• Cosmetic surgery- this is not really needed for health purposes that’s why it is not covered. Most would undergo cosmetic surgery for aesthetic purposes but if the cosmetic surgery is recommended for correction of certain conditions and it is endorsed by doctors then most likely it would be covered. An example of cosmetic surgery that may be covered under your health insurance policy is a reconstructive injury because of an injury or injuries due to birth defect like cleft palate. Face lifts and liposuction are not covered because these are elective surgeries that you should pay with your own money.
• Non-traditional treatments- treatments that are used instead of conventional medicine and treatments are called alternative treatment. Sometimes, these can be used together with the conventional medicines and treatment but it is not really required. It is not covered because it considered as experimental and non-traditional in nature. Examples of such are acupuncture, yoga, acupressure, massage or biofeedback.
• Home care and private nursing care- there are some type of sickness that does not require for you to stay in the hospital and would just require home care. This type of care is not covered for some health care benefit however there are some policies that offers this as an advantage.
• Mental health treatments- depending on the policy some would cover for mental health treatment and drug rehabilitation.  However if the substance abuse is because of addiction and self satisfaction as opposed to abuse due to mental illness, then for sure it is not covered. You will have to get referral from your doctor to be able to get mental health treatments.
• Common drug benefit exclusions- drugs that are used for cosmetic purposes are not covered as well as non-traditional drugs used for treatment. An example is hair growth stimulants or diet and weight loss pills.  You can also expect food supplements and vitamins to be not included in the coverage.

These are only some of the exclusions and limitations in health insurance policies. It is important that you get to know and study your health insurance policy to get to know more about this. It is helpful to know these things so that you can avoid paying for medical expenses out of your own pocket. If in doubt, you could always ask your insurance company to be sure and not get shocked when the bill would come only to find out that it is not covered. You can also discuss with your doctors to stick with treatments that are covered by your insurance to avoid extra expenses.