sometimes insurance doesnt cover some medical things. my mom said that she knew a man who had cancer in his eye and his insurance wouldnt cover it because they said it was comestic. does it depend on the company? and usually what other things does health insurance not cover?
Insurance - 4 Answers
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Understand medical underwriting. Ahhh, here's the best kept secret in purchasing private health insurance. When a plan discusses the need for medical underwriting of the policy, they intend to screen your medical history (including covered family members) for any indications of problematic health conditions. Now, please be aware, they are not just screening for serious conditions. Rather, they are attempting to screen out all policy holders who might ever require significant health care. For example, if your weight is too high, you may be denied coverage! Obviously, if you or a family member has a serious issue such as heart disease, diabetes, asthma, a disability, etc., then you can assume health insurance will either be denied or that coverage will be offered for all health care except for the specific health issue (known as a waiver of coverage for a specified condition).
2 :
Health insurance covers procedures that are "medically necessary" if the man had cancer in his eyes that would hardly be considered cosmetic. Cancer of the eye would definitely be covered.
3 :
It depends on the company, but most, if not all companies, don't cover cosmetic surgery (like nose jobs, liposuction, face lifts, breast enhancements) unless it's reconstructive after cancer or accidents. Most don't cover infertility treatments. Some don't cover maternity, some don't cover birth control. Keep in mind, each company has multiple plans in every state - and some things are required by the state, so it ALSO varies by which state you live in.
4 :
Health insurance works by estimating the overall risk of healthcare expenses and developing a routine finance structure (such as a monthly premium, or annual tax) that will ensure that money is available to pay for the healthcare benefits specified in the insurance agreement.
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