What’s Covered

Or Really What Isn’t

If you are worried that a medical service isn’t covered by your insurance, take a chill pill. That chill pill is probably covered under health insurance, and so are surgeries, x-rays, hospital stays, blah blah blah.

If a health care provider is about to use a medical service on you, they sometimes need permission from your health insurance company to do it. This is called prior authorization. When your health plan gives the OK, then the provider can use the medical service on you, and the treatment will be covered by health insurance. But there are some things that health insurers just will NOT pay for.

A health plan will probably not cover experimental services. This means anything that’s new or doesn’t have a lot of research backing it. An obvious example: marijuana. Although many people scream that it’s a wonder drug, it’s still considered an experimental drug (which a lot of people experiment with), and if you get a prescription from a doctor for medicinal marijuana, you will need to pay full price. Sorry, but you’ll need to budget your munchie funds.

Services that are cosmetic only are generally not covered by health insurance. Sorry ladies, you’ll need to save for those silicone implants. If a surgery is only intended to change appearance it will probably not be covered unless it’s done for the person’s health, like a skin graft for a burn victim.

Vision and dental care are interesting as they each have separate insurance plans even though they are both very important to a person’s health. I guess the eye doctors and dentists are too cool to play with the other doctors. Anyway, you will probably need a separate insurance policy if you want coverage for glasses and contact lenses or if you need to get your scummy teeth cleaned.

And if there’s one thing that health plans absolutely hate, its alternative therapies. If a person is sticking long needles into your skin to relieve “bad karma,” insurance is probably not going to pay for that.