## Health Insurance Basics: What’s Covered and What’s Not?
Navigating the world of health insurance can feel like deciphering a foreign language. But understanding the basics is crucial for protecting your health and your wallet. Let’s break down what health insurance typically covers and where the gaps might lie.
Generally, health insurance plans cover a wide range of services designed to maintain and improve your health. This includes:
* **Preventive Care:** Routine checkups, vaccinations, and screenings are usually covered at little to no cost. This is thanks to the Affordable Care Act, which emphasizes preventative care for overall health.
* **Doctor’s Visits:** From routine checkups with your primary care physician to specialist consultations, most plans will cover a portion of the cost.
* **Emergency Services:** Don’t hesitate to head to the emergency room in a true emergency. Health insurance typically covers emergency care, although out-of-network ER visits might come with higher costs.
* **Hospital Stays:** Whether it’s for surgery or an illness, hospital stays are generally covered, although deductibles and co-insurance often apply.
* **Prescription Medications:** Most plans have a formulary, a list of covered drugs. Different tiers within the formulary dictate your out-of-pocket costs.
* **Mental Health Services:** The ACA mandated that mental health services be covered similarly to physical health. This includes therapy, counseling, and psychiatric care.
However, health insurance doesn’t cover everything. Common exclusions include:
* **Cosmetic Surgery:** Procedures deemed purely cosmetic are usually not covered.
* **Experimental Treatments:** Treatments considered experimental or not yet proven effective may be excluded.
* **Alternative Therapies:** Acupuncture, massage therapy, and other alternative therapies may or may not be covered, depending on your plan. Check your specific policy.
* **Vision and Dental:** While some plans offer supplemental vision and dental coverage, they’re often separate policies.
**It’s vital to carefully read your insurance policy to understand exactly what’s covered and what’s not.** Pay attention to your deductible, co-pays, co-insurance, and out-of-pocket maximum. Knowing these details will help you avoid unexpected medical bills and make informed decisions about your healthcare. Don’t hesitate to contact your insurance provider directly with any questions you have. Taking the time to understand your coverage is a smart investment in your well-being.