How to Check for Health Insurance Limitations

According to the Journal of Health Affairs, recent studies show that an estimated 2 million Americans declare bankruptcy each year due to medical debt. What you might find even more shocking is that, of those 2 million Americans, a little over 75% of them had health insurance to help with the cost of medical treatment! How could medical expenses overwhelm an insured family so easily? Because a lot of people don’t realize that there are restrictions on their insurance coverage until the bill has already been submitted to the insurance company.

Are You Underinsured?

Many Americans who think they have adequate health insurance coverage are actually under-insured. If you think you might be one of them, check into your insurance coverage and make sure you find out specifically what your insurer will or will not cover. Before you make an appointment with a specialist, you might want to look over your insurance coverage and make sure you aren’t subject to any limitations which might affect whether your insurer will pay the bill.

Checking Health Insurance Policy Limitations

How do you check for limitations on your coverage? Generally, when you apply for coverage, you will receive a booklet which details the terms and limitations of your policy. Also, if your employer has an annual open enrollment time at work, that is a good time to call different companies and ask them specific questions about their coverage such as:

  • Does my plan cover preexisting conditions?
  • What is the maximum out of pocket expense?
  • What if I use a doctor outside of my network?
  • What limitations on devices or medications do you have?

If you have any conditions which require you to see a certain kind of specialist, or if you are currently taking any medications, you may have other questions which apply to your specific situation as well.

Also, be sure to check the mail for any correspondence from your insurer which might indicate a change in your health insurance coverage. Nobody plans to get sick – but the more you understand about your health plan the more likely you are to be safe than sorry.