There are plenty of reasons to live in Houston, TX. One of these reasons is access to world-class health services. Unfortunately, world-class health care is expensive, so you want to make sure you have reliable insurance. While comparing policies, it’s easy to get lost in the murky details. Let’s take a minute to demystify some of that murkiness. Insurance Over Texas has put together this quick list of benefits that will and won’t be covered by most insurance policies.
10 Essential Benefits
The ACA mandates certain levels of minimum coverage, regardless of state. While the applications of this coverage will vary by your policy, you can expect at least some coverage in these ten areas:
- Outpatient services (you didn’t have to be admitted to the hospital)
- Emergency services
- Maternity care
- Mental health and substance abuse services
- Prescription Drugs (though not all varieties will always be covered)
- Lab Services
- Preventative services
- Pediatric services
By federal law, health insurance has to address all ten of these benefits. That doesn’t mean that the coverage will be identical across policies. Deductibles and premiums will still vary even though these ten benefits are universal.
What Isn’t Covered
It’s hard to make broad statements about coverage because there is so much variety, but these services are rarely covered by insurance:
- Alternative medicine (like acupuncture)
- Cosmetic surgery
- Geriatric care (although there are alternatives to help with this)
- Dental and Vision (unless you get specific policies for these benefits)
- Weight loss treatment
- Some medications
You might notice that medication appears on both lists. Some amount of prescription drug coverage is required by law, but insurers have a lot of room in how they distribute those benefits. You might only be covered for generic medications as opposed to brand names, for instance.
If you want a complete view of how your policy works, it helps to talk to an expert. Your Insurance Over Texas agent can go over the details with you to make sure there is no mystery or uncertainty. Remove the doubt so you can have less stress in your life in Houston, TX.