What Health Insurance Doesn’t Cover

Health insurance doesn’t cover everything. Listed below are some of the most common health procedures along with reasons why they most likely won’t be covered by your health insurance.

1. Travel vaccines, if going abroad, are not covered because travel is not medically necessary so therefore neither are the vaccines.
2. Acupuncture and chiropractic care are often not covered, but this is an area that is governed by the various medical plans and the state you live in. Chiropractic treatment from an accident will often be covered but visits to make you “feel better” usually are not.
3. Cosmetic surgery is generally not covered as it is not medically necessary. However, reconstructive breast surgery following a mastectomy would most likely be considered necessary.
4. Nursing home care is not covered by commercial health insurance plans or Medicare – that is what long-term care insurance covers. Also, Medicaid does cover nursing home care. Short-term rehab care in a skilled nursing facility following an accident is covered since it represents a medical incident.
5. Dental, vision and hearing coverage are non-existent in most health insurance plans; you have to purchase a separate plan for these services and in doing so, check carefully what you are paying for and what will specifically be covered. There are some Medicare Advantage plans that do cover some of these costs.
6. Weight loss surgery is somewhat covered by Medicare and Medicaid in some states. Some procedures for bariatric surgery are covered and some are not. Compare plans carefully.
7. Preventative tests such as colonoscopies and mammograms are covered but PSA tests and Vitamin D testing are not. Go to healthcare.gov to see which tests are covered in your state.
8. Medications are not always covered. There is flexibility by drug companies in creating their formularies; make your list of medications and do comparisons of different plans.

For greater detail go to nextavenue.org