With the dawn of the Patient Protection and Affordable Care Act (PPACA) phasing in new health plan requirements; many consumers remain miffed by what the terms of these new policies actually cover. Aside from the premiums, physician visits, and other standard medical co-payments, consumers tend to overlook what a basic Illinois health insurance plan covers. Whether it’s Blue Cross Blue Shield, Humana or Aetna, many Illinois health insurance policies have a litany of exclusions that consumer should note.
Maternities. Depending on the policy, certain Illinois health insurance policies do not cover the delivery charges or hospitalization costs for bringing a newborn in the world. While some policies include care for midwives and OB/GYN care, new families are often caught off guard with hospitalization costs.
Injuries or ailments incurred by illegal actions. Don’t count on any Illinois health insurance policy to cover the cost of any emergency care – hospital admission, resultant of drinking and driving, overdose of an illegal substance or even a failed suicide attempt. Also, accidents that are the outcome of a dangerous activity, such as jumping out of an airplane, bungee jumping or propelling off of a rooftop are often deemed excluded benefits.
Sexual reproductive enhancements. In the realm of sexual performance, reconstruction and transformation, most Illinois health insurance plans do not cover the cost of sexual transformation. While most health plans cover medications prescribed by one’s physician, diagnostic and surgical procedures for sexual dysfunction are predominantly excluded benefits.
Considering one’s health scenario, it’s important to create a list of medical service requirements. During the shopping process, compare the cost of any out-of-pocket exclusions to the cost of carrying a policy with all the needed medical services.
Hospice care, prescribed medications and home health care. Over the recent decade, some Illinois health insurance plans may or may not cover prescriptions and home health care. In an effort to keep health plans reasonable, some new policies offer programs for prescribed medications. Likewise, some Illinois health insurance plans cover custodial care and home health care. Once the PPACA is in full force, legislation requires Americans to set money aside for such services.
Even though the Patient Protection and Affordable Care Act will soon require that preventative medical services are free of fees, Illinoisans should still confirm which health benefits are included in each policy. While some plans offered via Humana One, Blue Cross Blue Shield features plans with preventative care benefits, not all health plans have revised their terms of service.
President of Illinois Life and Health.com Michael Novelli forewarns Illinoisans to peruse more than the policy’s premiums. Frequently, consumers obsess over monthly rates and are astonished when they discover that medical services such as maternal care are not a covered benefit.
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