subject: What Do Most Illinois Health Insurance Plans Exclude? [print this page] 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.
Maternity. Depending on the medical policy, some Illinois health insurance policies do not include delivery charges or hospitalization for newborn conception. As certain policies extend care for midwives and OB/GYN care, new families are often left to flip the expense of hospitalization costs.
Injuries or ailments incurred by illegal actions. Don't rely on any Illinois health insurance policy to cover the cost of any emergency care admission that is the byproduct of a failed suicide attempt, accident resultant of driving inebriated or an illegal substance overdose. Also, accidents that are the outcome of a dangerous activity, such as bungee jumping, hang gliding, or propelling from elevated facades are often deemed excluded benefits.
Sexual reproductive enhancements. As for sexual performance, reconstruction and transformation, few (if any) Illinois health insurance policies will cover the cost of gender changes. Even while some plans include prescribed medications for erectile dysfunction, diagnostic and surgical procedures are generally 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.
Prescribed medications home health care or hospice care. In recent years, certain Illinois health insurance policies may or may not include prescription and home health care. In an effort to keep health plans economical, some plans are strictly for prescribed medications. Correspondingly, some Illinois health insurance plans cover home health care, and custodial care. After the PPACA is in place, the law mandates that Americans will have to set aside funds for such services.
While the Patient Protection and Affordable Care Act will soon cover preventative medical services, Illinoisans should validate what benefits each policy covers. Blue Cross Blue Shield has several programs with these benefits; however, not all health plans have updated their terms of service.
President of Illinois Life and Health.com Michael Novelli alerts Illinoisans to analyze policies in their entirety. Frequently, consumers obsess over monthly rates and are surprised when they discover that services such as maternity al care are not a covered benefit.
by: Holly Bentz.
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