What Health Insurance Doesn’t Cover

When you are faced with an emergency medical condition, the first thing you do is to visit the nearest health care facility or an emergency room. In such situations, you are charged for treatment offered and other services provided. The larger portion of the bill is covered with your health insurance plan. However, there are those medical procedures that your insurance does not include. Understanding what your policy covers is extremely necessary to avoid getting a nasty shock later. This article covers some areas where your insurance may not cover.

Surgery medication

If you have a routine operation or a surgery, your physician will prescribe medication to you. Some of these medicines are covered in your policy while others are not. You should consult your doctor for information on this. A good example of a counter medication that is not covered with health insurance coverage is aspirin.

Cosmetic surgery

There are health insurance policies that cover different surgical procedures, but it is hard to find one that covers plastic or cosmetic surgery. This is because the operation is aimed at improving an individual’s appearance rather than his or her health. Those who feel that the operation will improve their life in any way are free to consult their insurance company and ask if they could consider it.

Experimental and investigative treatments

When you visit a physician for medication, he or she may propose a clinical trial for you depending on your recommended treatment and diagnosis. Many insurance plans do not cover every trial especially those that are treated as “experimental”. Some insurance companies will consider a clinical trial if you prove to them that there are health benefits that you reap from it.


Health insurance covers medical cost for pregnancy complications. Pregnancy is not considered as a pre-existing condition. Medical costs related to normal pregnancy are not covered with health insurance policy. Some insurance plans exclude a pregnant woman if she does not have maternity coverage before her contraception. It is, therefore, advisable to look into coverage in advance if you are considering having children. There are also some expenses that are not covered which include hearing aids and eyeglasses.

In conclusion, before you make any appointment with your doctor, find out what is covered and what is not covered from your insurer. Your health insurance provider will be able to give you detailed information about that. If you realize that you will have to meet the entire medical bill, consult with your doctor for other reasonably affordable options.