Private Medical Insurance

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Medical Cover Limitations

Before you commit to any particular medical insurance plan, be sure to know exactly what you're signing up for. Your medical insurance provider will give you a promotional package with only basic medical cover information included in it. It is important to read the fine print of the actual plan before you decide to go for it. There are quite a few catches and limitations that you may not be aware of concerning your medical cover.

Fee for service medical cover plans generally do not cover routine checkups and physicals. However, most managed care medical cover does. Be sure to check that part of your policy before you make an appointment so you don't end up with more fees than you can handle.

Another limitation is that most medical cover does not cover cosmetic surgery. Most plans will cover surgery for reconstructive purposes that are caused by an accident or a birth defect, but they will not cover elective cosmetic surgeries like liposuction, nose jobs, or face lifts. Those will be out of pocket expenses. Your plan may also cover your cosmetic surgery if your doctor assures them that it is for medical reasons.

A pre-exisiting condition is another case when there may be a grey area in your medical cover. Many insurance plans make you wait from six months to a year before they will cover any treatment of a pre-exisiting condition such as allergies or diabetes. You may want to consider getting a personal health insurance policy if you are leaving one job and moving to another because there might be a time when you do not have medical cover at your new job.

A lot of medical cover still does not cover non-traditional treatments like massage, alternative birthing, or acupuncture. Medical cover plans with this type of coverage are more common now days than they used to be, but many plans still don't provide these types of options.

Mental health treatment and drug rehabilitation are not generally covered by most medical cover plans. However, you may be able to get coverage if your doctor refers you to a mental health professional or to a substance abuse program. If substance abuse occurs with mental illness, it is more likely that your medical cover will take care of these expenses.

The Association of British Insurers has compiled a list of treatments that will not be covered by the majority of medical cover options.