Full coverage Doesn’t Mean “Full” Coverage

It often doesn’t get disclosed that even an insurance plan with full coverage has some limitations. These limitations may include certain treatments, medications, or services that may not be covered or may require additional approvals or meet specific criteria.

They Will Tell You What’s Covered, Not What’s Not Covered

Insurers generally emphasize what is covered under your policy, but they may not always be forthcoming about what is not covered. It's important to review the policy's exclusions, limitations, and conditions to understand what might not be covered.

A Hospital “In-Network” Doesn’t Mean All Its Doctors Are

If a hospital is considered "in-network" by your health insurer, it doesn't necessarily mean that all the doctors practicing there are also in-network. Remember that doctors often have their own contracts with insurers, and they may choose to be in-network or out-of-network for various reasons.

Balance Billing is Your Enemy

When a healthcare provider bills you for the difference between their usual charges and the amount covered by your insurance it results in balance billing. In some cases, an out-of-network provider might charge significantly more for a service than what your insurance considers reasonable, leaving you responsible for the balance.