If you need to buy an individual health insurance policy, chances are it’s not going to cover the drugs and services you assume it will. So do you know when a health policy is hazardous to your money?
Consumer Reports Health Senior Editor Nancy Metcalf says to always avoid ceilings on your care. A policy may say it covers 100 percent of hospital care but only up to the fee schedule – and the fee schedule says it only covers up to $900 a day. Sometimes a plan will only cover $5000 of a surgery that might cost in the tens of thousands of dollars, or will only initiate coverage of hospital stays on the second day – the day after the initial emergency room visit and the massive expenses that come with it.
Know what you have to pay out of pocked. Make a list of all the kinds of health care you may need in the future – hospital stays, surgeons, drugs, outpatient treatments, diagnostics, physical therapy. If they aren’t specifically mentioned in the policy, assume they are not covered.
As is always sound guidance, the best way to avoid random ‘gotchas’ is to read the whole policy carefully, including the fine print, Metcalf says.