No one sets out to fall ill. However, it happens to the best of us. Without any form of insurance coverage, medical costs can be too high and overwhelming. That’s why both wealthy and financially challenged people need insurance. Since the advent of Obamacare, insurance coverage rates have significantly increased.
According to Health Care, 91.6% of Americans had insurance in 2019. The level of coverage varies from one provider to another. While there are many ways to live your healthiest life, insurance coverage should be top of the list. In this article, you’ll learn about the types of medical health insurance plans, what these services do, and how they can help you live your healthiest life now.
What Is Covered Under Health Insurance?
Health insurance typically doesn’t cover every medical treatment or service. Some services, such as cosmetic surgery, are out of the question for most health insurance plans. Similarly, an insurance plan might not cover some medical needs, such as dental braces. However, many medical services are part of the coverage regardless of the insurance provider.
The Health Care highlights ten essential services an ideal marketplace insurance plan must provide. The services depend on multiple factors, including the provider, employer, health needs, and local laws. However, even the most basic coverage can help you live your healthiest life. Here are ten medical services covered in health insurance plans and how they benefit your health.
1. Preventive and Wellness Services
Most health insurance plans cover preventive and wellness services. According to the Health Care.gov website, marketplace insurance plans must cover some of your preventative services, such as screening and shots, at zero cost. Preventive services may include a consultation with a dentist, a mandatory vaccination, or screening for breast cancer. However, these services vary depending on age and gender. For example, adults 50 years and above may require screening for lung cancer, colorectal cancer, and type 2 diabetes. Diet counseling and immunizations are also covered as essential services in health insurance plans.
How do preventive and wellness services benefit your health? As the old saying goes, prevention is better than cure. Prevention is less costly than treatment for both insurance providers and healthcare systems. If you want to live your healthiest life now, visit your doctor regularly for checkups. Even the most severe illnesses, such as cancer, are treatable when detected early.
2. Emergency Services
No one sets out to get an emergency, but they happen daily. You may be eating a healthy diet, minding your business, and keeping fit and still find yourself in an unforeseen problem. When you have a health emergency, the last thing you want to worry about is where you’ll get funds to cater for medical attention. Picture a situation where you need surgery, and you can raise money for treatment costs right away. Things can go south fast before you decide the way forward. That’s why emergency services are classified as essential services that should be covered in any medical plan.
One of the most common emergency services in response to fatal accidents. If you are involved in an accident, you’ll need immediate medical attention before seeking a personal injury lawyer. Other common medical emergencies include:
- Heart Attack and Chest Pain
- Burns and Scalds
- Deep Cuts and Wounds
- Electrocution Wounds
- Choking and seizures
Remember emergencies are sudden, and you might not have enough cash to cater for treatment right away. This is where insurance coverage comes in handy. Health insurance coverage ensures you have support when you need it most.
3. Laboratory Services
Laboratory services are also classified as essential services that insurance plans should cover. They’re not always part of the treatment plan but can be the difference between a misdiagnosis and an informed diagnosis and treatment plan. Laboratory services may include screening tests, sample collection, and preservation. Laboratory scientists ensure doctors make the right prognosis. In some cases, a doctor must have lab results to decide. Modern machines such as PET scanners and X-Ray machines are essential for determining if someone has cancer.
Imagine this: You go to a hospital with some symptoms. The doctor thinks you need to go to the lab. Assuming you don’t have coverage, your treatment might be delayed until you can get the finances to cover your lab services. Therefore, coverage for lab services can help you live your healthiest life now by enabling early and informed treatment.
4. Pediatric Services
You will not live your healthiest life if your kids can’t access medical services because they don’t have insurance coverage. Pediatric services are medical services for infants, young children, and adolescents below 18 years. The services range from injuries and infections to cancers and genetic conditions. A pediatrician has a similar qualification to a physician who treats adults, but they focus on how illnesses affect developing children. Interestingly, some services typically not covered by adult health insurance plans cover children, such as dental and vision insurance.
If you’re a parent, your children’s health is your top priority. Therefore, you want to ensure their health is covered as you deal with other concerns such as groceries, car for rent, and school fees. Insurance coverage for pediatric services ensures your kids can access pediatric services anytime. Pediatric services are essential for providing age-specific treatment.
Sometimes, you may need to be hospitalized to recoup faster. According to the Agency for Healthcare Research and Quality, septicemia, heart failure, osteoarthritis, pneumonia, and diabetic complications are some of the most common illnesses requiring hospitalization. Hospitalization means that you’re admitted to a medical hospital under the care of physicians and sometimes with auxiliary equipment support.
Modern hospitals are equipped to handle the voluminous traffic of patients. They have top-range medical equipment, specialized beds, alarm systems for security, and 24-hour personnel. Sometimes hospitalization can extend life, reduce caregiver burden and prevent deterioration of symptoms.
That’s why the U.S. government classifies hospitalization as a basic service any marketplace insurance provider should provide. Hospitalizations are often quite expensive, especially if one needs round-the-clock monitoring or some services such as dialysis. With insurance coverage, you’ll worry less if you’re hospitalized and focus on recovery.
6. Prescription Drugs
When dealing with an illness, prescription drugs are essential to live your healthiest life. According to the U.S. Food and Drug Administration, prescription drugs are prescribed by a doctor and intended for use by one person. When used correctly, prescription drugs can treat and cure many illnesses.
Many people get through a hospital consultation but get stuck after the doctor recommends prescription drugs because of their cost. Prescription drugs that require hefty research and development (R&D) budgets are often out of reach without insurance. Some specific health insurance plans may cover drug costs for treating genetic and congenital conditions.
You need a health insurance plan that covers prescription drugs because you never know when you’ll need one. Advances in pharmaceutical research have allowed researchers to find treatments for many deadly diseases. However, these options may remain in your vicinity without suitable treatment. By enabling you to access costly but vital rugs and treatment, health insurance enables you to live the healthiest life.
7. Rehabilitative Services and Devices
Rehabilitative services are essential for helping individuals with injuries or chronic pain regain mental and physical skills. Medical rehabilitation is not the same as services offered in Alcoholic Anonymous groups or education programs in prison. Rehabilitative services such as neurological rehabilitation help patients get back on their feet, literally and figuratively, and regain functioning for daily living.
Rehabilitation and habilitative services and devices are vital for millions of people in the U.S. and beyond. According to the World Health Organization, about 2.4 billion people with various conditions benefit from rehabilitation. Rehabilitation devices include mobility aids, specialized robots, and virtual reality. You may not need rehabilitation services if you don’t have a recent injury or are not in pain. However, injuries and chronic pain can happen to anyone at anytime for several reasons that may be hard to foresee. Rehabilitation services are vital to recovery after a debilitating injury.
8. Mental Health Services
For the longest time, physical health was held as the top priority in medical fields and society. However, there’s an increasing awareness that for you to live your healthiest life, your mental health matters too. Mental health services vary depending on many factors, including the patient’s age, history, and mental health problems. Mental health services may include:
- Psychiatry emergency rooms
- Psychiatry inpatient hospitals
- Behavioral and substance abuse centers
- Full hospitalization
- Tele-mental health services
Although the government highlights mental health services as essential, many insurance providers either don’t cover mental illnesses or the coverage is minimal. According to NAMI, 11.3% of U.S. adults who require mental health services had no coverage in 2020. However, if you have mental health services coverage, you can always access a mental health clinic when battling with issues such as depression, substance abuse, or anxiety. Insurance helps prevent and alleviate conditions associated with health problems, enabling you to live your healthiest life.
9. Pre-Natal and Post-Natal Services
Another essential medical service recognized by the government is pre-natal, maternity, and post-natal services. Mothers have various needs that require a medical professional or treatment. In fact, for some mothers, the only time they ever visit the hospital is when planning for a newborn. Some preventative services are free of charge in public hospitals, even without insurance.
However, most pre-natal, maternity, and post-natal services require insurance. If you’re expecting, you’ll need pre-natal checkups, prescriptions for supplements, and ultrasound checkups. If your pregnancy has complications, your medical provider may recommend a treatment option or physical therapy. The insurance plan may also include menopause and hormone therapy.
Pre-natal and post-natal services are essential for assuring the health of both the mother and the child. According to the National Institute of Child Health and Human Development, newborn screening is one of the effective services that has helped reduce infant mortality. Therefore, for you and your child to live your healthiest life now, you may require a health insurance plan.
10. Ambulatory Patient Services
Ambulatory services are the outpatient care services you can get in a hospital without being admitted. Almost anyone, from children to older adults, requires ambulatory patient services once in a while. Some of the services classified as ambulatory include diagnosis, observation, intervention, and consultation services.
With modern inventions, sometimes you don’t need to go to a hospital to acquire medical services. Some people use mobile apps to schedule an appointment with a doctor. Insurance providers are responding to the changing topography of outpatient care and thus may cover such services.
Senior adults may use ambulator patient services, especially if issues such as falls and slips are common. It would be best to have insurance coverage so their available cash can go to other aspects, such as elder law service costs. Ambulatory patient services are essential in responding to medical needs immediately without overwhelming health systems.
Benefits of Health Insurance to Your Health
Now you know the essential services that marketplace health insurance plans cover. But how do these services benefit your health? How does health insurance help you live your healthiest life now? Here are five health insurance benefits.
- A health insurance plan covers basic health benefits that are essential in maintaining your wellbeing
- With a health cover, you can access preventive care services such as screenings and vaccines even before achieving your deductibles
- A cover protects you from sudden and high medical costs
- With a cover, you pay less for covered-in-network health costs
Most people look forward to living long, fulfilling, and healthy lives. While some people get to live healthy lives without doing much, living a healthy life requires some practices, habits, and principles. A health insurance plan is one of the best strategies to live your healthiest life. Next time you consider a health insurance plan, check if it offers the above ten essential services.