WHAT DOES HEALTH INSURANCE COVER?

Do you know what’s covered by your health plan? You can find out what’s covered (and the costs you’ll pay for services) when you review your health plan details. Read your plan’s Summary of Benefits and Coverage for information about coverage and costs.

Here are 10 essential health benefits covered by health insurance plans. (Details and costs vary depending on your plan.) Remember to check that your provider, clinic or hospital is in your plan’s network.

  1. Yearly check-ups. Routine yearly visits are usually free. Don’t miss this chance to find problems early, while they may be more easily treated. 
  2. Primary care and specialist visits. This includes visits to a health care provider if you get sick. It also covers care for ongoing problems like asthma or diabetes. Staying on top of those conditions can keep you healthier longer.
  3. Cancer screenings. Many recommended tests, such as colorectal cancer screenings and mammograms, have no copay. 
  4. Blood tests. For example, tests for cholesterol and blood sugar levels can help uncover problems so they can be treated. They can also show whether current treatments are working.
  5. Recommended vaccines. Shots, including yearly flu shots, can help prevent illness.
  6. Prescription drugs. These are drugs prescribed by your doctor to treat a condition. There are some limitations. See your plan for details.
  7. Emergency care. Accidents happen. It’s good to know you are covered in case you need it.
  8. Maternity and newborn care. Prenatal care and the care needed for labor and delivery are covered. So is newborn care.
  9. Mental health services. This includes coverage for mental health and addiction issues. Note your plan’s limitations.
  10. Rehabilitation services. If you’ve had certain surgeries, an accident, illness or stroke you may need rehab services. These include physical, occupational and speech therapy.

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