Types of Things Health Insurance Covers

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    Doctor Visits

    • Most health insurance plans cover routine visits to your primary care physician. Some plans provide full coverage for regularly scheduled wellness checkups once or twice per year. However, most charge a co-pay, which can range from $5 to $50 per visit. UnitedHealthcare indicates its plan covers 100 percent of the exam costs after the co-pay amount. Some plans require that you visit a doctor who is included in their network of approved doctors. Other plans allow you to see the doctor of your choice. In most instances, visits to a specialist will be covered only if you are referred to a specialist by your primary care physician.

    Emergency Room Visits

    • Plans typically include coverage for emergency room visits and treatments, such as X-rays. The number of visits allowed per year may be restricted and you may be required to pay any charges incurred above certain limits. You are typically responsible for an emergency room deductible that must be satisfied before coverage kicks in. Plan deductibles can range from $200 to several thousand dollars for a family health plan.

    Required Surgery

    • If you develop a serious medical condition or experience an injury, most health insurance plans will cover the cost of surgery and post-operative treatment. In some cases, insurers may deny coverage for a surgical treatment. The condition or injury must be considered life-threatening or significant enough that it affects your quality of life for the insurance company to issue an approval. Elective procedures, such as laser eye surgery, are not covered by most health insurance.

    Prescription Drugs

    • The cost of prescription drugs is covered by most major health insurance providers as long as the medicine is prescribed by your doctor or by a specialist who was referred by your primary care doctor. UnitedHealthcare provides members a list of all covered prescription drugs. You are typically responsible for a co-pay, which can vary depending on the details of your plan. Most plans encourage members to accept generic prescriptions, which cost less than name brands.

    Medical Equipment

    • According to HandicappedEquipment.org, most health insurance plans cover medical equipment and supplies prescribed by your doctor. For example, if you suffer an injury or have a condition that requires the use of a wheelchair, crutches or other devices for mobility assistance, those items may be covered under your plan.

    Mental Health

    • Health insurance often provides a benefit for mental health coverage. The National Health Information Center recommends calling your insurance provider to learn what coverage is available. Some plans cover visits to a certified mental health counselor or behavioral psychologist. Health insurance also may cover substance abuse counseling for those who are addicted to prescription drugs, alcohol or illegal substances.

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