The Californer - 13 Things You Won't Believe Your Health Insurance Doesn't Cover

Trending...

NEWPORT BEACH, Calif. - Californer -- What is deemed medically necessary is usually covered by health insurance, unless it's a brand new medication, service or technology that is not time-tested or doesn't justify a large cost difference between an accepted substitute. Also, you may be able to appeal the case.

1. Drug Use
Off-label drug use refers to the practice of prescribing or using a medication for a purpose or in a manner that is not approved or specified by the U.S. Food and Drug Administration (FDA) or other regulatory authorities. This can include using a drug to treat a condition or symptoms different from its approved indications, using it in a different dosage, or for a different patient population. Off-label use may be based on clinical judgment, medical research, or anecdotal evidence, but it often lacks the same level of scientific scrutiny and regulation as FDA-approved indications. Healthcare providers may use off-label drug use when they believe it is the best treatment option for a patient's specific medical condition. However, it should be done with careful consideration of potential risks and benefits, and patients should be informed about the off-label nature of the treatment.

More on The Californer

2. Brand New Technology

It's not so much that health insurance will not cover prescriptions and devices that rely on brand new technology, just that it takes some time to approve the added cost. Medicare and private health insurance plans are slow to adopt new products and services. Insurance companies typically require medical treatments and technologies to have a proven track record of safety and effectiveness before they provide coverage. For instance, most insurers offer coverage CPAP machines for sleep apnea as well the newer, surgically implanted device, Inspire, for sleep apnea.

3. Adult Dental Services

Dental services are costly and require a separate dental insurance plan. Note that there is a difference between dental and oral surgery. Dental surgery, like an extraction, would be covered by dental insurance. Oral surgery, however, is covered by medical insurance. Oral surgery can include the removal of diseased or impacted teeth, dental implants, biopsies, tumor removals and other similar issues. If you can't afford a plan, consider a discount dental plan that offers reduced rates on dental services when you use participating providers. Some communities offer low-cost or sliding-scale dental clinics. Do some online research to see if there is a clinic near you.

More on The Californer

For the remaining 11 things that health insurance won't cover, visit here https://smartfinancial.com/health-insurance-coverage-for-retirees