What Is And Isn’t Covered In Health Insurance

What Is And Isn't Covered By Health Insurance?

The Short Answer Of What Is And Isn't Covered By Health Insurance

uMedMarket What Is And Isn't Covered By InsuranceIt depends. You have to read your policy very closely to know if something is or isn’t covered by health insurance. Some things are often covered, like preventative care, but other things depend heavily on the type of plan, like co-pays and deductibles. 

The Long Answer

Insurance was originally created to protect you from catastrophic financial loss when things go wrong, kind of like car insurance. When there’s a problem, your insurance will kick in. Health insurance has morphed over time to be more than that. Depending on how much you pay, certain services may be covered beyond the “when things go wrong” services. 

Sometimes health checkups are covered, sometimes shots and vaccines are covered, usually preventative care is covered, and occasionally only the major stuff, like surgery or hospitalization, is covered. Some uniformity has been added by the government on what minimum coverage looks like. However, there will always be fine print. 

A common one is that primary care doctor visits are covered, BUT, sometimes only up to a certain amount or only a certain time of year. And it is always upsetting when you go to the doctor expecting your expensive insurance to cover your $200 visit but get a bill for $100. Maybe because your insurance only actually covers $100 visits or this is your 4th visit this year, so you have to pay for the whole thing. Is it in the fine print? Yes. It is hard to understand and know what’s happening? Also yes. That is why uMedMarket can help.

How uMedMarket Helps
At uMedMarket, we help make things clear. When you go to the doctor, you will pay exactly what our price shows and we show exactly what that service includes. Decide you want something more? Totally fine, but you’ll have to pay for those things because that wasn’t in the original package. The situation is like getting to the airport and then deciding you want to fly first class. You can, you’ll just have to pay for the upgrade. When you shop with us, we do our best to show you all the prices we can. If your doctor says you need a test (or something additional that wasn’t in the plan), you can ask how much it costs or look up the cost. uMedMarket also is easy to explain to employees. They don’t get a complex policy that they have to figure out and spend time reading. It is very simple and straightforward. Additionally, if something is complex, we make it simple. When your employee needs an MRI, they can look up the cost. There’s no extra fees or charges that get tacked on at the end, the price they see is the price they pay. See our FAQ For Employers here.
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About Cash Discounts In Healthcare

Cash is king because it lowers the cost of providing care.

The doctor doesn’t have to deal with insurance billing, delayed payment or collections. That’s about 25-30% of their overhead.
Our independent providers don’t charge “facility fees” which are allowed by insurers to compensate hospitals for costs associated with operating a hospital.
Our providers are competing for patients against Billion Dollar plus Health conglomerates.

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What Is Co-Insurance

Co-Insurance is way to split payment for specific services between you and your insurer. Typically only certain high cost services will have a co-insurance payment, like hospitalization. With a co-insurance amount (usually a percentage of the allowable charge), you will always pay that percentage each time you use that specific service.

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Looking For Something Else?

We Can Help! Not only do we serve Greenville, Spartanburg, Simpsonville, Anderson, And Seneca, but for significant procedures like knee surgery, we can find exactly what you want for an amazing price. If you want the lowest cost, we can find it, or if you want the surgeon who does 200 of these procedures per year, we can find them too. Just Let Us Know!
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