Often times, Americans compare health insurance to European plans. We know the out of pocket costs are lower over the pond, but what do overseas plans actually cover?
This article explains what UK citizens currently recieve under their National Health Surveillance Agency rules. It’s interesting to see that not everything is free or even covered by insurance.
Those who care to have medical insurance are worried about having high quality services for their families and so it is very important to know what health insurance is able to offer – and also what they do not have to cover.
Of course each plan has its own coverage; however it is always great to know some facts that are common in all plans, regardless of your age, plan or even coverage.
UK medical insurance plans are not required to cover:
- Rejuvenation treatment (Botox application) or weight loss with aesthetic purpose
- Transplantation, except cornea and kidney and other transplants such as (e.g., graft bone, muscles, and skin)
- Experimental clinical or surgical treatment (treatments that do not yet have scientific evidence)
- Clinical or surgical procedures for aesthetic purposes (eg plastic surgery)
- Orthotics supplies (eg, contact lenses, eyeglasses, crutches, vest, elastic stockings), prosthetics (eg eye prosthesis, ear, nose, mechanical limbs) and clothing accessories, not related to surgery or for cosmetic purposes
- Supply of medicines not recorded in the National Health Surveillance Agency. You can see if the medicine is registered on the web
- Supply of medicines for home treatment (plans are not required to pay for medications taken at home), except oral anticancer drugs for home use and the control of adverse effects related to chemotherapy
- Artificial insemination is also not covered by medical insurance
- Illicit, unethical or unrecognized by the authorities treatments (eg abortion)
- Disaster cases and wars declared by the authorities
Guaranteed services that UK medical insurance must offer to you and your family:
- Unlimited doctor visits, days of hospitalization and ICU.
- During the hospital stay, rehabilitation sessions should be covered by other health professional (dietitian, speech therapist, occupational therapist, physical therapist, etc.) for an unlimited time, as long as requested by the attending physician. This is available even in the most basic and affordable health insurance.
- Consultations / meetings with other health professionals (psychologist, occupational therapist, speech therapist, and nutritionist) have mandatory coverage in outpatient segmentation. Of course some affordable health insurance plans might say they do not cover it, however you should insist.
- Laparoscopic surgery (less invasive and less risk to patients) and radiation with IMRT (beam intensity modulation) for tumors of the head and neck (with use of guideline).
- Immuno-biological drugs for treatment of rheumatoid arthritis and immune-biological intravenous drugs to treat psoriatic arthritis, Crohn’s disease and ankylosing spondylitis, in ambulatory plans.
- Mandatory provision of collection bags to ostomy patients.
- Mandatory coverage of preventive procedures, restorations, endodontics and consultation and ancillary or additional tests requested by the dentist assistant (when you include dental plan).
- Mandatory coverage of dental minor surgeries, considered those carried out in an outpatient setting without general anesthesia (when you include dental plan).
The bottom line.
Even the most affordable health insurance plans should offer basic services that for some are denied.
If you want to learn more, you can also check out this site.
It is important to know your rights in order not to be left behind by huge companies that want nothing but profit. The more you know about your rights the easier it will be to get the right treatment.