What does health insurance cover?

22 comments

1. Orthodontics is usually a dental insurance thing, which is annoyingly and confusingly separate from most health insurances

2. Do you mean what kind of services are covered? Or are you asking how the money part of it works?

3. That is such a general question because in this country it depends. HMO isn’t very good, PPO is better, but it costs more. Dental and vision are separate insurances. It all depends on your employer, some of them have the high deductible health insurance which is a scam.

4. Sometimes everything sometimes nothing, normally general health expenses not including dental and vision.
   Sometimes you pay very little others you pay everything up to a certain point.

5. There are three general types of insurance, health, dental and vision. Health usually covers, to varying degrees, the medical things that dental and vision dont

6. Depends

7. Asking does health insurance cover ____? Is a loaded question in the US as everyone’s coverage is different.

   I can say that my health insurance will cover some dental surgery, but your normal dental visits, dental implant, orthodontist, and other things are all covered on a dental insurance plan (also provided by my employers but separate)

8. Generally that’s a dental insurance thing, and it depends. I know that’s not a very helpful answer, but things like orthodontics coverage can get very complicated and it varies depending on your specific plan.

9. Depends on the health insurance.

10. There are [907 different health insurance providers in the US](https://policyadvice.net/insurance/insights/health-insurance-companies-us/), each offering a wide range of plans.

    Orthodontics are part of dental insurance, which is treated separately from health insurance. Most plans offer partial coverage for orthodontics, not full.

    [Here’s why vision and dental is separate in the US](https://www.nbcnews.com/better/health/reason-your-dental-work-isn-t-covered-medical-insurance-ncna813666). TLDR: dentistry has long been deemed a different practice than medicine and the US has not closed that idea.

11. Dental and vision insurance are typically separate policies. It’s less common but not unusual for them to also be paid for by employers.

    Ultimately what and how much your policy covers will depend on the exact policy itself.

12. There is literally no way to know. They might carry a portion, maybe not a particular procedure or medicine for a procedure. Even doctors don’t know.

    Usually a percentage of care. There are sometimes deductibles and sometimes caps.

    Not dental except maybe 2 cleanings a year.

    Like they cover colonoscopies, but the hospital can charge a “facilities charge” which was 1000 for me. Insurance doesn’t cover that aspect.

    ​

    Here’s some info: [https://www.moneygeek.com/insurance/health/average-cost-of-health-insurance/](https://www.moneygeek.com/insurance/health/average-cost-of-health-insurance/)

13. What we call health insurance, most of the time contains two policies, medical and prescription. Most people don’t realize that unless they are trying to get durable medical equipment at the pharmacy other than glucometers. The details vary by plan.

14. Specifically for orthodontia, my plan covers it at no user cost for children, but not at all for adults

15. Health insurance usually doesn’t include dental or vision, you have to pay to get those separately. All of the dental plans I’ve had over the years have always covered orthodontics at between 30-50% of the cost and you have to pay the rest out of pocket.

16. Depends on the plan and depends on the coverage.

    My company’s expensive plan covers orthodontia, but the inexpensive plan does not.

17. Depends and dental insurance, in my experience, covers a lot less. I have a 10k smile and insurance didn’t cover a dime.

18. “Depends” is the only answer. I have great coverage now, paid by work, with only a $250 deductible. But I’ve had shitty insurance, paying $300 a month, with a $6k deductible. If I got sick or hurt, I would have had to come up with six grand that I didn’t have. Healthcare in America is truly awful. Anyone who says it isn’t has good insurance and doesn’t realize how most people live here.

19. Very general question. It might help to understand *how* insurance works in the US.

    >What does the health insurance paid for by employers cover?

    First, health insurance isn’t usually paid for by your employer, it’s typically chosen by and subsidized by your employer. In my case my employer chose 3 plans offered by the company Aetna (two of which are so bad no one chooses them). I pay $300 a month as a premium (cost to have access to the insurance plan), my employer pays some amount as well.

    Insurance doesn’t really cover anything (other than the narrowly defined mandated scenarios) until you’ve hit your deductible. The deductible is how much you have to pay, separate from your premium, before the insurance starts to pay. I have to pay $2200 before my insurance starts to partially cover services.

    After I’ve paid the deductible, if the insurance agency can’t cook up a way to disqualify the service, my insurance company will 75% of the cost and I have to pay the remaining 25%, until I’ve hit my maximum out of pocket of $8500 (not including premium). Then my insurance will cover everything if you’re good at arguing with them.

    > Does it include orthodontics?

    Dental is not healthcare, so we have separate deductibles and out-of-pocket for anything dental-related. It’s much harder (and medical is already pretty difficult) to get dental work to qualify for coverage.

    Eye exams are almost always covered with a $100 frame allowance once every two years though.

20. r/healthinsurance is that way.

21. I work for the government, so I pay about 175$ a month for my insurance.
    Doctors visits: I pay a copay of anywhere between 25$-50$ per visit
    Medicine: I pay anywhere from 2$-50$ depending on the drug.
    Hospitals/surgeries: I pay anywhere from 50$-2,000$ depending on what I need.
    Dental: 50$-200$ per visit.
    Vision: Fully covered visit and glasses once per year.

22. Depends on your insurance