Sure, your health insurance covers your annual physical and your kids’ checkups, but if you’re not familiar with your policy, you may be missing out on—or worse, paying out of pocket for—procedures and prescriptions that are commonly covered. Of course coverage varies from state to state and policy to policy, but it can never hurt to call the customer service number listed on the back of your health insurance card to learn what you might have access to. Not convinced yet? Read on for 11 often-covered services and procedures that will inspire you to look more closely at your plan.
1. Next-Generation Birth Control
Health insurance used to cover birth control pills, IUDs—and not much else. But many policies have been expanded in the past few years, says Keith Mendonsa, consumer insurance specialist at eHealthInsurance.com. If you’re interested in newer methods of birth control, including NuvaRing and Depo-Provera, it’s worth it to touch base with your insurance provider.
2. Durable Medical Equipment
If you break your leg, insurance will of course cover your hospital visit—but it can also help you get around after you leave. Under the “Durable Medical Equipment” section of your policy, you’ll likely notice that crutches and wheelchairs are covered as well as all or a portion of prosthetic limbs. Also noteworthy: Under this section, nursing moms can purchase a breast pump for as much as 90 percent off—often for a savings of hundreds of dollars.
3. Weight-Loss Surgery
Medicare and Medicaid have been covering weight-loss surgery since 2006, and most commercial plans have followed suit, says Lisa McDonald, a representative of George Washington University Hospital, which has a highly regarded bariatric center. In order to qualify you’ll need to meet physical criteria—you often have to be 100 pounds over your ideal weight or have a BMI of 35 or higher—and you’ll likely need documentation from your physician indicating that conventional diet and exercise haven’t worked for you in the past.
4. Elective Pregnancy Prevention Surgery
Oral, injectable and physical birth control aren’t your only options when it comes to preventing pregnancy. If you’re interested in surgical pregnancy prevention—tubal ligation for a woman or a vasectomy for a man—consult your health insurance policy, suggests Mendonsa. Many people assume they’ll have to cover the cost of elective surgery, but because pregnancy prevention surgery could save your insurer money in the long run, they’re often happy to subsidize it.
5. Drugstore Clinic Visits
Walk-in drugstore “clinics”—including about 500 MinuteClinics in CVS Pharmacies across the country—are staffed with nurse practitioners or physician assistants who are able to diagnose and treat minor illnesses, including bladder, bronchial, ear, eye and nose infections, and strep throat. And many are considered “in-network” by major insurance carriers. You can also get vaccinations at drugstore clinics, rather than making an appointment with your regular doctor and spending your lunch break lounging in a waiting room full of sick people.
6. Acupuncture and Other Non-Western Medicine
If your regular physician just doesn’t have the cure for what ails you, you might consider alternative treatments, including acupuncture, massage therapy, chiropractic services and herbal supplements. Many are covered by insurance, says JoAnn Laing, author of The Consumer’s Guide to Health Savings Accounts. And you can always use your health savings account to pay for acupuncture as long as it’s prescribed by a doctor, notes Laing.
7. Gym Membership
Many major insurance companies are making exercise more attractive by offering discounts on gym memberships, says Ellen Laden of UnitedHealthcare’s Golden Rule Insurance Company. Customers who exercise regularly are generally less likely to suffer from costly medical ailments—including diabetes and heart disease—so covering gym memberships pays off for insurance companies over time.
8. Breast Reduction
Sure, a breast reduction could be considered cosmetic surgery. But if your chest is causing you health problems, you might be able to get insurance to cover the surgery, says Erinn Springer of GoHealthInsurance.com. Chronic back pain that interferes with your lifestyle is often reason enough to get insurance to chip in for a breast reduction; keep in mind that you’ll need documentation from your doctor before you go ahead with surgery.
9. Sleep Studies
Having trouble falling asleep? Most doctors will prescribe a sleep aid, but your health insurance policy might be able to help you get to the root of the problem, says Springer. If you’re willing to put a little more time into learning how to catch some shut-eye, your policy may allow you to participate in a sleep study, which could reveal that you have anxiety, sleep apnea or restless leg syndrome—all of which can be relieved without medication.
10. Lasik Surgery
Are you sick of wearing eyeglasses? Check your policy! You might be able to chuck your clunky frames, says Douglas King, vice president of Individual and Family Plans and Small Group Markets for Blue Shield of California. Many policies now cover all or part of laser vision-correction surgeries, such as Lasik.
11. 24/7 Nurse Lines
If your baby’s sick but you don’t want to bug your doctor at 2 a.m., you’re in luck if you have access to a 24/7 nurse line. Many health insurance companies give members a toll-free number where they can reach registered nurses around the clock, says Leah C. Malof, the director of Health and Productivity Practice for Buck Consultants. Call when your husband has an unbeatable migraine or if you’re not sure how much Tylenol to give your toddler. If they can’t answer your questions, they’ll direct you to someone who can.
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