| Other medical
expense benefits fall into a category in addition to the hospital,
surgical and medical benefits previously discussed. These
optional benefits vary from insurer to insurer and may or may not
include as part of their standard policies. Separate
policies can sometimes be written to include these benefits. Some
of them are:
- Maternity
- Convalescent
– Nursing home
- Emergency
first-aid
- Home health
care
- Mental
infirmity
- Hospice care
- Prescription
drugs
- Dread disease
- Outpatient
treatment
- Dental
- Private duty
nursing
- Vision
Health
Insurance Quotes
Get Quotes for a variety of different health plans, including
individual and family, small group, short-term, student, Medicare
supplemental and dental plans.
We will not
cover all of these options, but will let’s take a look at the
most common.
Maternity
benefits are sometimes included in policies subject to certain
conditions and limitations. The most usual limitation is a 10
month waiting period designed to prevent the purchase of health
insurance just to cover pregnancy and childbirth expenses.
Interesting to note, however, group policies for employee groups of 15
or more are required by law to provide maternity benefits on the same
basis as non-maternity benefits. This means that in a case
such as this, the waiting period would not apply unless non-maternity
benefits also required a 10 month waiting period.
Aside from
the group scenario above, many policies just exclude maternity benefits
totally but make them available at extra cost. Where
maternity benefits do apply, the benefit usually includes newborn care
while the mother is in the hospital.
Other
benefits that are sometimes available under the same maternity coverage
might include cesarean deliveries, natural abortions and elective
abortions.
Emergency
First Aid Coverage applies to an accident that may call for immediate
first-aid on the scene. This applies when a medical
professional who just happens on the scene provides first-aid service
he/she might bill the insured. Sometimes treatment like this
must be performed without the knowledge or assent of the
insured. Some policies offer coverage for such contingencies
and normally must incur within a very short time after an accident.
Mental
Infirmity historically has been excluded from most policies.
However, in recent years more and more policies include this type of
coverage but with limitations. The benefits are usually much
lower than physical ailments and a stated percentage of the benefit
paid for other types of medical care is included.
Common
exclusions and limitations. Both disability income and
medical expense policies limit or exclude coverage for certain types of
injuries or illness. There is a difference between
limitations and exclusions. The mental infirmity policy
limitations we discussed
above is an example, whereas an exclusion is completely omitted from
any coverage.
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