Basic health insurance pays for medical expenses if you should get sick or have an accident. Usually not every dollar of medical expenses are paid. There are common health insurance limits that you should be aware of before buying health insurance.

Preexisting Condition Limitations

Some policies, usually individual health insurance policies, will not pay for a condition that you were treated for before the effective date of your health insurance. This period of time varies but 12 months is common. After a waiting period that condition may be covered.

Coverage Limits

Some basic health insurance policies will cover medical expenses up to a certain dollar amount. Any expenses over that amount have to b paid by the patient. These limits can be an annual limit or a lifetime limit. There may also be health insurance limits for certain kinds of services such as mental health or certain medical conditions.

Deductible

Another kind of limit is the annual deductible. This limit says that no expenses will be paid until the insured person has paid a certain amount out of their own pocket. Once this amount has been reach the insurer will begin to cover the medical expense for the rest of the year.

Coinsurance

Some policies have a limit of the percentage of covered expenses that they will pay. For example a policy may cover expenses at 80% and the remaining 20% is the amount that the insured must pay.

Exclusions

There are certain medical costs that are not usually covered by insurance. These include dental and vision services. Over the counter medications and certain medical supplies are reimbursable. Procedures that are purely cosmetic are usually excluded. The definition of what is medically necessary and what is cosmetic is usually decided by the insurer with information from the physician.

Home Health Care

Although some policies do still cover medical services in your home such as nursing care, other insurers have excluded or limited this type of coverage. Careful comparison of insurance quotes will let you know whether this is covered or not.

Reproductive Expenses

It is common for basic health insurance to limit coverage for infertility treatments such as in-vitro fertilization or hormone therapy. Expenses for sterilization and abortions may also be part of a policy's health insurance limits.

Hearing Aids

Treatment for hearing testing and treatment may be limited. The cost of hearing aids may not be covered at all. Much like dental and vision care this is sometimes considered separate from basic health insurance.

Whether you currently have basic health insurance or you are looking for a policy to buy it is important to read the fine print and ask questions so that you thoroughly understand what kind of policy limits there are.