One of the most common questions that health insurance buyers have is whether or not a certain policy is going to pay for surgery costs. Surgery can be extremely expensive, and while most health insurance companies will cover some or all of the associated bills, things such as coinsurance rates and coverage types can be extremely important in determining how much policyholders need to pay out of pocket. Ideally, policyholders should take a close look at their insurance plans before purchasing coverage to make sure that they understand what's covered and what isn't.

Coinsurance is particularly important, as a policy's coinsurance is the amount of a bill that policyholders must pay for different types of claims. Health insurance companies will only pay for pre-agreed coinsurance percentages, so policyholders have several steps to take in order to find out how much they'll have to pay towards surgery costs. The first step is to get an estimate. Doctors will often be able to provide an estimated bill before surgery, which should include the actual costs of the procedure, anesthesia and pre-surgery costs including required tests. The estimate will contain a total cost and a detailed breakdown, which can be useful when looking through a policy to determine coverage. An easy way to find out which bills will be paid for by insurance is to give this estimate to an insurance agent.

The policyholder will need to pay coinsurance on the surgery, which can be a hefty amount of money in some cases. However, many policies have maximum limits on coinsurance. Once these limits are met, all subsequent costs will be paid by health insurance providers. All policyholders should understand their coinsurance limits, as this can have a tremendous effect on coverage. It's also helpful to note that under-managed care plans such as HMOs and PPOs using an in-plan provider may lead to a lower coinsurance rate, drastically decreasing the costs of many types of surgery.

Buyers should look into coinsurance rates and areas of coverage when buying health insurance policies. Most types of non-elective surgery will be covered under a standard health insurance policy, but the extent of that coverage will vary significantly from one company to the next. The only reason that a surgery claim could be denied outright is due to an undisclosed preexisting condition or if the surgery is required during the waiting period at the beginning of a health insurance policy. However, buyers should carefully read through their health insurance contracts and do appropriate research when surgery is required, as this will make it easier to understand and plan for out-of-pocket expenses for any type of medical bill.