As a consumer, you can use this Health Insurance Resource Center site for its: excellent glossary of health insurance and medical insurance terms; quote request form for information on low-cost health insurance programs designed for the self-employed, individuals or small businesses; many consumer tips on buying health insurance; answers to some common health insurance questions; and a tutorial on what risk pools for the medically-uninsurable are. The Health Insurance Resource Center at healthinsurance.org provides the tools to help you become a better-informed medical insurance or individual health insurance consumer, and get a free insurance quote from a reputable, financially-stable health insurance company or companies. There is no such thing as cheap health insurance but you can find it. Health Insurance: Understanding What It Covers What are "covered services"? Your health insurance policy is an agreement between you and your insurance company. The policy lists a package of medical benefits such as tests, drugs and treatment services. The insurance company agrees to cover the cost of certain benefits listed in your policy. These are called "covered services." Your policy also lists the kinds of services that are not covered by your insurance company. You have to pay for any uncovered medical care that you receive. Return to top What is a medical necessity? Is that different from a covered service? Keep in mind that a medical necessity is not the same as a medical benefit. A medical necessity is something that your doctor has decided is necessary. A medical benefit is something that your insurance plan has agreed to cover. In some cases, your doctor might decide that you need medical care that is not covered by your insurance policy. Insurance companies determine what tests, drugs and services they will cover. These choices are based on their understanding of the kinds of medical care that most patients need. Your insurance company's choices may mean that the test, drug or service you need isn't covered by your policy.
