What Types of Services are Generally Covered by a Group Health Insurance Plan?

A group health insurance plan is an employer-based benefit an eligible employee can avail of during employment. The primary and major consideration to be taken into account by an employee prior to the insurance application is the summary of benefits covered in a group insurance policy. So what types of services are generally covered by a group health insurance plan?

Group health insurance coverage varies widely from insurer to insurer but almost all insurance policies generally cover similar types of services. Services that group health insurance plans cover generally are emergency, routine and maternity-related medical procedures.

One of insurance coverage is the professional services of recognized medical practitioners, doctors of medicine and osteopathic physicians. Osteopathic medicine is a healthcare system which puts greater emphasis on holistic health. Osteopathic physicians commonly use osteopathic manipulative medicine to provide excellent medical care and cater to both the mental and physical needs of the patient.

Hospital charges are also included in a group health insurance policy. These hospital charges include semi-private rooms, board cost for hospital admission and other medical supplies and services necessary in the patient’s hospitalization. Blood transfusions, ambulance services and medicines and drugs which have prescriptions are also part of health insurance summary of benefits.

Group insurance plans also offer types of services that don’t involve hospitalization such as x-rays, radium treatments and other diagnostic laboratory tests. These laboratory procedures are conducted to determine a person’s illness as well as his or her general health status.

Costs for physiotherapy treatments are also covered in the group plan. Physiotherapy, also called physical therapy is a conventional method of treating diseases, disabilities and disorders using physical means. If the patient is not responding to the treatment, a new approach or more physiotherapy sessions are recommended by the doctor.

Expenses incurred for rental of mechanical equipment used in therapies, of wheelchairs and hospital-type bed are also paid by the insurance provider.

Charges for the services rendered by registered or licensed practical nurses and trained aides who provide nursing and other health associated services for someone in his or her home are also covered in the health insurance policy.

Anesthetics, oxygen, other gases and other expenses incurred in their administration are also billed in health policies. Surgical charges are also one of a group health insurance benefits which include facility charge and fees for surgical procedure, assistant surgeon and anesthesia.

Braces, Crutches, casts, splints, trusses, artificial limb and other prosthetic appliances are also covered in the health plans.

Vision and dental care are not commonly covered in group health insurance plans. However many insurance providers offer both dental and vision care as add-on services on the existing health policy.

Although group insurance is employer-supported health policy it doesn’t mean that an employee will lose coverage upon disengagement from the employer. He has the option to have the coverage active and there are procedures to be followed to continue having the healthcare coverage. Having a healthy lifestyle is one effective way to prevent illnesses but there will always be chances of acquiring serious and sometimes deadly diseases. It is important for the employee to figure out his or her general state of health before any ailment develops. An employee must also evaluate his/her health care situation and must have a clear understanding on the summary of benefits contained in the insurance policy.