A Few Things You May Be Surprised to Know Aren’t Covered by Health Insurance

Health insurance is a hot button topic lately. Even with the introduction of the healthcare mandate and the Affordable Care Act in place, there are still some surprising things that aren’t covered by health insurance, but really should be.

Clinical Trials


Image: Wikimedia Commons

Many believe that participants get paid to participate in clinical trials every time. However, many new therapies that are still in the trial phase require that you pay for your treatment during the trial.

These therapies can be expensive, even under the Compassionate Care Act that allows healthcare providers to petition for their patients to be allowed to participate in these trials as a last-ditch effort to save their lives.

Hearing Aids

If you have hearing damage, a trip to an audiologist or an ear, nose and throat doctor is usually covered by your health insurance. If you need hearing aids to correct that hearing damage, though, you’re out of luck. Hearing loss affects as many as one out of every 3 Americans over the age of 65 – and with 10,000 baby boomers turning 65 every single day, that’s a lot of people.

Unfortunately, Medicare doesn’t cover hearing aids. This may be because they have so many other concerns – reaching retirement age often means that you have a host of new health problems to worry about. After all, healthcare would be cheap if people didn’t get sick, but that’s not necessarily an excuse for entirely refusing to cover something that more than 48 million patients need every year.

Invitro Fertilization (IVF)

Roughly 10 percent of womenin the United States suffer from fertility problems, according to the CDC. For many, invitro fertilization, or having pre-fertilized eggs implanted into a prepared uterus, is the only way that they can have biological children.

It is an expensive treatment, with one round costing between $12,000 and $15,000. In spite of this, only 15 states have laws requiring insurance companies to cover fertility treatment at all, and a few of them specifically exclude IVF from their coverage requirements.

Laser Eye Surgery

With roughly 250 million people worldwide suffering from some sort of vision impairment, you’d figure that insurance companies would cover a simple surgery that can repair vision, allowing the patient to return to close to 20/20 vision without the need for glasses, right?

Assuming you can even get your eyes checked — because vision insurance is an add-on that you have to pay extra for with most insurance policies — laser eye surgery isn’t covered unless you can prove that having 20/20 vision is necessary for your job. Which means if you fly airplanes, for example, you might be able to get the insurance company to spring for your surgery appointment, but there’s no guarantees.

The Future?

If you can get health insurance, there’s no guarantee that it will cover what you personally need.  The Affordable Care Act was supposed to make healthcare accessible to all. It definitely fell a little short, but it was well-intentioned, and still a better plan than the one we’re currently looking at under the Trump administration. Did any of these surprise you? Things are only set to get worse under Trumpcare.

However, Democrats are currently discussingsome viable alternative options for the future. They won’t pass any time soon, but the best we can do is stay informed and throw our support behind these initiatives so that the American people can get the care they need at prices that are reasonable.

Author: Kate Harveston