Why doesn’t my insurance cover ________?

Many patients ask the question why my insurance doesn’t cover this. This can be anything from surgery, orthotics or x-rays. What is even more confusing is that you may know someone who has the same insurance as you and they had that particular benefit covered.

The benefits that are covered under a particular medical plan are most often determined by the employer who is offering the medical plan. Your employer carves out a plan that they feel suits the needs of both the company and the employee. There are many factors that determine the benefits and riders the employer chooses including but not limited to the line of work and the cost of the benefits. 

Many employers will offer their employees more than one plan option, for instance HMO, PPO and Traditional plans. It is very important to carefully read over your entire plan options and choose the one that will best suite your needs
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