Health plans: benefits and exclusions

A health plan can vary significantly in terms of its coverages, deductible value and contract exclusions, but if you know your policy in depth, I am sure you will get the most out of it.

Among the main benefits of a health policy are the annual PAP exams, prostate exam, dental benefit, benefit for glasses, mammography, vasectomy voucher, and many others that may vary according to the contracted plan, all these benefits are given under reimbursement, meaning that you can go to the doctor of your choice or take a medical appointment under co-payment, request your documents and then ask the company for your reimbursement, which in this case will be up to the limit of coverage for benefits.

Another important point is to know the exclusions of your contract such as: excess of medical fees, medical care with podiatrists not registered in senecyt, sunscreens, moisturizers or moisturizing creams, vitamins in general, hormonal treatments for growth, any treatment or aesthetic or cosmetic, negative COVID tests, medical examinations of discard, single use items (bagas, diapers, syringes, sheets) this list is out of coverage in most insurance companies.

Knowing the benefits and exclusions of a policy allows the member to have a clear picture of what will be covered and what will not, and among these exclusions are pre-existing medical conditions not declared or that have not met the waiting periods. Once you know your policy you can take advantage and enjoy every benefit it provides, as well as verify that the doctor is applying the pertinent values to your treatments, always remember to get a second medical opinion and go to doctors who have their degree and documentation in order.

If you have doubts about your health plans or you are not satisfied with your policy you can always change Plan and broker at any time of your contract, we recommend that if it is the first time you take a medical insurance your first payments are monthly so if you are not happy with your plan you can cancel it and look for a different option. We are Bluebox advisors and we are here to help you.

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Carlos Ramirez
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