10 medical services not covered by health insurance

5. Private nursing

Private nursing is often left out of health plans, with 92 percent of insurers not willing to pay for the benefit.

4. Weight loss program

93 percent of plans exclude weight loss programs from their benefits. And that’s a flaw in the country’s health plans, experts argue, as obesity is a life-threatening condition that affects millions of Americans.

Though PPACA requirements will ensure coverage of weight loss diagnosis and counseling, insurers may continue to refuse payment for enrollment in third party programs such as Weight Watchers as well as surgical interventions, HealthPocket researchers note.

3. Infertility treatment

Couples looking to expand their families are mainly out of luck: 94 percent of health plans don’t cover infertility treatments.

As is the case with weight loss, the exclusion of insurance coverage for infertility treatments affects millions across the United States. With the average cost of a treatment cycle at $12,400, and multiple cycles often needed for success, lack of coverage for in vitro fertilization can make the procedure inaccessible for many Americans, researchers argue.

“A lack of insurance coverage for widespread conditions like obesity and infertility affects millions of people across the United States,” says Kev Coleman, head of research and data at HealthPocket. “Given that most of the medical service exclusions within the Top 10 list can continue after the implementation of health reform, it is vital that consumers closely examine their benefit coverage options when they shop for health insurance this October.” 

2. Cosmetic surgery

Cosmetic surgery is No. 2 on the list of most common services not covered by insurance, as 98 percent of health plans do not cover it.

According to WebMd, the most popular cosmetic procedures are lipoplasty, eyelid surgery, breast implants, nose jobs, facelifts, and Botox injections.

1. Long-term care

Have a plan that includes long-term care? Then consider yourself (very) lucky. Almost all health plans — 98 percent — exclude long-term care.

LTC includes professional health services for people requiring assistance for an extended period of time due to a chronic condition or disability. The elderly have disproportionate representation among long-term care recipients though younger age groups also receive this type of care.

The Community Living Assistance Service and Supports Act, a federal LTC insurance program championed by the Obama Administration, was suspended in 2011 before the insurance was available due to concerns about the program’s financial sustainability and then subsequently repealed in The American Taxpayer Relief Act of 2012.

See also:

Obesity: The not-so-new disease

Real celebrity: Extended care, part 1

10 things to know about state health insurance exchanges