Do you really think you have $5,000,000 of coverage for the life of your health insurance policy? Take another look. Most plans, probably close to ninety-five percent, or more, have internal limitations. The limitations in these plans most health insurance agents are not aware of. Your local auto and home insurance agent? Forget it! Only the exceptional insurance agents will know. These are the ones that take the time to find this information.

There are so many internal limitations in plans I won’t be able to list all of them here. Refer to your health insurance expert. If you are on a group plan, limitations are still there – some will be higher than private insurance – some will be lower.

These limitations can range from a certain number of doctor visits or wellness coverage to $250,000 maximum coverage for organ transplant, in or out-of-network. Quite frankly, that isn’t nearly enough for organ transplants. One of the biggest limitations, and it’s one of the most expensive, is outpatient physical therapy. This one is huge. Some of the most well known carriers put these limits on their policies to control abuse of these services. It’s more like controlling costs. If you needed $20,000 in physical therapy, based on your situation, you could be vulnerable to at least $17,000 ($3,000 max benefit). Some could be as much as $19,640 ($360.00 max benefit)!

When would you ever need physical therapy? It could be for a little sprain in the ankle or wrist to as big as a heart attack or stroke. Physical therapy isn’t cheap these days. What if you broke your leg and needed to learn how to use it again, but you were well enough to be released from the hospital? You would go through rehabilitation therapy.

Some of the carriers that have such limitations are as follows, but not limited to:

-Blue Cross and Blue Shield
-Aetna
-Unicare
-Celtic

Check your state variations.

Each one of these carriers has their own limitation which varies from company to company. Where does this leave you? Vulnerable possibly? Medically bankrupt?

Since we don’t have a crystal ball we can’t predict the future. If you claim you are not worried about physical therapy I would say: Congratulations, you are officially the world’s smallest insurance company. Have you ever seen an ambulance fly by with their lights and sirens on? Do you really think they are just practicing?

By now I think you get the point. Some carriers have raised the bar on this limitation. Some have raised the outpatient physical therapy to twenty visits. If you had to go to therapy a couple times per week, that’s almost three months of therapy – that’s reasonable. Some others have raised it to sixty visits – depending on the plan you choose. To ensure that your insurance is covered, it might not be a bad idea to get a good amount of Critical Illness Insurance. Critical Illness Insurance is a policy that pays one lump sum if you are diagnosed with a critical illness. It could save your life, literally.

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