[grkvlt]

> By limits to the coverage, I meant health issues that are not covered [...]

Again, being British, this is staggering to me. I just kind of assumed that health insurance covered, you know, your health. Do you mean that with American health insurance I could get turned away from the hospital for having the wrong kind of disease or something? I would understand if it's cosmetic surgery or similar that isn't covered; but even here I have friends who have had rhinoplasty (nose jobs) on the NHS, for essentially cosmetic reasons! I sort of forget how good our system is, sometimes, with all the media complaints about it here...

[thedufer]

I'd like to repeat that these are assumptions - the worst I've ever done is broken a finger, so I'm not the one stretching the limits of the plan. Some of the things I don't know about:

Is abortion covered? I don't know; I'm a guy. Mental health issues? Not sure; I've never had any. Preventive/elective surgeries? Birth control? Where's the line between dental and health insurance? (I know my dental is a little weaker.) These haven't come up so I haven't bothered to learn about them. Maybe I should.

I expect that if I have to go to the ER, I'll be covered; its some of the the edge cases I don't know about. There are probably laws that ensure some of these, but I just don't know much about it. I'm a largely healthy person and have been my whole life.

[Devthrowaway80]

I think the whole problem is "it depends on your plan."

I had to select a healthcare plan (an idea which I found rather strange) and spent many happy hours in October curled up with countless HMO/PPO/WTF policy books, looking into exactly these details. I have a history of mental illness and addiction, and my wife came within about 12 hours of death during a two month hospital stay earlier this year, so minor questions like "can I receive appropriate treatment for a potentially life-threatening illness?" have taken on an urgency that they did not possess when I was younger.

Is abortion covered? I still haven't found an answer there despite poring over my plan manuals. My wife has not been able to take birth control until very recently and we are not in a financial situation to be able to care for an infant. Did I click the right button in my convenient private healthcare web app?

Dental, weirdly enough, is not actually covered under Canadian universal healthcare, despite the relationship between dental health and seemingly-unrelated things like cardiovascular health (seriously!). It's pretty strange.

If I had any actionable advice to offer, it would be to look into this crap now. Some of the plans on offer were shockingly bad, despite the price tag - "we pay up to 75% of your hospital bill!" Fantastic. My wife had her appendix out in Florida on vacation, the surgeon lost a few staples in her abdomen, and next thing you know, she's looking at a $250,000 bill (covered by travel insurance, thankfully). $250,000 * 0.25 = $62,500. Not checking this stuff out could cost you - health problems strike when you least expect them .

[thedufer]

Thanks for the response. That's all very interesting.

> If I had any actionable advice to offer, it would be to look into this crap now.

Is that still relevant given that I don't have options? My company only offers one plan (and they cover the monthly cost, so I might as well take it). I'm wondering if there are situations where knowing what is covered would change my actions, even if I can't change which plan I'm using.