Health Insurance

What Does Health Insurance Cover?

Doctor Visits (Primary Care & Specialists)

Includes routine visits to your primary doctor and specialist consultations for specific conditions.

Preventive Care

Includes services like annual physical exams, vaccines, cholesterol checks, and cancer screenings. These are often covered at 100% to help catch health issues early.

Emergency Room & Urgent Care Services

Covers ER visits for life-threatening conditions and urgent care for less severe but immediate medical needs.

Hospitalization & Surgery

Pays for hospital stays, including surgery, overnight care, anesthesia, and related treatments—whether planned or for emergencies.

Prescription Medications

Helps cover the cost of medications prescribed by your doctor. Depending on the plan, this may involve a copay or coinsurance for each prescription.

Lab Tests & Imaging (X-Rays, MRIs, etc.)

Covers diagnostic tests such as blood work, urine tests, and imaging procedures like X-rays, CT scans, and MRIs.

Mental Health & Substance Use Services

Includes therapy, counseling, psychiatric evaluations, and treatment for mental health conditions and addiction recovery programs.

Maternity & Newborn Care

Covers prenatal visits, labor and delivery, and postnatal care for both the mother and newborn in the early stages after birth.

Pediatric Services

Provides medical coverage for children including routine checkups, vaccinations, developmental screenings, and care for common childhood illnesses.

What Is Not Covered by Health Insurance?

Cosmetic Procedures

Treatments or surgeries done to improve appearance—such as facelifts, liposuction, Botox, or nose reshaping—are usually not covered unless medically necessary.

Alternative or Complementary Therapies

Alternative therapies like acupuncture or herbal treatments may not be covered unless listed in your plan.

Over-the-Counter (OTC) Medications

Drugs like ibuprofen, vitamins, or cold medicine that can be bought without a prescription are not covered unless prescribed and explicitly listed as covered.

Out-of-Network Care

If you receive care from a provider outside your plan's network, you may have to pay most or all of the bill yourself—unless it's a true emergency.

Experimental or Investigational Treatments

Treatments still under study or not yet approved by the FDA are often excluded. This can include some new cancer treatments or clinical trial medications.

Long-Term Care

Health insurance generally doesn't cover nursing homes, assisted living, or full-time in-home care for chronic conditions. That requires separate long-term care insurance.

Non-Emergency Care While Traveling Abroad

Most standard plans only cover emergency medical care outside the U.S. Routine or elective care abroad is not covered unless you have international health coverage.

Injuries from Illegal Activities

If you're injured while engaging in illegal acts, your insurance may deny the claim based on policy exclusions.

Key Benefits of Our Health Plans

Financial Protection

Avoid paying full price for doctor visits, emergency care, and prescriptions.

Preventive Care Included

Stay healthy with screenings, checkups, and vaccinations often covered 100%.

Multiple Plan Options

Choose plans with the right balance of deductible, copay, and premium to fit your lifestyle.

Peace of Mind

Coverage during unexpected illnesses, accidents, or hospital stays.

Personalized Support

Allcoast agents help you select the best plan for your family or business.

Health Insurance FAQs

What is a deductible?

The amount you pay for healthcare services before your insurance begins to pay. For example, if your deductible is $2,000, you pay the first $2,000 of covered services. This resets annually.

What's the difference between copay and coinsurance?

A copay is a fixed amount (like $25) for a service. Coinsurance is a percentage you pay after meeting your deductible (for example, 20% of a hospital bill).

What is an out-of-pocket maximum?

It's the most you'll have to pay in a year for covered services. After you reach this amount, your insurance pays 100% of all further covered care.

Can I keep my current doctor?

That depends on your plan's provider network. GoldenTrust helps find plans that include your preferred providers and confirm their participation in your chosen network.

Do I need health insurance if I’m healthy?

Yes. Insurance protects you against unexpected medical costs due to accidents or sudden illness while also giving you access to preventive care.