Why isn't this covered by my insurance?

FRIDAY, OCTOBER 7: The BHeC (Bermuda Health Council) and the Bermuda Sun have teamed up to answer your questions about the island’s healthcare system.

Visit www.bhec.bm to submit your queries and look for our response in each Friday’s Bermuda Sun and on bermudasun.bm.

This week’s question focuses on what is covered by health insurance.

Q: I need specialised gum and periodontal treatment that is unavailable in Bermuda and have been referred overseas by my dentist.

I have been informed that my insurer will not pay for the associated costs (airfare, and so on) and will only cover a small part of the cost — I have comprehensive dental cover and full major medical.

A: The worst way to find out that you’re not covered is when you need treatment that’s not included in your health insurance policy.

This can be an unpleasant experience at best, and a life or death decision at worst.

In your case, the answer really depends on your policy, and that can only be ascertained with your insurer.

It is always a good idea to be familiar with the level of coverage we have.

As with other things we buy, we tend to find the limits only when we reach them.

When we decide on a health insurance policy, we are deciding what to include and what to leave out.

At the time of making the decision, we may feel some things are not essential, or that we’re unlikely to need them.

But, of course, the purpose of health insurance is to protect us from unexpected medical expenses, and the financial impact they can have on us.

So when we decide on our level of coverage, we are actively deciding to take a financial risk should those unlikely medical needs arise.

In Bermuda, hospitalization cover is legally mandated in any insurance policy — that’s the Standard Hospital Benefit.

But everything beyond that is optional, resulting in situations like the one you’re facing now.

Discuss your coverage with your insurer to determine what’s included in your policy, and reconsider whether you have enough coverage to meet your needs.

The reality is that most of us are unlikely to have policies that cover 100% of everything.

For more information go to www.bhec.bm.