What Do You Mean It's Not Covered: Basic Terms and Definitions
Ambulatory surgical center: Any public or private establishment which is licensed by the state; has permanent facilities that are equipped and operated primarily for the purpose of performing surgical procedures; has continuous physician services and registered nursing service whenever a patient is in the facility; and does not provide services or accommodations for patients to stay overnight.
An "ambulatory surgical center" is an outpatient center that performs surgery. Many minor procedures can be performed at such centers for a lower cost than in a hospital. A distinctive characteristic of an ambulatory surgical center is that it does not have any accommodations for patients to stay overnight.
Complications of pregnancy: Conditions requiring hospital confinement (when the pregnancy is not terminated) whose diagnoses are distinct from pregnancy, but are adversely affected by pregnancy, including but not limited to: acute nephritis, nephrosis, cardiac decompensation, missed abortion, and similar medical and surgical conditions of comparable severity; or non-elective cesarean section, termination of an ectopic pregnancy, and spontaneous termination of pregnancy occurring during a period of gestation in which a viable birth is not possible. Complications of pregnancy do not include false labor, occasional spotting, physician prescribed rest during the period of pregnancy, morning sickness, hyperemesis gravidarum, pre-eclampsia, and similar conditions associated with the management of a difficult pregnancy not constituting a nosologically distinct complication.
These paragraphs are important because some health insurance policies do not cover expenses resulting from normal pregnancy and normal childbirth (you can buy optional pregnancy and childbirth coverage, for an added premium). But most policies will pay expenses resulting from complications of pregnancy, as defined in the contract. dependent child: An insured person who is 25 years old or less, single and dependent on you.
Many policies cover your dependent children. Age, marital status, and financial dependency determine a child's eligibility for coverage. Not all policies cover a child who is 25 years of age, though. Many terminate coverage at age 19 or 21.
