What Do You Mean It's Not Covered: How the Policy Defines "Insured Expenses"

You're required to pay deductible and copayment amounts. Since the policy covers "insured expenses," you must also pay any charges which are not covered by the policy (excluded items, such as normal childbirth, elective cosmetic surgery, etc.). Expenses which are not covered cannot be applied toward a deductible. Except for these amounts, the insurance company will pay additional insured expenses up to the maximum payment. As mentioned earlier, the deductible and copayment percentages are shown in the policy schedule, and this policy uses a sliding scale for copayments. If more than one insured person is involved in the same accident, only one deductible will be applied to their combined expenses. An example: You and your spouse have a major medical policy with a $1,000 deductible applicable to each person and each injury or sickness. After you're both injured in an automobile accident, your medical bills are $1,400 and your spouse's are $2,200. Since only one deductible applies to this accident, $2,600 of the charges are covered by the policy -- subject only to copayments.