Covered expenses

“Covered expenses” in the context of health insurance are the types of medical services, treatments, and procedures that are included under an insurance policy for which the insurance company agrees to pay. These expenses are outlined in the policy documentation and can include a wide range of care, such as prescription drugs, dental care, vision care, paramedical services, ambulance services and semi-private hospital rooms. In Canada, your provincial or territorial government health insurance plan pays for medically necessary hospital and physician services, so a private policy’s covered expenses are mostly costs the public plan doesn’t fully cover. In Quebec, a group plan that covers prescription drugs must provide coverage at least equivalent to Quebec’s basic prescription drug insurance plan. The policy will specify conditions and limitations for these expenses, including any required copayments, coinsurance, and deductibles that the insured must meet. These are what a specific policy agrees to pay for; what a health spending account can reimburse is described under “eligible expenses”.