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The ABC’s Allowances, Benefits & Coverage

Did you know there are differences between Allowances, Benefits, and Coverage?  Let’s take a moment to go through them.

Allowances

Allowances apply to any approved Wellness Treatment or Service. When referring to “Allowances,” as they apply to your health insurance policy, we are talking about approved treatments and services that will count towards your deductible. The intent of Allowances is to incentivize you to utilize healthy, proactive, and preventive services such as chiropractic care, massage therapy, and more.  Allowances also provide a way to pay down your deductible while utilizing preventative and wellness services you may enjoy already.    

Approved Wellness Treatments & Services include: 

  • Acupuncture 
  • Massage Therapy 
  • Chiropractic Care 
  • Naturopathic Care 
  • Holistic Care 
  • Homeopathic Services 
  • Physical Therapy 
  • Hearing Tests & Hearing Aids  
  • Supplements & Essential Oils, including Cannabis  

Benefits

Benefits refer to “non-medically necessary” treatments or services also offered in the Nova HealthCare Plan. Benefits included are Dental, Vision, Wellness Visits, Gym Memberships, which are reimbursable up to the limits. *See Health & Wellness Treatments and Services for details. Other notable benefits are the Member Referral Program, Personal Care Advocates, Open Enrollment, and our Open Network. 

Coverage

Coverage refers to any healthcare services that a physician would provide to you, the patient. The service must evaluate, diagnose, or treat an illness, injury, disease, or its symptoms. Coverage is not intended to pay for elective, preventive, or Wellness Treatments & Services. Instead, your Coverage provides a safeguard against financial disaster should a significant health crisis arise. As stated above, the Nova Pathfinder Plan Coverage includes all (EHB’s) Essential Health Benefits
*See above in ACA Essential Health Benefits for a list of EHB’s