What does a Schedule of Benefits inform the policyholder about?

A Schedule of Benefits is a crucial document for policyholders as it outlines the medical services that are covered under their insurance policy. This schedule provides detailed information about which procedures, treatments, and services are eligible for coverage, thereby helping policyholders understand what medical care they can access without incurring out-of-pocket expenses.

By clearly listing the covered services, the Schedule of Benefits enables individuals to make informed decisions about their healthcare, knowing what is included in their insurance plan. It also outlines any limitations or exclusions associated with certain services, which can guide policyholders in planning their healthcare needs.

Furthermore, while reimbursement amounts and penalties for not using network providers are important considerations, the primary focus of the Schedule of Benefits is to define and categorize the scope of coverage provided by the insurance plan.