Allowances, Benefits and Coverage

Did you know that Allowances, Benefits, and Coverage all have different meanings? Let’s take a closer look at them one by one.

Plan Allowances

Allowances apply to any Wellness Treatment or Service that has been authorized. When we speak about “Allowances” in the context of your health insurance coverage, we’re referring to authorized treatments and services that will count toward your deductible.

Allowances are intended to encourage you to use healthy, proactive, and preventative services such as chiropractic treatment, massage therapy, and others. Allowances also allow you to pay down your deductible while using preventive and wellness services that you may currently use.

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

Plan Benefits

Benefits relate to “non-medically necessary” treatments or services that are also available via the Nova HealthCare Plan. Dental, Vision, Wellness Visits, and Gym Memberships are among the benefits that are reimbursable up to certain limitations. * For further information, see Health & Wellness Treatments and Services. The Member Referral Program, Personal Care Advocates, Open Enrollment, and our Open Network are other noteworthy benefits.

Plan Coverage

Coverage refers to any healthcare services provided by a clinician to you, the patient.
A sickness, injury, disease, or its symptoms must be evaluated, diagnosed, and treated by the service. Coverage does not include elective, preventative, or wellness treatments and services. Instead, your coverage protects you against financial ruin in the event of a major health crisis.

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