What services do Combination plans primarily cover?

Combination plans are designed to offer a broad spectrum of coverage, specifically focusing on both diagnostic and preventive services. The term "usual and customary" refers to the standard rates that most providers charge for similar services in a specific geographic area, which indicates that the plan covers these services in a manner that aligns with the prevailing pricing in the market.

Diagnostic services typically include tests and evaluations that help identify health issues, while preventive services are aimed at preventing health problems before they arise, such as vaccinations and routine screenings. By allowing coverage on a usual and customary basis, combination plans aim to ensure that policyholders receive necessary healthcare services without incurring excessive out-of-pocket expenses, as the plan helps cover both categories comprehensively.

In contrast, focusing only on diagnostic services would limit the coverage significantly, while covering only major and preventive services would not encompass the full variety of important diagnostic tests. Moreover, restricting coverage to exclusive services from a specific list would defeat the purpose of a combination plan, which is meant to provide a more flexible approach to healthcare needs rather than limiting choices.