Health care insurance plans have to be carefully worded so that costs do not spin out of control.
For instance, many lonely people like to go to the doctor. Some people do not talk to another human for days at a time. Some do this by choice, others are just really lonely.
Dad sold life insurance. When asked why he did not also sell health insurance, he would say, "Well, there is no question about whether someone is dead."
Doctors and nurses have years of training and still sometimes cannot tell whether someone is ill, or what illness they have, or how to cure the illness. Doctors and nurses make complex decisions regarding our health that are sometimes questioned unreasonably by people with no medical training. But if no one questions any health care decision, greedy doctors can make money treating someone who is not at all sick, and does not need the care the doctor orders. (There are greedy people in every profession.)
For this, and other reasons, ALL health care plans are confusing.

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