Least Expensive Alternative Treatment
What Does Least Expensive Alternative Treatment Mean?
The least expensive alternative treatment (LEAT) is a provision in a health insurance policy that states the insurer will cover only the least expensive option when multiple treatment possibilities are available. This means that policyholders must choose the least expensive treatment or pay out of pocket if they opt for a more costly option. This clause helps to reduce costs for the insurer.
It is also referred to as the least expensive professionally acceptable alternative treatment (LEPAAT).
Insuranceopedia Explains Least Expensive Alternative Treatment
Mostly found in dental insurance, the least expensive alternative treatment (LEAT) provision is a strategy insurers use to lower the costs of providing coverage. It allows insurers to cover treatments that are both adequate and cost-effective. By covering acceptable treatments rather than the most expensive ones, insurance companies can increase their net underwriting income.
For example, if a dentist presents a policyholder with multiple filling options for a cavity, and the enamel-colored filling is the least expensive option, a policy with a LEAT clause would only cover this choice. This approach allows insurers to provide coverage for clinically and professionally acceptable treatments without covering what may be considered more of a “cosmetic” rather than a functional treatment.
Because a LEAT clause can leave you paying the difference between covered and preferred treatments, it is worth checking for this provision when comparing and choosing health insurance plans. Understanding how your plan handles cost sharing through premiums, deductibles, co-pays, and coinsurance will also help you estimate what you might owe out of pocket if a LEAT rule applies.
