Health insurance is an insurance that helps in eliminating the risk of occurring medical setbacks.
This means that in case of a medical issue the huge amount of medical bills can be taken care off by the insurance companies instead of the individual.
They do not have to bother themselves with paying an excess amount of bills to get treated and to stay in the hospital for the recovery period.
All this is covered by the policy.
There are many factors that decide the amount of money that will be covered by the company.
The premium and deductible are the things we all know about.
Some of the features which an individual needs to be aware off are listed below.
Health insurance states certain exclusions.
These are listed so that the insured is aware of the certain illness and bills that are not covered by the insurance companies.
In case any emergency occurs which is listed under exclusion the individual will have to pay the entire bill and the company cannot be help liable to pay anything at all.
Health insurance may also have a coverage limit.
This is a limit that is specified by the insurance companies that specifies the upper limit.
This means that the company will have to pay this amount in total for the period.
If there are more bills after the specified limit, the money will have to be paid by the individual.
For example if the company has an upper limit of $ 20,000.
This means that in a year of the individual has more than $ 20,000 bills he will have to pay the excess amount from his pocket.
The company is only liable to this specified amount and cannot be made to pay more.
Health insurance may also have something called an out-of-pocket maximum.
This is very similar to the coverage limit.
The difference is that this limits the amount of money that the individual has to pay in case of an emergency.
After this any amount that is still in excess has to be paid by the company.
This can be specific in nature or broad as per the terms stated.
They may cover only the prescription drugs or go on to include other things.
Capitation is another feature mentioned in Health insurance policies.
This is the amount that is paid by the insurer to the health care provider.
This amount is paid so that the health care provider treats all the people covered by the insurer.
In network providers is another feature.
According to this, the company lists certain health care providers for the insured.
If the insured selects any health care provider from the list then they get additional discount on the co payment, co insurance and other payments that have to be paid by the insured.
This works because the company already has an agreement with a health care provider which enables them to pay lesser amount of fee to them for the service rendered by them.
This means that in case of a medical issue the huge amount of medical bills can be taken care off by the insurance companies instead of the individual.
They do not have to bother themselves with paying an excess amount of bills to get treated and to stay in the hospital for the recovery period.
All this is covered by the policy.
There are many factors that decide the amount of money that will be covered by the company.
The premium and deductible are the things we all know about.
Some of the features which an individual needs to be aware off are listed below.
Health insurance states certain exclusions.
These are listed so that the insured is aware of the certain illness and bills that are not covered by the insurance companies.
In case any emergency occurs which is listed under exclusion the individual will have to pay the entire bill and the company cannot be help liable to pay anything at all.
Health insurance may also have a coverage limit.
This is a limit that is specified by the insurance companies that specifies the upper limit.
This means that the company will have to pay this amount in total for the period.
If there are more bills after the specified limit, the money will have to be paid by the individual.
For example if the company has an upper limit of $ 20,000.
This means that in a year of the individual has more than $ 20,000 bills he will have to pay the excess amount from his pocket.
The company is only liable to this specified amount and cannot be made to pay more.
Health insurance may also have something called an out-of-pocket maximum.
This is very similar to the coverage limit.
The difference is that this limits the amount of money that the individual has to pay in case of an emergency.
After this any amount that is still in excess has to be paid by the company.
This can be specific in nature or broad as per the terms stated.
They may cover only the prescription drugs or go on to include other things.
Capitation is another feature mentioned in Health insurance policies.
This is the amount that is paid by the insurer to the health care provider.
This amount is paid so that the health care provider treats all the people covered by the insurer.
In network providers is another feature.
According to this, the company lists certain health care providers for the insured.
If the insured selects any health care provider from the list then they get additional discount on the co payment, co insurance and other payments that have to be paid by the insured.
This works because the company already has an agreement with a health care provider which enables them to pay lesser amount of fee to them for the service rendered by them.
SHARE
