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Secrets of Your Health Insurance Policy
Summary: Learn what to know when looking for a good health
insurance policy. Why take chances when proper planning can help
you avoid costly mistakes in the future!
Everybody knows what a big risk it is to become ill when you don’t
have any insurance coverage. Today, even a few days in a hospital
can add up to thousands of dollars in medical costs. We also know
that many hospitals will even refuse treatment to a patient who
lacks adequate coverage by a reputable insurance company. That
puts health insurance in the ‘must have’ category.
A health insurance policy is in fact a legal document with pages
of terms and conditions in small type and technical language. It
is a binding contract crafted by the insurer’s capable legal staff
between the company and the policy holder in which the company
promises to provide treatment for illness and injury in return for
the payment of regular premiums by the policyholder. If it is an
individual policy, only the policy holder is covered, In the case
of some policies, the holder’s family members are also covered at
the cost of additional premium payments.
Individual policies tend to be quite costly unless a percentage
paid by the insured’s employer by adding him to the firm’s group
policy. Twenty years ago, it was common for bigger employers to
pay 100% of the health premiums for key employees as an incentive
to join the company. Today, thanks to spiraling costs, the
company’s share is usually limited to 30-50% of total premium
cost.
No matter what the source, a complicated insurance policy is
difficult for the layman to understand. If you don’t truly
comprehend all those terms and conditions, you may very well get a
big, unpleasant surprise when you submit a claim. This arises from
language like ‘pre-existing conditions’, ‘medically necessary’,
‘recission period’ ‘covered services’ ‘out of pocket’,
‘deductible’, ‘lifetime maximum’ and ‘exclusions’. It is strongly
suggested that you have your policy’s terms and conditions
carefully reviewed by a knowledgeable person or attorney prior to
signing it to ensure that the coverage meets your needs.
Remember that the insurance company is in business to make money
and they do so by collecting far more in premiums than they will
pay out in claims. This is partly determined by actuaries who
calculate that a significant number of insured people probably
won’t file claims that exceed the total of their premium payments.
Another of their little secrets is in all that fine print and
fancy technical language. For example, most policies exclude
coverage for pre-existing conditions or medical problems that the
insured had prior to buying the policy. A heart attack and cancer
are good examples. If these exist, the company merely lists them
under exclusions for things they won’t cover under the policy.
Then there is ‘medically necessary’ defined as something your
doctor feels is necessary for you. The insurance company lists
‘medical benefits’ or things they will cover, but keep in mind
that they might not always agree with your doctor and deny the
medical coverage.
Certain health care falls under what the company calls a ‘waiting
period’ meaning it will not be covered until a stated amount of
time elapses.
The bottom line is that you need to really understand what you’re
paying for even if you must hire an attorney to review it. If you
don’t, you may find that there are many, many little loopholes
that can cost you big money if you’re ill.
Original Article
Source:
http://www.medicalneeds.com |
