Health insurance provides a financially protection plan to you which covers costs of medical expenses, like covers the costs of medical treatment, medication and hospitalization of the insured. It is like a contract between an individual who is like an investor for his medical emergency occuring and insurance company.
Insurance is a way to manage your risks. Insurance provide you protection in a case of lot of crises if you face in any situation in your life in future. The insurance company helps you to overcome the situation by helping you financially. Insurance is financially a safety point or network for you that helps you and your loved one’s recover after something bad happens — such as a fire, theft, lawsuit or car accident. By purchasing an insurance you save your or your love one’s life to become difficult after any incident.
How health insurance company work:
The policy holder or client pays a regular premium every month and in return, the insurance company agrees to pay a portion or all of the medical expenses incurred by his client.
Why health insurance is important for you?
- Unexpected medical expenses: Health issues or medical emergencies can be occur unexpectedly any time any where which leads to financial disturbance and increase the financial burden on you. Thus health insurance policy helps their clients to overcome from these any unhappy occuring.
- Peace of mind: Health insurance provides a peace to your mind when you know about the benefits of health insurance. You never worry about your illness or mental stress while having insurance policy.
- Access to quality health care: Many insurance companies make plans to provide access to a network of quality health care providers. Then you can easily approach them .
Types of health insurance:
- Individual health insurance: This type of individual health insurance plan is a policy which covers a single person under the policy against medical bills and hospitalization costs occuring during illness. You can purchase an individual health insurance policy for yourself, your spouse, your children, or even your ageing parents or for your beloved one’s.
- Employer – sponsored health insurance: In this type of health insurance policy contribution to the premium offered by the employers to their employees.
- Government – sponsored health insurance: This type of health insurance includes many programs provided by government like Medicare plan which is for elderly and disabled persons and Medicaid which is for low-income individuals and families.
- Short-Term Health Insurance: This is the temporary coverage for a limited period. This is for short time.
- Cost: Lower premiums than traditional health insurance, but limited coverage.
- Benefits: This type can be helpful for short-term needs.
Key components of health insurance plan:
A health insurance plan typically includes so many key components that determine its coverage and costs. By understanding these components of health insurance plan, you can be able to choose a plan that best suits to your needs:
Premiums:
Every month you have to pay the fees which is fixed to be paid to maintain your insurance coverage regularly. Premiums can be different based on many factors like age, health status, location, and the type of plan of health insurance.
Deductibles:
An insurance deductible is a specific amount which you have to must spend before your insurance policy pays for some or all of your insurance claims. Insurance companies use deductibles to ensure that policyholders have skin in the game and they will share the cost of any kind of claims.
Higher deductible, lower premium: Generally, plans with higher deductibles have lower premiums.
Co-payments:
These are fees you have to pay at the time of service for certain or specific medical procedures or visits. This is the amount of money that a patient with health insurance pays for each health care service, such as a visit to the doctor, laboratory tests, prescription of medicines, hospitalization or stay at hospital. The amount of the co-payment usually depends on the type of health care service which is provided to him.
Examples: Co-payments might apply to doctor’s visits, prescriptions of medicines, or hospital stays.
Coinsurance:
Coinsurance is a term used in insurance to describe the shared responsibility between the insured and the insurer in covering the cost of a claim. This is the percentage you’re responsible for paying after your deductible is met.
Out-of-Pocket Maximum:
This is the maximum amount of your insurance policy which you’ll have to pay out-of-pocket for covering the medical expenses in a given year.
Network:
Preferred providers: This refers to the group of healthcare providers like doctors and hospitals that your insurance company has contracted with them for his insurers.
In-network vs. out-of-network: Generally, you’ll have to pay lower costs for services provided from in-network providers.
Coverage:
This includes the specific types of medical services covered by your plan of insurance company.
Examples: Coverage may be include hospitalizations, any surgeries, prescription of medicines, preventive health care and mental health services.
Exclusions:
These are some types of services or conditions that your health insurance policy will not cover.
Examples: These may include experimental treatments, cosmetic procedures, or pre-existing conditions of their clients.
Additional factors to consider:
- No-claim bonus: This factor provides a discount on your premium if you don’t file any type of claims during your policy year.
- Sum insured restoration: This feature allows your sum insured to be restored after a claim, ensuring you have enough coverage for your future medical expenses.
- Health checkups: Some policies may include annual health checkups as a benefit of health insurance policy.
- Maternity benefits: If you’re planning to start a family, ensure the policy covers maternity expenses.
- Dental and vision coverage: These can be valuable add-ons, especially if you have specific dental or vision needs.
- Accessibility: Ensure there are network hospitals and providers in your area or where you frequently travel.
Exclusions and Waiting Periods:
- Understand the exclusions: Be aware of any conditions or treatments that are not covered by the policy.
- Waiting periods: Some insurance policies may have waiting periods before certain conditions or treatments are covered.
- Flexibility: You have to check if there are options for customizing your coverage to meet your specific needs and budget.
- Company Reputation and Customer Service
- Financial stability: You should research about the financial stability of the insurance company.
- Customer reviews: Read reviews from other policyholders to get an idea of the company’s customer service and claims processing occuring in insurance policy.
By carefully considering these additional factors, you can choose a health insurance policy that provides comprehensive coverage and meets your specific needs.