Most people take health insurance plans for granted. They always think they are young and healthy enough to have health guarantee or insurance plans. They believe it is better to get health assurance when they are going to be hospitalized. It is actually a misconception. It is always better to have your health insurance as early as possible. Health insurance is a process. Companies need to verify if your case is qualified to the coverage of their insurance. This is one of the reasons why health plans are highly recommended.
Today, companies and other employers provide health coverage or insurance as one of the benefits for their employees. Still, it is important to know what kind of insurance policy they are implementing. Is your family being covered by this particular health assurance or insurance? Do they also cover death and permanent disabilities?
Before applying for health insurance plans, here are some guidelines to help you.
- Coverage. The most important thing you can do is to verify with the agency the coverage of the insurance you are applying for. Do not hesitate to ask them anything about the insurance coverage they are offering.
- Details. Do not take anything for granted. Every document is important. Make sure you have the copies of their insurance policy and read everything before signing.
- Costs. Make a list of their packages and prices. Compare these prices to other insurance companies to have an idea about the insurance plans you are applying for.
- Credibility. In all aspects, it is always important to check the credibility of the company. Always settle for the best health coverage company to avoid discrepancies and lapses.
Why have health insurance plans?
Apart from protecting yourself and your family from unexpected costs of hospital bills, one incentive you can get from health assurance or insurance plans is the benefit of tax. Some health plans allow the beneficiary to deduct the income tax they have to pay to the government.
Basic services of health insurance plans:
- Emergency care
- Laboratory exams and results
- Hospital services
- Diagnostic services
- Vaccinations and checkups
- Rehabilitation therapies
Individual health insurance plans are made particularly for students. This is to ensure the educational quality and achievement of the students who need special health care. It is usually a formal written agreement between the school staff and the family of the students. It also requires a certification from the student’s physician or health care providers to prove that the person must undergo proper medical care.
Functions of individual health insurance plans:
- Provide proper emergency management to students.
- Create more opportunities for the students.
- Make a special program among students, parents, and staff to see the performance of the students.
- Set different goals such as school social activities, sports, and other educational trips.
- Maintain a medical program and monitor the health status of the students.
Families and income earners should prioritize getting good health insurance plans. These may come handy during emergencies. With a good plan, you can get coverage on costly medical expenses for illnesses, physical examinations, regular check-ups, doctor consultations, and medications.
You should know the basics of insurance plans before looking for a reputable insurance company. There are many types of health insurance plans specifically designed to meet the needs of the individual or family. When choosing a health plan, make sure to consider all the factors aside from the cost and monthly premiums.
One factor you should consider is the details of your plan, specifically what medical treatment it covers and what it doesn’t. Ask your agent if the coverage includes dental care, skin care, and regular check-ups. This is important because some insurance companies only offer pre-determined services and treatments.
You should also know the various payment methods. There are three options you can select – quarterly, monthly or on an annual basis. Select which one is easiest on your budget. One good tip on getting a health insurance is to devise a budget system. This will help you allot your resources properly so you won’t have a hard time paying the premium. Any delays in payment may cause policies to lapse.
Types of health insurance plans
Your health insurance should fit you and your family’s needs. Make sure to choose the right one because plans vary. There are those that will cover you alone or your spouse. You should consider health coverage for the entire family if you have children.
Figure out the health needs of everyone you want to include in your insurance plan. You should also consider if you need regular visits to your doctors or specialists so your plan will cover the expenses. Employees from private companies get health coverage as part of their benefits; however, their options are limited. Those who are self-employed, on the other hand, may choose from different private health plans.
There are two types of insurance available for you: the indemnity plan and the managed care plan. The indemnity plan offers more flexibility and is more costly. Many people get this because they can choose their own doctors and hospitals. A managed care plan is more affordable but you can only choose from the list provided by the insurance company.
Major medical insurance plans 101
Another term for this is the traditional health insurance. With this type of plan, the insurance company compensates the policyholder up to 80% of the total medical expenses. This means patients will have to shoulder the expenses first then file a claim to their providers.
If you get major medical insurance plans, you have to pay a certain amount before the health insurance company begins to give out reimbursements. You should pay for this amount every year for the renewal of your health plan. This kind of plan doesn’t pay for all the health services but can suggest good medical providers for consultation.
Do your own research before getting any kind of insurance plan. Ask for recommendations from friends and family. Try to read all available information so you’ll understand filing procedures and all the basic information you need to know when getting health insurance. Knowing these will allow you to choose the right health insurance company for you and your family.
Good health is an invaluable asset to any individual. Like many others, you would love to invest a significant amount of money to get fit and healthy. So, it doesn’t make sense to think for long when it comes to buying a health insurance policy to protect you and your family against the medical expenses incurred by major health issues. Health insurance plans are specially designed to provide you with the financial security when you are under any severe treatment. They come to you as a real help when you are surrounded by the rising hospital bills and doctor’s fees.
Right health coverage ensures that you will get the proper medical attention when you need it the most. They enable you to bear the cost of different activities like visiting to your doctor for regular medical check-ups, attending critical surgeries, and taking even emergency treatments.
Types of Plans:
There are two types of health insurance plans provided by many insurers – The indemnity plan and the managed care plan
Indemnity Plan – Also known as the fee for service plans, indemnity policies provide users with the wider flexibility and freedom under which a policyholder can choose a doctor, hospital, and other medical service provider of his choice. Illnesses and accidents are covered under this kind of plan, which doesn’t include the preventive care like birth control and flu shots.
Managed Care Plan – These health insurance plans differ from the previous ones in terms of many ways. Under this coverage, only those who have contracts with the Health Maintenance Organization are entitled to choose doctors, specialists, healthcare facilities, and other medical service provider. This plan also covers the mental health treatment and preventive care.
Here are some important terms along with their meanings which are primarily used in health insurance:
Deductible – A minimum amount which you have to pay to the insurers for the medical expenses before your plan begins. They are made annually.
Allowable fee – This is known as the maximum amount an insurance company pays for a medical procedure.
Fee-For-Service Plan – Under this coverage a policy seeker can ask for a doctor or specialist of his choice. It includes payment of deductibles and co-payments or co-insurance.
Flexible Spending Account – It works well when it comes to allowing policy seekers to pay for the hospital bills that are not covered by the policy like co-payments and deductibles.
Co-Payment – Policy holders are asked to pay a fixed sum in order to avail the medical services under some insurance plans. This is known as the co-payments. Higher co-payments are liable to be paid by the insured while getting the expensive medical procedures.
Co-Insurance – There are several insurers who ask the insured to pay a certain percentage of the expenditure of covered healthcare services. In general, it varies between 20 and 30 %.
Schedule of Allowance – It can be defined in the form of the sum your plan covers for each health procedures.
Where to find a Health Plan?
If you are seriously looking forward to buy a health policy for you and your family, then you can use the internet service and get the most suitable health insurance online. It is much convenient there to find the affordable health insurance of your choice.
A health insurance plan is an essential part of financial planning in this era of skyrocketing medical costs. Medical inflation has been aggravating at its full spree which makes it all the more important to buy a Health Insurance plan which could sponsor the hospitalization and medical treatment bills or expenses.
It is important to evaluate and look for the following parameters to get a best health plan for you and your family.
1. Check for the Waiting Period Clause
You must be feeling care free after taking an insurance, but your health insurance comes with a waiting period clause for specific conditions. There is an initial period clause which says that any hospitalization claim will not be admissible in first 30 days of the policy commencement apart from accidental hospitalization.The pre-existing diseases or conditions are also not covered immediately after you purchase a policy.There is a waiting period ranging from 2 years to 4 years as per the plan conditions in the industry. Also, there are certain surgeries and treatments like hernia, cataract, joint replacement, etc. which can be treated after a specific waiting period of 1 or 2 years.
So,it is important to check the waiting period clause before you finalize the health plan.
2. Check for Sublimits
There are certain capping or sublimits in your health plan which says that the specific kind of expenses are paid by the insurance company upto a specific limit and beyond that the insured or customer has to bear them at his own. For example: Room rent charges are capped on per day basis for different health plans. Some health plans also come with a mandatory co-pay where the portion of the admissible claim is to be borne by the insured and the remaining is paid by the insurance company.
Check for the sublimits in your health plan to avoid any last minute surprises at the time of claim.
3. Check for Network Hospitals
The insurance companies offering health plans have certain empaneled network hospitals with whom they have a tie up. Any hospitalization or treatment taken in the mentioned or specified network hospital list is done on the cashless basis subject to policy conditions.
Check for the list of network hospitals of insurance company and ensure you have network hospitals of the insurer near your place of residence in case of any emergency hospitalization. Also, a treatment in non-network hospital may not offer cashless treatment and some insurers have a co-pay clause if you take a treatment in non-network hospital.
4. Check for the Claim Process
Different insurance companies have different claim procedures. Some settle or administer claims through Third Party Administrators (TPA’s) and some have their own in house claim settlement unit to foster quick and hassle free claim processing. Also, check the claim settlement ratio of the insurer you intend to buy a health plan from to have a clear picture on the number of claims settled by the insurer.
It is important to have a handy information on claims procedure to have a smooth and hassle free treatment in the times of hospitalization.
5. Compare & Buy Online
It is important to take a right buying decision which can be done by comparing the available health insurance plans online. You can compare the price, key features, policy benefits, value added benefits, eligibility, exclusions,etc. of multiple health insurance plans to make a right informed choice of your own without any interference of the agents. Buying online health insurance plan is a hassle free process which required least documentation and quick policy processing. There are certain online portals which will enable you to make an easy comparison and will assist you in choosing the right Health insurance plan.
Online buying of the health plan is economical as companies offer discounts on premium for buying a policy online. The reason for an insurance policy to be cost effective if bought online is because the intermediary cost of the premium component is removed. When there is no intermediary in between, Co.’s save on the commission and policy issuance cost, which the Co. transfers it to the customers.