Health insurance is insurance that covers the insured for his medical
expenses only; it will not provide death benefit caused by whatever
situation. If the insured suffers an accident or illness, the medical
expenses incurred will be paid by the insurance company, thus health
insurance is also called medical insurance.
Some basic health insurance policies do not cover major
illnesses and critical medical conditions. The insurance company will
normally issue a medical card to the policyholder, with this card the
hospital admission and medical bills will be taken care of upon the
discharge at the appointed panel hospital.
The benefits of a medical insurance provided by the insurance
companies vary, but basically the features are quite same, that include:
·Room and
board expenses, daily and maximum up to 120 or 365 days, including
nursing care and dietary requirements. Once the length of stay has been
exhausted, there will be no more benefit provided.
·Intensive
care, daily and maximum up to 120 days
·Operation
fees
·
Anaesthetic fees
·
Diagnostic expenses
·Medical
specialist consultation fees
·
Hospitalization
·Ambulance
services
·
Outpatient payment
·
Miscellaneous services including X-rays and medications.
The benefits are specified in the policy, different policies
provide different benefits and services.
Different Types Of
Health Insurance Policies
Health insurance is
also referred to as medical insurance; its coverage is medical expenses.
An accident is an injury that resulted from accident; a sickness is an
illness or disease that is not caused by accident. There are some
policies provide just one or combination of benefits. Knowing the
difference is important because like health insurance only covers
medical and surgical expenses resulting from sickness and accident, also
an accident insurance does not include sickness, like wise a life
insurance does not cover accident and sickness, to have all these
coverage one needs to purchase a few separate policies.
Health insurance is
designed to cover two types of losses; the policy is categorized into
Disability Income Policy and Medical Expense Policy
Disability Income
Policy
Disability Income
Policy can also be referred to as loss of income. This type of policy
will compensate the insured if he is disabled and can no longer work to
earn a regular income. The payment can be weekly or monthly depending on
the policy.
Most people give
more attention to life insurance than other kinds of supplemental
insurance. When a person becomes crippled or disabled and unable to
work, his livelihood will change drastically. As living standard is
getting higher each day, a disabled person suffers mentally and
physically, no income and yet he has to struggle for a living and
medical treatment.
Disability income
insurance can help to generate at least a portion of the disabler’s lost
income; this replacement of income can help to alleviate his infliction.
Disability income
insurance is available individually and as a portion of a group benefit
provided by an employer in their group package. Individual policies are
often sold to self-employed and professional people. The amount of
benefit is generally up to 60% of monthly net income.
However, disability
income insurance is essential for a bread-winner, it relates to the
overall family finances, this provides income replacement if the insured
becomes disabled and produces no income.
When buying for a
health or accident insurance care must be taken when talking about
“total disability”, because different companies may have different
definition on total disability.
Total disability can
be defined as the insured’s inability to perform any or all the duties
of his occupation. But if the insured may no longer be able to conduct
the duties of his current occupation but may be able to perform duties
in a relevant field should this classify as total disability or not,
some companies may have their own definition, therefore read the fine
print carefully.
Some criterions to
classified total disability in many of the disability income policies
called presumptive disability are adopted; these may automatically
qualify the insured for total disability classification.
These conditions are
·Total
and permanently loss of sight
·Loss
of two limbs
·Loss
of hearing
·Loss
of speech
If the earnings
after disability significantly drop to a given percentage, the insured
may be considered as totally disabled, or the compensation may be made
by percentage on the sum insured.
Other disability
categories are confining, non-confining, residual, partial, recurrent,
delayed, combined accident and sickness and non-disabling, be aware of
their existence and check them out from the policy for these types of
disability.
Most companies offer
optional short term benefits for an additional cost, a typical
disability income policy may include all or part or none of these
features, these are
Supplemental income
– this provides additional income during the first several months of a
long-term disability.
Hospital income –
this pays a stipulated amount per day when hospitalization has extended
for a certain period.
Indemnities – this
provides lump-sum payments for certain injuries like fractures,
dislocation of bones, sprains or amputations of fingers or toes.
Medical Expense
Policy
Medical expense
policy has a wide range of coverage from minimal to comprehensive
packages. Some provide coverage include both accidents and illnesses,
various hospital expenses and other costs pertaining to medical care.
Things to be
considered when buying medical expense policy
·Does
the policy feature only specific benefits or is the coverage
comprehensive?
·Do you
need to choose the specific providers or hospitals?
·Is the
plan limited to a specific region or is it worldwide.
Common exclusions
and limitations
Both disability and
medical expense policies have limitations and exclusions on certain
types of injury and illness. It is important for a buyer to know those
items that fall into the common exclusions and limitations.
·
Existing diseases before purchasing the policy
·
Suicide
·
Self-inflicted injuries
·
Injuries or death resulted from commotion and war
·
Military duty injuries
·
Injuries while committing a crime
·
Non-commercial air travel
·Injury
or death due to the influence of alcohol or narcotics.
·Vision
treatment such as eye exam, eyeglasses and contact lenses.
·
Cosmetic surgery other than accident injury.
·
Sexually transmitted diseases.
·Organ
transplant
·
Alcohol and drug abuse treatment
·Any
condition that specified in the policy
Group Health Insurance
Many employers provide group health coverage as a benefit to
their employees, either by paying the entire premium or share part of
it.
As opposed to a single person covers by an individual policy
a specific group of people is covered by a single policy. Because of
this circumstance the insurance companies have to take measure to make
certain that the number of people covered by a group stays at a certain
level. In normal practice in a group situation is to include all
eligible employees regardless of physical condition or age.
A single master policy is issued to an individual or entity
representing a group of people and is called the employer. The employer
bears the responsibility to apply the coverage for the group, holds the
policy and make premium payments to the insurance company when due.
All people regardless of their physical condition before they
may be included in a group policy one condition must be met, that is
they must apply for coverage during a specified eligibility period. An
initial 90 days employment period is typical for group coverage, after
which the employee has a 31 day eligibility period. If the employee
fails to apply that eligibility period, then the employee will be
required to take a physical examination.
This is how an insurer can afford to cover a group of people
without individual selection. Otherwise some people might choose not to
enroll until they discover they have an illness or they become disabled,
therefore requiring a physical exam after the eligibility period helps
to preclude this event.
Considerations needed when choosing a health insurance
·Make sure
the product is adequate for your needs.
·Read the
fine print and understand what is included and what is excluded
·When does
coverage begin?
·Does the
coverage include major medical expenses?
·Does the
coverage include prescriptions?
·Does the
coverage include X-rays and lab fees?
·Do you
have your own choice of physician and providers?
Individual Health
Insurance
Individual or family health insurance is also commonly known
as personal health insurance. Family health insurance is where you, your
spouse and your children are all included in the same plan. If you work
in a big organization your choice of group health insurance can be taken
care of. But anyone who is self-employed or his/her employer does not
provide insurance benefits to the employees; individual health insurance
can be purchased for oneself and the family.
The qualifications and regulations of this policy vary from
one insurance company to another, the difference is that the health
plans available to individuals and families are not guaranteed issued.
This means that if you have pre-existing medical condition the private
health insurance company may turn you down for coverage, or they may
approve you for medical insurance coverage but exclude benefits for
treatments of your pre-existing condition.
Group health insurance may provide better benefits but some
people can’t get this because they are self-employed or work in a small
company, or they can’t enjoy COBRA benefits or for some other reasons.
So people under these categories have to resort to individual health
insurance; that is they buy their own insurance.
There are different types of private health insurance plans,
such as indemnity health insurance, health maintenance organization
plans, preferred provider organization plans and health savings account
plans. Buyers should compare health insurance quotes and choose
carefully, make sure the type of policy is suitable for you, because
each plan has different cost and choice.
Many insurance companies offer this product to individuals
but if a person is over 50 years old, he might face some problems, the
reasons are
·If his
health is not in good condition, the insurance companies will not take
the risk to insure him. But the thing is, how many people can maintain a
good health up to this age
·The
applicant might have to undergo a medical exam to prove that he is
insurable
·The
applicant might get fewer benefits
It is not an easy thing to raise a family, you have to give
your children good education so that they know what is good and what is
bad, and at the meantime you must support them financially, but if you
die prematurely, your asset may not be sufficient to raise them until
they are self-support. Perhaps insurance is the most ideal scheme to
solve this problem, but with a single plan the coverage might not be
enough.
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life insurance quote, shop carefully and make your money worth paying.