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All About Health Insurance

All About Health Insurance

Understanding Health Insurance is challenging due to its complex terminologies and often changing system. There are numerous factors that have a direct or indirect influence on health insurance. To get a clear understanding, one must know what is medical insurance, who is the provider of medical insurance, how do health insurance operate and many other questions.

What is Medical Insurance?

Medical insurance is a safeguard for individuals and their families against unanticipated expenses that results from injury, accidents or illness. The medical insurance cost is exorbitantly high and is rising every year. Simple medical procedures can cost thousands of dollars. The different polices available are getting more complex along with the availability of health care.

To lessen the risk of unpredicted medical costs, a wide range of medical insurance plans are presented by private insurance companies. The plans come with different coverage, benefits and costs. These make it necessary to know the differences in the plans. In spite of similarities between different plans, there are quite big differences when the plans are reviewed. Medical insurance is a confusing thing with its difficult terminologies, limitations and exclusions that are included in the policies.

Who Is The Provider Of Medical Insurance?

One can purchase medical insurance from commercial insurance companies, hospitals as well as plan providers in medical service such as Blue Cross and Blue Shield. One can also buy medical insurance from health Maintenance Organizations (HMOs) like PacifiCare and Care and HealthNet.

There are other types of medical insurances that are meant for military members, federal civilian employees, elderly (Medicare), military service veterans and special interest groups like Alaskan natives and American Indians.

Medical Insurance is available for individuals or groups. Group health insurance are mostly offered by employer, though it may also be provide by other organizations like federal societies, college health departments, consumer and rural health cooperatives and labor unions. The cost of group health insurance for employees is borne by employer either partly or fully. However, there is difference in protection provided in the different group health insurance plans.

If the group health insurance plan does not completely provide coverage to an individual, or the individual is self-employed, then one needs to supplement their coverage by purchasing an individual health insurance plan. One can customize their individual health insurance plan to their specific needs and also make a choice of the insurance company as well as agent.

How Do Health Insurance Operate?

Payments are made either to the policy holder or directly to the medical provider. The policy booklet or employer benefit booklet provides the details regarding the terms and conditions that are available in the coverage under the insurance plan. One must read thoroughly the contract of the policy before using the health insurance plan. One can ask the agent or employer to explain any confusing thing found in the contract.

Deductible is also available with these policies. This means, one has to pay a certain amount first and after such payment, the medical insurance company starts paying back the benefits in the contract. Deductible is generally from $100 to few thousand dollars. The higher the deductible, the lower is the overall medical insurance premium.

Preferred Provider Organizations (PPO) Plans provide one the freedom to select a physician or hospital from a “preferred providers” list to get maximum benefits.

Health Maintenance Organizations (HMOs) provide preventive health care before any member become ill. HMOs consist of hospitals and doctors as well as allied medical personnel.


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