Protecting your financial security in a period of unexpected crisis is the rational and practical basis for investing in insurance, health insurance, in this case, is the instrument by which you can protect your assets during a health crisis.
In order to compare health insurance plans you will need to grasp the commonly used industry terminology, contract utilization structure and a sense of value about the essential benefits every person needs. To begin, here are the basic terms and correlative ideas.
When it comes to purchasing health insurance you will need to be conversant in regards to policy elements that relate to benefit utilization. Here’s the language you will, sooner or latter, need to know.
Acute care – Attention and care by an expert is necessary to restore a person to good health.
Aftercare – Patient care and services that are specialized and necessary following hospitalization or rehabilitation.
Ambulatory care – Ambulatory care, in this case, does not require hospitalization.
Ancillary – This refers to supplementary services that go beyond room and board charges. Benefit package – This is a through description of the policyholder’s coverage under the terms of the health insurance contract.
Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) – This law gives employees of companies with more then 20 employees the guarantee of group medical coverage at the company’s expense for a period of time.
Continuation – Continuation allows employees who have been terminated to continue their group health insurance coverage under certain conditions.
Covered Expenses – This is the term used for medical costs incurred when the policy holder qualifies for reimbursement.
Provider – The entity that that provides health care service.
Copayment – This copayment is either dollar amount or a percent.
Deductible – total amount you will pay before your health insurance company takes over your insurance payments.
Excess major medical policy – Normally, this category of health policy has a very high limit as well as a high deductible. The upper limits of the coverage are $2 million and up.
Health maintenance organization (HMO) – In contrast and comparison to health insurance contracts HMOs attempts to stay away from deductibles or copayments. This focus and mode of operation is achieved by an HMO owning private clinics and staff. And, it follows, only visits to staff within the HMO network are covered by the policy.
Major medical / Major Medical Policy – “Major” means relating to severe, catastrophic extreme health problems.
Managed care – Cost efficiency is the focused intent of managed care and medical decisions are made by the individual insurance provider. This management, according to theory, controls and keeps premiums lower.
Out-of-pocket maximum – This is maximum amount of covered medical and surgical expenses you will be liable for each year. This provision in your policy you be protected by limiting what you will pay at the end of the year between copayments and deductibles.
Preferred provider organization (PPO) – PPO is an organization, similar to an HMO, that provide health care services at a reduced cost. Because HMOs own their own clinics they typically less flexible than PPOs in allowing policy holders to visit out-of-network professionals.
Your private health insurance is a financial issue you cannot avoid. Understanding these concepts and terms will help you to benefit even more from your family health insurance.
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Tags: Health and Fitness