YOUR SOURCE FOR HEALTH INSURANCE AND WELLNESS INFORMATION |
Standard Health Insurance
As a general rule, if you have advance knowledge of the need for a medical procedure, you should contact your insurance company to get a firm commitment regarding what they will cover. Policies will often pay only a portion of your physician’s billings if they deem them to be in excess of what they consider the usual and customary fees in your area for that particular procedure. For the same reason it is wise to get a cost estimate for any procedures or surgical costs from your doctor and hospital. Medical
expense coverage provides a wide
range of benefits for hospital, surgical and medical care. Additional benefits are
also available,
private nursing, convalescent care and more
Medical policies written to cover only one or two types of expense, such as hospital, miscellaneous medical or surgical expenses are known as basic plans. Comprehensive policies may cover all expenses resulting from accident or illness using some specific exceptions. Medical plans include fee-for-service wherein doctors and other providers receive a payment that does not exceed their billed charge for service provided. Prepaid plans provide medical or hospital benefits in the form of service rather than dollars. The following areas need to be considered when selecting a medical expense plan: Specified coverage
versus comprehensive care -
In plain language, does the plan feature only specific benefits or
is the coverage comprehensive? Are you
required to choose from a specific list
of providers? Is the plan limited
to a specific geographical region
or are benefits payable nationwide? Insured versus subscribers
- are participants considered insured (the person who receives the
benefit) or
subscribers (the person who is paying the premium)?
Major
Components of Medical Insurance Policies: The broad definition of basic medical expense insurance in most states includes hospital, medical and surgical expenses. The purpose of this type of insurance is to cover a wide range of medical, hospital and surgical expenses as well as separate categories of medical expenses. Individual
Coverage and Group Coverage: It can be specific or comprehensive, but the basic purpose of a medical expense insurance policy is to reimburse for the cost of care whether it results from injury or illness. Both individual and group policies are available to consumers. Usually individual policies are more costly and have more limited benefits but generally speaking, both types cover the same medical services.
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