It is very difficult to assess which health insurance plan is best for you if you do not have a basic knowledge of the language and terminology of the insurance industry. An insurance provider may describe several insurance plans for nausea, but if he does not understand the technical conditions, he is unlikely to be wiser towards the end.
The following are some of the most used and important medical insurance terms:
Exceptions:
Services that will not be covered by health insurance. Exceptions vary by provider, but examples of common exceptions are cosmetic surgery, experimental treatment or home care.
Surcharge:
A fixed amount of cash you will pay for each medical service or prescription before your provider pays for the service or prescription. This amount also depends on the policy, but generally ranges from $ 10 to $ 50.
Coinsurance:
A percentage of the total cost you pay for medical expenses. Co-insurance can be carried out instead of a surcharge or in addition to this. It also varies according to the policy, but the general agreement is 20% of the patient’s payment and 80% of the insurance company’s payment.
Deductible:
The amount of cash you will pay before your health insurance provider pays for health care costs. The annual deductible can vary from 500 to one thousand dollars, depending on the type of insurance plan you choose.
Coverage limits:
The default amount of money covered by the health insurance plan. After incurring medical expenses that exceed the limit, you must pay the full amount of your pocket. (Note: Obama’s health reform includes the gradual elimination of annual coverage limits by setting annual limits of at least $ 750,000 this year, $ 2 million in 2012 and banning them completely in 2014).
Premium:
The amount of the monthly payment you pay to your health insurance provider to continue coverage.
Maximum out-of-pocket expenses: The time when your payment obligation ends and your healthinsurance company pays all future covered medical expenses. These maximum cash costs can be applied to a specific benefits section or to all the benefits of the policy.
How to determine which health insurance plan is correct
Health insurance should be based on individual needs and financial resources.
Cost is obviously a huge factor, but fortunately consumers have many options for a health plan. The cost of a health plan will vary depending on the benefits it provides and the insurance company that provides it. Exceptions, coverage limits, deductibles, etc. They will affect the size of the monthly premium.
Finally, you must ensure that the plan is offered by an accredited health insurance company. It is also useful if you have a professional insurance agent with whom you can meet. An insurance agent can better inform you about all your medical insurance options, help you determine which plan best suits your financial and medical needs, and answer any questions you may have.