what is health insurance ?

what is health insurance ?

What is Health Insurance, and Why Do You Need It?

What is Health Insurance ? Technically Speaking ,  is an Contract It is a legal Contract  Company Promise you to pay amount upto your hospitalisation cost If you keep on paying premium to the company This premium depends on your Age , Family Size and Sum Insured This Premum is fixed for a Year ( Annual premium) In lieu of that , Company given you protection against a financial loss. This financial loss is due to Hospitalization. Insurance Company is not accountable , Untill you admit in a hospital ( In Patient) IPD Charges are the expenses incurred due to admission in hospital as In Patient.. So Company will pay if and only if Admission has happened It could be Cashless or Reimbursement In case of Reimbursement , You pay on your own and then ask company for refund. You have to send all Bill and Medical documents to company office for reimbursement.

Other mode is Cashless, Which is popular these days. Insurance company does tieup with major hospitals in country. After this Tieup , Those hospital are knonn as Network Hospitals for Cashless That means , In case of eligible claim after hospitalization in Network Hospital Company will directly pay the eligible amount to the Network Hospital In cashless Claim, All communication is happening between Insurance Company and Hospital. Company has signed a MOU ( Memorandum of Understanding) with Hospital It states that If a Policyholder gets admission in a network hospital , Then Hospital will directly ask for claim amount.

If claim is permissible , then Company will directly pay the amount to hospital. In this case, Customer need not pay anything ( except non payable items) to hospital. { Please note 100% claim is never paid, Customer has to bear cost of Non Payable Items) Company will pay the Permissible amount of Bill directly to Hospital. Pl Note, Amount is not immediately transferred to Hospital. This Transfer of money is as per terms decided between Company and Hospital. It could be 3 days or weeks or months This transfer is a commercial transaction between Hospital and Company . Policy Holder has no Role in it. Again , The 100 % claimed amount is never paid. Non-payable items under the health policy has to be paid by you, so knowledge of your policy is important. IRDA Publish this list of Non payable items every year. for latest list Recently , This list is divided into Various Categories For example , Cost of Diaper is not covered. Now, Whether the cost of Diaper is included in Hospital Bill, It depends on hospital.

So, There are lots of Non Payable items in the hospital bill. This list is ever changing as per interaction of IRDA or other professional organisation on various Platforms. Who will pay for a particular item, It is decided. Do you know , Bandages , Cotton , Diaper , Mask etc..are not covered in claim ? Most People are not aware of it. So , Be realistic and expect some deductions depending on type of hospitalisation. Whether it is Cashless or Reimbursement .. Extra amount has to be paid by policyholder. If someone is guiding you that ” Simply go to hospital with a card and your claim will be 100% settled “… Pl dont believe it. 100% claim may be payable in a very rare scenario .. Mostly in real life, 100% claim is never paid. Many times, People complain that out of 200000 claim , they got only 140000.

Does it mean that Often Company doesn’t pay most of the amount ? No, First of all, Lets understand that there are two main parts of Health Insurance. 1. Basic Structure 2. Valued added features. Basic Structure remains same for all Insurance Companies. Basic System/Criteria to decide ,Whether claim will be paid or not , It remains same in all companies. Many People search out for Claim settlement Ratio for comparison. They wonder whether to take Policy of a company with highest Claim settlement Ratio This hold no truth Most data of claim settlement ratio available on Internet is outdated Dont give much importance to it A 2 year old data has no role on the Policy.

How will you verify the reason of claim rejection in that data ? Claim were rejected due to fraud, Hidden facts or due to misseling , How will you judge it ? How will you ascertain that this Old claim settlement ratio data can help you in selecting Policy ? Basic structure of claim settlement process is same in all companies. Its better to read Policy terms and conditions on your own , when you are buying a Policy. If you are unable to understand them , Hire a consultant or professional If you buying online , Ask the call centre executive to explain you them in great detail. Basic Thumb Rule :- Dont pay the premium , Untill you understand the product pro and cons. It is important for you to know, How claims are paid and not paid in certain situations…Please know them well. Other Part of Policy is ” Value Added Services ” e.g. This Policy is valid in India or Abroad as well.

Few Products give worldwide coverage AS an example, They will give claim support for an emergency hospitalisation Singapore Most of the policies dont give such claims They are applicable for claims in India Only. Other VAS are Free Health Checkups Few Companies offer Free Annual Health Check up Few Companies gives Health checkup upto 3 or 5 thousand on yearly basis for whole family. Many Companies dont offer any health checkup Many Companies offer health checkup after 2 or 4 years on a condition on Claim free years Many Companies offer upto 1 % of Sum Insured, Other offer a fix amount. These VAS vary from company to company (***** Our Consultancy fee is 499 *****) Recently , Benefits like Restoration or Recharge are in Vogue.

Basic Structure of the Policy remains same in All So Basic Structure and Framework of All Health Insurance Policies is Same. ( As Approved by IRDA) Difference in these policies is their No Claim Bonus. It could 5% , 10% , 20% , 50% , 100% , 150% or 200% SO if Value added services are different , the premium for the policies also varies. So when you do comparison of Policies on an Online portal , the premium does not present correct picture. I am not saying, Your way of thinking is wrong Basically, If two phones have different prices. It means their technical features are different. Costlier one will have Better RAM , Processor , Screen Protection Its not easy for a layman to compare 2 insurance Policies. Often People ask me ,Which is the best Policy for me ? Now, Best Policy is one ,Who suits your specific needs.It must be suitable as per your present health status , City of living , Family size Medical history of all family members , Your budget etc Many more factors like these in you NEED BASED ANALYSIS will decide which is the most suitable policy.
Untill and unless , You don’t identify your specific needs.. You cannot choose a best suitable policy It is not possible that One product of a company is suitable for all Indians. Nothing is a BEST POLICY SUITABLE Policy is the right word So first of all Understand terms and condition of this contract.Health insurance is a system that gives members access to healthcare when they really want to buy their own. You can get out of your own pocket and have a lot of money on your arm and need a setting and a cast that will cost you three thousand dollars or twelve thousand Twenty Five Thousand Dollar Tear A Ligament In Your Knee Surgery and Physical Therapy Whenever you run out of coverage, you may run out of coverage. Financially devastating effects of damage to a common fund each month ahead of a common fund, such as a health fund to work for an insurance company. There are very strict federal laws and used to pay for our network of medical providers and doctors and labs imaging centers and hospitals.You can find the discounted price at the Blue Cross member of your discounts column Many people with advanced degrees in mathematics who are very good at predicting the cost of health care directly will be able to pay for the cost of health care directly. Our members are in need of the future and they are the ones who tell us how much they are charged. We have lost more than 200 million dollars in 2019 and we’ve lost more than 200 million dollars in this group of people. The first federal law tells you exactly what needs to be covered by the Affordable Care Act that passed in March. The 2019 state law also says that what we need is a policy and then we look at the science and economics of what we can do to cover the health plan and make sense financially. Between three and four percent of your premiums have been added to the federal level since 2019, so what are you doing when you decide to take control of some of those things? Out-of-pocket  care costs are the lowest in the first half of your network. A primary care physician with a strong relationship with a PCP is critical if you want to stay healthy over your lifetime. Your pediatrician’s children are going to your doctor’s office for much less expensive than an emergency room or a hospital for teen care and finally sign up for your blue cross member account at WWDC. or via our be CVS la appliance keep on top of your claims and see if you can find out more about the benefits and the services covered by your health plan and the straight .

What is Supplemental Health Insurance?

Insurance and supplemental health  could be a more descriptive and confusing name if it dried I bet you know what it is like to be able to do what you want. There are two primary types of supplemental that are very common and almost expected in most cases. For your Medicare Parts A and B, the Medicare Supplement and Almost Everybody has a Medicare Supplement to go with their Medicare course only for people 65 and older so you are not in that group Worry about it, however, you have a supplemental policy for your regular under-65 policy that will keep you from spending so much time now. His  takes a look at those under-65s crowdfunding and how-tos and how-tos and how-tos in their supplemental cover great question is basically the goal of any supplemental policy. There are two types of policies that are out of danger and critical illness that I am gonna stop right here and put up a big note disclaimer. There are two different types of policies that you can buy under the Affordable Care Act: What is this policy that is basically a lump sum or a fixed dollar? nt that you have chosen the options that you have and they are gonna pay you for that amount of money up front for the cost of the accident.

There are two primary types of supplemental that are very common and almost expected in most cases. For your Medicare Parts A and B, the Medicare Supplement and Almost Everybody has a Medicare Supplement to go with their Medicare course only for people 65 and older so you are not in that group Worry about it, however, you have a supplemental policy for your regular under-65 policy that will keep you from spending so much time now. His  takes a look at those under-65s crowdfunding and how-tos and how-tos and how-tos in their supplemental  cover great question is basically the goal of any supplemental policy. There are two types of policies that are out of danger and critical illness that I am gonna stop right here and put up a big note disclaimer. There are two different types of policies that you can buy under the Affordable Care Act: What is this policy that is basically a lump sum or a fixed dollar? nt that you have chosen the options that you have and they are gonna pay you for that amount of money up front for the cost of the accident and in most cases the dollar can be anywhere from as low as $ 2,500 Somewhere in the neighborhood of 10,000 and sometimes up to the fixed benefit, however, that’s where the gonna be. Then the policy will pay you a set dollar amount for those particular items next The question is how much of a critical sum of money is going to cost you, unless you are diagnosed with a set dollar amount. There are some serious illnesses out there that are badly diagnosed and it’s outlined in that policy. $ 50,000 policy Here’s a quick list of examples that will help you find out if you have a critical illness policy that covers more than 90 days after a heart attack.vision of loss of speech major transplant paralysis of the quadriplegic paraplegic and hemiplegia and coma These policies are for you or for your family and some instances we’ll get to in a second but of course more people will add to the plan and the higher the dollar amount you have, the more money you will have. You have a big question that you need to answer, how much do you really need and how much do you think it is worthwhile to say that you hate it but honestly it’s going to depend on you? Many people again like the same age as me but if you just want to cover the policy and again the overall coverage amount is just gonna give you an example. A little bit weird but I doubt that you can afford it but if you want to buy a casualty policy for me and my wife and we have two young children we can go back to that level and we can go with fifty to one hundred.dollars a month so if i want to just take everybody off and just run it for a single person male thirty-one years old I forgot that I should probably say 31 to $ 30 a month what would that cost? So for now, a single person will be able to pay for the four-year-old’s money on the basis of what amount of money you have picked up.

These policies have been made to make the most sense of supplemental health insurance. It has been a long time to be around, and before long it has been hard for you to ask for a few extra dollars for a very expensive  . However si nce the Affordable Care Act has taken place or Obamacare has really kicked off in 2019.I guess there’s a change in the way that policies look, and if they do, you can get a subsidy from government. There is a good amount of money left over for a portion of your  and a lot of cases where you could have used a good amount of money left over. Fifty-twenty dollars a month extra to pay for a supplemental that is going to help cover the gap that is most likely to be deductible. The bottom line is that supplemental is not always going to make sense but there are high deductibles that you are forced into. ly is a much better chance of finding a place in your kind of portfolio if you want to change the law I just wanted to make sure you go to the math and see if there is one. These are the two types of that provide you with some type of favorable financial protection.

 Health Insurance Easy Peasy Finance for Kids and Beginners

Willie when I went to the doctors they asked me for my health insurance but what  is covered by a doctor’s visit to hospitalization medications and many more but this is a certain amount you have to pay. There are a number of factors that can be used to make sure that your company is on a regular basis. Well, what are the different types of  that can be classified into two types of deductible and the other is a copay deductible one where you need to pay a certain amount up to $ 2,000 before the example. For example, if you have $ 2,000 of hospitalization then you would have to pay for all of that 2000 But if you have anything to do then the insurance company would pay for it because you have already paid your deductible and the copay is a certain amount every time you visit a doctor or a hospital for example. doctor visit cost $ 200 you would pay $ 50 which is the sum of the copay and the $ 150 what the pays if the medical bills even if it is a lot of money. For example, apolicy might say that a hospital room If you have more than $ 200 per night, it’s more than $ 200 a night if the  will pay only $ 200 and the rest of your premium will be paid by your .

If a doctor doesn’t want you to get the insurance premium you need to get the  to go up, you may not have a fall sick oh no. Most companies offerto their employees, but most of them do not have to pay for their own health care costs. Offer  or you can be self-employed as a but we will cover that in another . This is usually the case for an open enrollment period, which is usually between October and December, when you can buy a policy. DECEMBER 2018 You will buy to cover the entire year 2019 What most  companies do not cover many policies that are not medically necessary. Excluding dental and vision insurance.How Work?When it comes to work, there are three basic principles of the first principle of deductible. Most individual major medical policies can help you reach that deductible multiple times if you have a thousand dollar deductible you can reach that deductible three times This means that your entire deductible exposure for the entire family would be about three thousand dollars for a lot of people who would have gotten a thousand dollars if you had a thousand dollar deductible but many people in the family need the deductible. or have a problem throughout the year you could meet the deductible up to three times but that’s what comes Coinsurance is the best way to go about your first deductible. Together, the most common type of coinsurance is 80/20 everybody’s heard of 80/20 80/20 what’s the mean 80/20 what it means is that the company pays 80% and you pay 20% but most companies with the level of what it’s 80 / 20 of $ 10,000 which means you are responsible for 20% of the next $ 10,000 of the well over twenty percent of the ten thousand is an out-of-pocket exposure of $ 2,000 so your out-of-pocket exposure is 80/20 of the ten thousand $ 2,000 now like that can be inductive all the coinsurance can also be found in a policy most of the time it will be two times so many times your total coinsurance exposure to the family would be $ 4,000 so your basic thousand dollar deductible 80/20 major medical plan that tells me most of the time your out-of-pocket Exposure to your deductible is three thousand and your coinsurance is the most likely four thousand. Most of the companies that we have around three million dollars and that per person are the health of your basics. Every plan you can ever see is a deductible coinsurance and lifetime maximum.Copay You Know A Doctor’s Office Co-Pays When You Go To The Doctor And It Costs Us Twenty Five Dollars To Go To The Doctor What Do You Know? ell people say you and your family let’s say you have to go through eight times a year and you have to spend $ 200 on a gonna spend $ 200 in doctor’s office co-pays Gonna cost you a hundred dollars a month and you can pay $ 25 a month if you choose not to. Doctor visits let’s say doctor visits SI’s $ 80 $ 80 out of your pocket times the same eight times Twenty Five Dollar Doctor Visits $ 200 That Is A Very Better Number To Take A More Thing To Do With This $ 80 Doctor Visit If You Pay It Yourself d here in central Indiana it’s the sagamore network but wherever you are the network is going to be $ 80 as much as forty percent let’s say the $ 80 is going to go to $ 50 after it gets repriced through the network The doctor’s office copay you can spend four hundred dollars instead of four hundred dollars and you can take your deductible.

Your deductible is $ 200 here This is a good year as you have a lot of doctor visits throughout the year. The money and you don’t mean that you have a good year down here when you have a hundred bucks a month and you still have a few hundred dollars a month.co-pays number five everybody probably co uld guess prescriptions are a very simple way to work with most prescription plans you have a ten dollar generic drug card $ 25 brand name in addition to that you may have a deductible Twenty five dollar generic drug card kicks in front of you If you have any plans to take a prescription or not, you may want to take a look at your prescriptions at Walmart at CVS Generic Prescriptions. The average generic prescription is four dollars, and in most cases, the most prestigious card on the money is that you don’t have to take this option. They are still counting on your deductible so that you can take care of the basics of individual health insurance deductible coinsurance lifetime maximum doctor’s office co-pays and prescription cards. If you are going to the doctor 20 times a year, you are probably not going to get your insurance unless you have the most money. ‘Don’t go to a doctor’s office copay it does not make sense to have a good value with the same thing as a prescription car. These are the kind of steps that you can follow and understand if you take your prescription card off them.

Health Insurance  Types of plansThere are a lot of options out there that are going through a lot of data, combining and going to a large number of people I recommend that There are several different plan structures out there that you need to focus on: HMO plans and PPO plans with two primary dividers and an HMO plan. Medical centers and hospitals are usually organized by a county or a number of counties, but they go to a geographic region. People who live in more populous areas If you have a relationship with a particular doctor I would encourage you to find out if your doctor participates in a particular HMO because you do If you are a traveler who has a lot to do with a network or a network outside of a little bit more freedom, If you want to go to a specialist right away, you may want to look for a general physician and then you may want to consider a PPO. If you live in the area or you want to go straight to a specialist let’s say you have an ear infection. Another option that people will see is an HSA or health savings account. you put money into a specified ac The money goes to your medical and prescription expenses but you can keep the money in that account any year. If you have to spend your money on the end of the year, then you should be able to afford it all the next year.Medicare at 65 That Money is Still Yours In addition to that, you need to know your family and take a real honest hard look at what I am going to be looking for in the future when I need someone to check in with. I would like to know if I can afford a well-paid doctor visit and test if I have someone to take a medication for. I would like to know if there are any questions that you need to know, but you don’t have to worry about the questions. Every option that you have is going to be covered by what you are going to do with your services. The more thought you can put into it the better off you are going to be.

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