Health Insurance – Understanding The Language

Because of the cost of medical care, it is only wise that you have a health insurance plan in place. Much as it is important though, you need to understand the language of health insurance. What is covered and what is excluded and how much coverage do you need?

When shopping for health insurance, please bear the following in mind:-

1. There are two types of health insurance policies.

a. Managed care plans. This includes plans like the Health Maintenance organizations (HMO’s), Point of Service Plans (POS’s) and Preferred Provider Organization’s (PPO’s). They provide a broad range of coverage but they all involve the insurer and a network of health care providers. In this plan, it would be expected that a primary health care provider in the network would take care of your general health needs but would refer you to a specialist in the network if the need arises.

b. Indemnity plan also known as reimbursement plan. This is the plan where you get to choose your doctors, hospitals and payment plan. You can either pay your bills in part, or fully or for a stipulated number of days in the month.

2. A good health insurance policy would have different coverages:-

a. Physician’s expense insurance. This covers the doctor’s hospital visit or your visit to the doctor

b. Surgical expense insurance, covers the surgeon’s fees and other bills related to surgery

c. Hospital expense insurance would cover all your hospital expenses if you are hospitalized.

d. Major medical insurance covers a broad range of medical needs. It has high benefits; it is designed to give you coverage for losses arising from debilitating illnesses and injury.

3. You should check for the following additional benefits when you are shopping for health insurance:

a. Preventive care

b. Ante-natal and post-natal care

c. Optical care

d. Prescription drugs

e. Mental health care

f. Dental care

4. You need to shop extensively so that you can get the best deal for your health insurance. There is no such thing as a perfect health insurance plan. But with diligent shopping, you will get a good blend of quality service and affordable prices.