No one plans to fall sick or hurt, but individual needs medical care at some point in time.It has become the need of the hour and buying insurance policies is an effective step that can be taken to protect you and your loved ones.The cost of health insurance depends on several factors such as sum insured the medical profile of insured, age, current health condition etc.In fact, there is no thumb rule to decide the ideal coverage of health insurance.One may plan it according to his/her lifestyle, age, medical condition, ability to afford the expenses of insurance and much more.Also, you should not forget to compare prices and benefits of different insurance plans before selecting, after all your health are your real wealth, it can't be put into risk.
Let us take an example to clearly understand the concept of health insurance: Mr Billy, age 46 was admitted to a hospital when he faced severe chest pain and the symptoms indicated the possibility of artery blockage.After proper tests and examination, it was found that arteries were completely blocked and the doctor suggested for artery by-pass surgery as it was the only solution.Luckily, Mr Batra had an insurance policy of $50,000 and all the bills of the hospitals of worth $20,000 were paid by the insurer.Thus, we can see that how insurance policy played an imperative in the tough situation by paying his all medical bills.
* Broadly health insurance covers following two types of policies:
1. Personal Health insurance: Under personal health insurance policy, plans/policies are brought by an individual for himself and his family.
2. Group Health Insurance: In group insurance policies, the plans are offered by an organisation to its employees/workers and are termed under employees benefits.
HOW IS HEALTH INSURANCE BENEFICIAL?
Due to skyrocketing inflation and limited income, hospitalisation and medical costs are rising day by day.It is not easy to bear these quality health care costs and in that case insurance companies provides aid to the insured as risk gets spread into a large number of people.Having health coverage is important for various reasons:
1.Insurance plan provides a feeling of safety and security in stressful situations(injury/sickness/accidents).
2.The loss/risk gets distributed among large of people that are exposed to similar risk and compensation is made to the needy person out of those funds generated by various insured.
3. It protects the insured from unexpected high medical costs and covers essential health benefits, related to maintaining their health and treating ailments.
4. If you are covered under marketplace plan and another qualifying health plan, you need not have to pay the penalty that people without coverage pay.Most Americans who don't bring any plan have to pay a tax of $695 per adult or 2.5%of annual income (whichever is higher).
5. Health insurance mainly helps to cover expenses related to -
i) Medical tests, doctor fees
ii)Ambulance expense
iii) Hospitalisation cost
iv)Post hospitalisation cost that includes doctor visits, tests and medicine
* How insured can file a claim with the Health Insurance company:-
It is the liability of insurance company to compensate the insured in case of any injury /sickness.An insured can claim losses and expenses from the insurance company in the following ways:
1.Cashless: Every insurance company has its chain of hospitals where cashless treatment is offered to the insured/policyholders.The companies have a direct billing arrangement with these hospitals and pay the amount directly to the hospital.It means if you go to any of these hospitals, you only have to submit your insurance card there and cashless treatment will be provided to the patient as it subjects to insurance company's approval.In this case, insured person will have to pay only those expenses that are not covered under the policy.
2. Reimbursement: If you visit a hospital that is not included in the list of network hospitals of insurance companies, first you will have to make payment on your own and after that approach to the insurance company for the reimbursement of bills/expenses.You have to submit to the insurance company, original papers along with claim form for reimbursement.
Some of the top rated insurance companies in the USA as per market share are:
- Cigna Health Group
- HCSC Group
- Kaiser Foundation Group
- Humana Group
- Carefirst Inc. Group
- HIP Insurance Group
- Wellpoint Inc. Group
- Aetna Group
In brief, it can be concluded that health insurance has become necessary as it protects you and your family from the financial crunch during adverse conditions. It provides a sense of relief to the insured by paying for unforeseen medical emergencies.
SOURCE :http://www.policymantraa.com
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