Today the cost of health care is increased dramatically, lots of people can't afford it when something happen to them like falling into accident or have a major
illness.
Health Insurance is type of insurance that cover the health care cost when you need and protect your family and financial asset.
By estimating the overall risk of health care expenses , the insurance company can develop a routine finance structure, such as a monthly premium or payroll tax, to
ensure that money is available to pay for the health care benefits specified in the insurance agreement.
The Insurance Language:
Premium: The money the policy-holder or his sponsor (e.g. an employer) pays to the health plan to purchase health coverage.
Deductible: The money that the insured must pay out-of-pocket before the health insurer pays its share.
Co-payment: The money that the insured person must pay out of his /her pocket before the health insurer pays for a particular visit or service.
Coinsurance: A fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay
Exclusions: What services are not covered by the policy.
Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount.
Out-of-pocket maximums: The insured total payment for the calendar year , and health
insurance pays all further covered costs
In-Network Provider: A health care provider on a list of providers preselected by the insurer.
The insurer will offer discounted coinsurance or co-payments, or additional
benefits, to a plan member to see an in-network provider.
Out of network Provider: The policy doesn't cover the service or very less discount.
Prior Authorization: the insured has to get authorization that an insurer provides prior to medical service occurring.
Explanation of Benefits: A document that may be sent by an insurer to a patient explaining what was covered for a medical service, and how payment amount
and patient responsibility amount were determined.
The private health program:
The private program normal by buying health insurance coverage through insurance company as is Fee-for-Service or Indemnity Plan.
Insurance companies pay fees for the services provided to the insured people covered under the policy. This type of health insurance offers the most choices of doctors
and hospitals. You can choose any doctor you wish and change doctors at any time. You can go to any hospital in any states.
The plan you can buy through insurance company:
PPO(preferred provider organization)
HMO(health maintenance organization)
Health Saving Account
Dental Insurance
Vision Insurance
Travel Insurance
Medicare, a federal social insurance program for seniors( over age 65) and certain disabled individuals.
Medicaid, funded jointly by the federal government and states but administered at the state level, which covers certain very low income children and their
families.
SCHIP, also a federal-state partnership that serves certain children and families who do not qualify for Medicaid but who cannot afford private
coverage.
Military health benefits provided through TRICARE and the Veterans Health Administration and benefits provided through the Indian Health Service.
Some states have additional programs for low-income individuals and different from state to state.
