Educating yourself on the ins and outs of health insurance is essential to understanding it. Many people find the details to be confusing to say the least. If you stick to these 7 basics you will succeed in understanding health insurance. This will allow you to make wise decisions and educated choices while finding individual health insurance.
When going down the list of basics naturally the total amount the insurance carrier will pay is a huge factor. This is what they call the Lifetime Maximum. It simply means that they will never exceed that amount if you should reach it. On average they are $3-$5million. When thinking in terms of a major critical illness that can easily cost millions, this amount could be your deciding factor.
Deductibles also make a significant difference. The deductible is the amount you must pay out of pocket before the insurer will share any cost. A general rule is the higher the deductible the lower the premium will be. When you hear the term "Total out Of Pocket' it is referring to your deductible plus your co insurance.
After meeting your set deductible you may the start paying a percentage of your occurred medical expenses. This is what insurance companies refer to as co insurance. You may have a 70/30 plan with a maximum of $2000. So the insurer would cover 70% while you cover 30% until the maximum was met, at which time the insurer would pay 100% for the remainder of the year.
Another often misunderstood part of insurance is Co Pays. If your plan has built in Co pays for Office Visits you pay only the co pay amount even if you have not met your deductible or co insurance. There are some exceptions, if not noted in the plan as included in office visit you would still have to pay lab and x-rays.
Many insurance plans include what is called a Preventative exam. As a general rule the benefit allows one preventative exam a year. One thing that baffles consumers when they get an unexpected bill is the limits. Many have a maximum pay out. So if you went for an exam and the expense was $500 and the insurer pays a maximum of $300 you should expect a bill for the remaining balance.
One basic that is detailed in clear is the limitations. These are sometimes overwhelming to consumers and overlooked. But you need to take the time to know the limitations. They may restrict how much the pay for certain illnesses or treatments. They may only pay for 2 office visits a year.
Some catastrophic plans do not cover prescriptions. It is crucial that you understand this. On the more benefit rich plans you can expect to pay a co pay for you prescription. But take notice if you have a maximum the carrier will pay, some prescriptions can be very costly.
When going down the list of basics naturally the total amount the insurance carrier will pay is a huge factor. This is what they call the Lifetime Maximum. It simply means that they will never exceed that amount if you should reach it. On average they are $3-$5million. When thinking in terms of a major critical illness that can easily cost millions, this amount could be your deciding factor.
Deductibles also make a significant difference. The deductible is the amount you must pay out of pocket before the insurer will share any cost. A general rule is the higher the deductible the lower the premium will be. When you hear the term "Total out Of Pocket' it is referring to your deductible plus your co insurance.
After meeting your set deductible you may the start paying a percentage of your occurred medical expenses. This is what insurance companies refer to as co insurance. You may have a 70/30 plan with a maximum of $2000. So the insurer would cover 70% while you cover 30% until the maximum was met, at which time the insurer would pay 100% for the remainder of the year.
Another often misunderstood part of insurance is Co Pays. If your plan has built in Co pays for Office Visits you pay only the co pay amount even if you have not met your deductible or co insurance. There are some exceptions, if not noted in the plan as included in office visit you would still have to pay lab and x-rays.
Many insurance plans include what is called a Preventative exam. As a general rule the benefit allows one preventative exam a year. One thing that baffles consumers when they get an unexpected bill is the limits. Many have a maximum pay out. So if you went for an exam and the expense was $500 and the insurer pays a maximum of $300 you should expect a bill for the remaining balance.
One basic that is detailed in clear is the limitations. These are sometimes overwhelming to consumers and overlooked. But you need to take the time to know the limitations. They may restrict how much the pay for certain illnesses or treatments. They may only pay for 2 office visits a year.
Some catastrophic plans do not cover prescriptions. It is crucial that you understand this. On the more benefit rich plans you can expect to pay a co pay for you prescription. But take notice if you have a maximum the carrier will pay, some prescriptions can be very costly.
About the Author:
For fantastic service Agent Jeff Cline is ready to assist you with your individual health insurance needs. Agent Jeff Cline can assist you with all health insurance needs, even travel medical insurance for your wonderful trips you have planned. Contact us 365 days a year. Our toll free number is 866-526-9669
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