Today, health insurance is a basic need. Few families can afford the cost of even one single hospital stay. So, medical insurance represents good, logical planning for most of us. It also makes good health care possible for families that otherwise couldn’t afford it.
Health insurance is too complex to be discussed thoroughly in this pamphlet. But we can provide brief and general information to help you determine what type of coverage fits your needs.
There are two basic types of health insurance:
1. Basic coverage
2. Major medical.
Basic coverage includes hospital, surgical, and general medical expenses. Each type of basic insurance covers different health care expenses. The benefits paid are limited to a certain amount.
Major medical and comprehensive insurance offer broad coverage and high maximum benefits. There is usually a deductible paid by the insured.
Following is a more detailed look at the types of health insurance. Hospitalization—Covers daily and miscellaneous expenses when a person is in the hospital. Daily expenses include room and board and nursing charges. Miscellaneous expenses cover services such as X rays, drugs, lab examinations, dressings, and physical therapy.
Surgical expense—Covers fees for operations performed in or out of the hospital. Some policies pay only a maximum amount, which is based on a “relative value table.” However, if you have a preferred policy, it will pay according to the usual, customary, and reasonable expense. Surgeons charge different rates. Your policy should pay the rates charged in your community.
General medical—Covers any doctor’s visits in or out of the hospital that do not involve surgery. Diagnostic and laboratory tests also may be included. A general medical policy is limited. Find out how much it pays per visit, how many visits it covers, and whether the policy covers house calls and office visits.
Major medical—Pays a major share of treatment costs. Basically, it is designed to cover the huge expense of a catastrophic illness. It includes hospital, surgical, and other medical treatment not covered by basic policies. A major medical policy normally covers a percentage (70 to 90) of all expenses after you pay a deductible. The deductible is the amount of medical expenses you must pay before your insurance company starts paying. The remaining 10 to 30 percent of the expenses are paid by you. This is commonly called coinsurance, because you help pay the bill. This should encourage you to keep costs at a minimum.
Health insurance is too complex to be discussed thoroughly in this pamphlet. But we can provide brief and general information to help you determine what type of coverage fits your needs.
There are two basic types of health insurance:
1. Basic coverage
2. Major medical.
Basic coverage includes hospital, surgical, and general medical expenses. Each type of basic insurance covers different health care expenses. The benefits paid are limited to a certain amount.
Major medical and comprehensive insurance offer broad coverage and high maximum benefits. There is usually a deductible paid by the insured.
Following is a more detailed look at the types of health insurance. Hospitalization—Covers daily and miscellaneous expenses when a person is in the hospital. Daily expenses include room and board and nursing charges. Miscellaneous expenses cover services such as X rays, drugs, lab examinations, dressings, and physical therapy.
Surgical expense—Covers fees for operations performed in or out of the hospital. Some policies pay only a maximum amount, which is based on a “relative value table.” However, if you have a preferred policy, it will pay according to the usual, customary, and reasonable expense. Surgeons charge different rates. Your policy should pay the rates charged in your community.
General medical—Covers any doctor’s visits in or out of the hospital that do not involve surgery. Diagnostic and laboratory tests also may be included. A general medical policy is limited. Find out how much it pays per visit, how many visits it covers, and whether the policy covers house calls and office visits.
Major medical—Pays a major share of treatment costs. Basically, it is designed to cover the huge expense of a catastrophic illness. It includes hospital, surgical, and other medical treatment not covered by basic policies. A major medical policy normally covers a percentage (70 to 90) of all expenses after you pay a deductible. The deductible is the amount of medical expenses you must pay before your insurance company starts paying. The remaining 10 to 30 percent of the expenses are paid by you. This is commonly called coinsurance, because you help pay the bill. This should encourage you to keep costs at a minimum.