MEDICAL INSURANCE

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Medical Insurance is a kind of insurance which needs to be selected keeping in mind a number of factors. Therefore it can be both a difficult as well as tedious task, choosing a coverage package which is beneficial to us in the true sense.

There are different ways and course of action that might lead us to enjoy the medical insurance facilities. Following are some of them:

  • Employee Insurance Coverage: This is one of the most convenient ways of enjoying the benefits of a medical insurance without much headache. Through this your employer deducts the premium from your pay check. Other companies provide certain basic medical amenities like, doctor’s visits, prescriptions, emergency room expenses, etc. free of cost.
  • Insurance Brokers or Agents: The advantage of selecting an insurance broker is that since he is connected to a number companies providing coverage, he will be able to provide a wide range of opportunities at various rates. The other advantage for such an option is that an insurance broker might also provide you an unbiased approach to what insurance to be chosen.

Whatever the option me it is very important to know the rating of the company from which we purchase coverage. This can be done through A.M Best, an agency which tracks the fiscal status of each and every insurance company and agency. Other options should be sought if the rating of the agency is less than A.

Health Insurances and types:

Medical or Health Insurance can be broadly classified into two types; Service Plans and Managed Health Care.

  • Serviced Fee Plan: This is a conventional insurance plan wherein a claim has to be prepared with requisite documents for each and every medical cost and post due evaluation and scrutiny the same would be reimbursed.
  • Managed Health Care: Companies/Organizations like the PPO or HMO get into active management of different health care needs of clients. The companies provide various tailored health care services through authorized or recognized physicians, labs, chemists, hospitals etc. at predetermined costs which are much lower than general rates. However the only disadvantage in such a set up is that the choice of the health care provider has to be within the specified list of the company. The prime advantage of such an option is that it covers even minor costs as immunizations or routine examinations and checkups.

Checks before selecting a Policy:

A brief comparison between different insurance coverage programs on certain vital points is imperative before picking up a medical plan. However before we do that we should consider the following basic parameters:

  • Overall health of family and self.
  • Smoking history in the family.
  • Approach of the Insurance Company in addressing to fundamental care needs.
  • Post premium payment, the actual expenses which are still to be paid out-of-pocket.

When one goes through the basic details and enquires with his/her insurance coverage provider, one needs to ask the following questions to him/her self.

  • How frequently does one need to go to a doctor?
  • If specialized care is required for anybody in the family?
  • Is the plan covering the basic requirements beyond the yearly office visits?
  • Coverage extent towards maternity care, surgery, prescriptions, lab expenses, hospitalizations etc?
  • Is there any cover charge or extra amount that is deducted before the plan starts working?
  • Is there any co-payment?
  • What would be the fees for a doctor visit outside the plan?

After considering all the above factors, we can have a clear picture, which will help us to select the particular insurance plan providing a comprehensive and total cover.

Supplementary Coverage Health Insurance:

There are a number of Insurance Companies that also provide supplementary medical coverage such as Dental Care, Eye Care, Disability Coverage and Long Term Care Insurance.

There are certain providers which only provide partial coverage e.g. dental cleanings in case of Dental Care and Eye examinations in case of Vision Care. But they do not cover extensive procedures.

Disability Insurance cover is provided by a pay-out income that the insurance company pays to the individual on termination of services due to physical impairment or permanent disability.

Long Term Care Insurance is the coverage that is provided on expenses related to prolonged illness like homecare and physical therapy. A detailed study into the offers of different companies on supplementary insurance is required before selecting the right one.


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