Why Health Insurance is importance

Why Health Insurance is importance

Though you are very caring towards your family as well as yourself, you never know when a problem such as illness or accident comes to you. These two things come unexpectedly and could be very expensive. Health Insurance is there to protect from this unpredictable expense due to sudden serious illness or injury you and your family financially.

Health Insurance is nowadays considered necessitous in developed countries. It has made the modern treatment facilities affordable to all socio-economic classes of people. Health Insurance is perfect for the fixed income group.

Definition of Health Insurance

Health Insurance is basically a type of insurance coverage or the amount of risk or liability that is packaged for an individual or entity by way of insurance services. It pays for medical and surgical expenses that are incurred by the insured. Insured can reimburse health insurance for incurred illness or injury or would be paid to the care provider directly. Let me clear, here “provider” means clinic, hospital, doctor, laboratory, health care practitioner or pharmacy and “insured” means the owner of the health insurance policy or the person with the health insurance coverage.

Health insurance is provided by the state and seen as every citizen’s right in most countries including the United Kingdom or Canada. With modern civilization most countries including the USA, health insurance is provided with the exception of some groups, such as elderly or disabled people, veterans, and some others. In modern job system, health insurance is often included in employer benefit packages and seen as an employment perk.

So, basic health insurance is an agreement between you and your insurance company. It consists of a package of medical benefits like tests, drugs and treatment services. You would be paid off the cost of certain benefits listed in your health insurance policy by your insurance company. And if you want to be covered by the unlisted services by your insurance company, you have to pay for that uncovered medical care.

Types of Health Insurance

Types of health insurance may vary from brand to brand as they may offer one or more of health insurance plan. Including-

  • Health Maintenance Organizations (HMOs)

  • Preferred Provider Organizations (PPOs)

  • Exclusive Provider Organizations (EPOs)

  • Point-of-service (POS) plans

  • High-deductible health plans (HDHPs)


Health Maintenance Organizations (HMOs)

An HMO covers usually limit member to care provided by contractual doctors of the HMO. If you are out-of-network care, won’t be covered unless it’s an emergency. That means you have to be eligible for coverage with an HMO by living or work within its local service area. You will be provided integrated care and create awareness on prevention and wellness.

Preferred Provider Organization (PPO)

PPO consists of a group of participating medical providers such as hospitals and doctor. Here, care is covered even out-of-network. But if you use providers which belong to the plan’s network, you pay less. You don’t need a referral to see specialists and out-of-network providers.

Point of Service (POS) Plans

Though it encourages you to use doctors, hospitals and other healthcare providers in plan’s network you are required to get a referral in order to see a specialist from your primary care doctor. Moreover, you can make choice as to whether access health care services within or outside of providers’ network.

Exclusive Provider Organization (EPO)

Basically, EPOs is similar to HMOs but providers’ network is very small. Yet it can be premium cost savings.  You may not need any referral to see a specialist and EPOs may not require a Primary Care Physician for you. You should know what providers are in your network as mostly EPOs has no out-of-network benefits.

High-deductible health plans (HDHPs)

With a high deductible health plan, you may be able to pay less for your insurance. You will be provided higher out-of-pocket costs than other health insurance plans as the plan pays 100% of your care once you reach the maximum out-of-pocket amount.

The Way to Buy a Health Insurance

You can buy a health insurance from an insurance company. Make a contact with any health insurance company and find out the health insurance plans in your area. You can also buy insurance through an insurance agent or broker. With online health insurance seller, you can select the ideal plan for you comparing with the other options.

While buying a health insurance plan, you have to consider these points-

  • You have to decide wisely on the coverage amount with a long-term view of your health costs. Rethink on both your medical and financial requirements. From coverage amount to monthly premiums, co-payments, and deductibles. When you know your needs and priorities, associates you to look for a good plan.
  • Now make a choice between an individual cover and a family floater policy. Though the premium for family floater plan may be higher than the individual policy, a family floater policy will cover the entire family whereas an individual policy will only focus on you.
  • Let’s compare the hospital room rent capping clause before choosing a health insurance policy as you are eligible to claim expenses only up to a room costing below the threshold.
  • You should weigh the amount that most of the health insurance policies offer you to claim for specific treatments such as cataract or cardiac treatments.
  • You must check before buying a health insurance policy whether it provides the cashless mediclaim facility or not. With this service, you will be provided medical treatment at your insurer’s network hospitals without paying from your own pocket.
  • An allowable limit of room rent or other related expenses, it is wise to go with the plan which offers no sub-limits with higher allowable limits.
  • Also, checkouts your health insurance plan’s bonus and discounts as if you raise no claim in a year, the insurer is supposed to provide a No Claim Bonus which either include a reduction in the subsequent year’s premium or an increment in the subsequent year’s converge.

When it is about spending your hard-earned money, you should be careful about the making choice of products you buy. No rocket science, now with these pointers choosing the ideal health insurance policy for you and your family is so simple.






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