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Getting to Know Your Individual Health Insurance Policies
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An individual health insurance policy, like any other health insurance policy, is a binding contract between the insurance provider (company) and an individual or a group. It is usually in written form, formal, and it embodies the terms and stipulations of the two parties. The insurer (or the insurance company) will pay or reimburse medical expenses for specific health-related conditions, covered by the health insurance plan. The insured (be it an individual or a group) will in turn pay premiums that the insurance company charges.
Individual health insurance policies may contain blank spaces, wherein it can be filled up with words, clauses, phrases, rider or any other word that will form part of the policy. Before the policy is given to the insured, he must adhere to such stipulations set by the insurance company.
The insured should therefore make no concealments of any pertinent information which may be needed or is deemed important to the making of the health insurance policy. This information may refer to the physical health condition of the applicant, for example if the applicant has a pre-existing condition. Health insurance providers have different rules/regulations for such pre-existing condition. That is why the insured should be honest unless he wants his application to be denied. The contract will no longer be binding if after acquiring the health insurance policy, the insurer found out about what the person concealed.
Individual health insurance policies are much more expensive than the group health insurance policy. In an individual health insurance policy, the risks may not be possibly spread which makes it more costly, and so premiums being paid by the insured or the individual is much higher. So before choosing a health insurance policy, compare the benefits with the downsides of the different types of health insurance policies.
In purchasing an individual health insurance policy, you will have to choose between a managed healthcare plan and the fee-for-service health insurance policy. Most policies have customizations or choices like discount plans, co-insurance, etc. Be sure to keep in mind these four parameters while you choose your health insurance policy: 1. affordability of premiums; 2. benefits of the plan; 3. the extent of the coverage; and 4. premium competitiveness.
So now, you have your individual health insurance policy. But what does it actually mean? A lot of people purchase health insurance policies and after that, they just leave with no questions asked at all. It is very important to understand your individual health insurance policy, and what it actually covers. Don’t wait until such time that you’re to get your insurance claim only to find out that you’re not covered.
Here are some steps to follow to be able to understand your individual health insurance policy:
- Read your individual health insurance policy. Make sure that it contains all the coverage you wanted and actually paid for.
- If you can’t understand your health insurance policy, get help. Don’t just leave after getting your insurance policy. Talk your time to talk with the health insurance agent or company and ask all your questions (especially the ones you don’t understand).
- Ask for the time frame during which you should review the health insurance policy. You can still cancel that policy or get refund if your needs are not met.
- Keep all transaction receipts between you and health insurance agent.
- You can document all your vocal/written statements between you and the health insurance agent. This may be used when filing for insurance claims.
Ignorance is no excuse. Take time to know your individual health insurance policy. It pays to know more than know nothing at all.
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