| If you
recall, we explained that there are two broad categories of health
insurance policies: disability and medical expense. Thus
far we have covered disability. Now
we’ll take a look at basic medical expense insurance.
Basic medical
expense policies provide for medical expenses that result from
accidents and sickness. This
is a loose term that refers to various medical, hospital and surgical
benefits.
The broad
category of medical expense coverage provides a wide range of benefits
for hospital, surgical and medical care. Other benefits may
apply as well, such as private nurses, convalescent care, and more.
Policies may
be written as such that they may be limited to only one or two types of
coverage like hospital or miscellaneous medical costs or surgical
expenses. These are known as basic plans.
Other, more
broadly written, policies may cover all expenses resulting from
accident or illness using some specific exceptions.
Medical plans
include fee-for-service wherein doctors and other providers receive a
payment that does not exceed their billed charge for service provided.
Prepaid plans
provide medical or hospital benefits in the form of service rather than
dollars. Many things need to be considered when selecting a
medical expense plan such as:
Specified
coverage versus comprehensive care. In other words does the
plan feature only specific benefits or is the coverage comprehensive?
Any provider
versus a limited number of providers. Are you required to
choose from a specific list of providers?
National
versus regional operation. Is the plan limited to a specific
geographical region or operate nationwide?
Insured
versus subscribers. Are participants considered insureds (the
person who receives the benefit) or subscribers
(the person who is paying the premium)?
Health Insurance Quotes
Get Quotes for a variety of different health plans, including
individual and family, small group, short-term, student, Medicare
supplemental and dental plans.
We are going
to take a look at the limited coverage for hospital, medical and
surgical expenses. Discussing this separately first, will
help you to understand how the components are combined in major medical
and comprehensive policies.
The broad
definition of basic medical expense insurance in most states includes
hospital, medical and surgical expenses. The purpose of this
type of insurance is to cover a broad range of medical, hospital and
surgical expenses as well as separate categories of medical expenses.
Let’s
explore individual versus group coverage.
No matter how
a policy is written, narrowly or broadly, medical expense insurance is
designed to reimburse for the cost of care whether it results from
injury or illness.
Both
individual and group policies are available to consumers. Normally
individual policies are more costly along with having limited benefits
but generally speaking, both types cover the same medical services.
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