Health Insurance

Health policies can be divided into individual as well as group health coverage.

While an individual policy is purchased by the insured directly with the insurance company, in a group health insurance policy, the group is the master insured and the insurance company contracts with the group. Each member gets an insurance certificate which acts as the policy. Often group health insurance is less expensive than individual policies. Additionally it may also contain certain special coverage which may have been too costly for individuals.

Employer’s Insurance – Million of people obtain their insurance through employment. After meeting certain criteria, the employee is eligible to be covered under the employer’s group insurance policy. Medical insurance is also a common benefit of such a policy. The employer’s insurance policy and coverage may vary with different organizations.

Individual Insurance – Some major health insurance companies offer a broad range of coverage and options to individuals, who pay directly for the cost of the insurance. Many insurance companies require a medical examination and comprehensive details before offering coverage to the individual.

Government Sponsored Insurance – Some state governments offer affordable health insurance benefits to their residents based on their income. These plans are designed for the poorer individuals who are employed but no health care coverage is available where they work. It allows the state to protect its residents from calamitous loss due to illness, disease or accident without placing an additional burden upon its program for the extremely poor and underprivileged.

Association Sponsored Insurance – There are some health insurance benefits available to people belonging to a group or organization by virtue of membership.

Primary and Secondary Coverage

Many people have medical insurance from more than one insurance plan. To prevent double recovery or the insured making profit out of the insurance plan, the insurance company make provisions to determine how primary versus secondary coverage will be determined. Primary coverage is provided through an insurance plan of which the insured is a member or the plan under which the member has been a participant for a long duration. Secondary coverage, usually as a result of being covered as a dependent under someone else’s health insurance plan, provides reimbursement for medical expenses after exhaustion of coverage available through the primary plan.

There are several types of policies sold by insurance companies to individuals. Some of the common insurance plans include:

Major Medical Expenses

Hospital and Surgery

Hospital Confinement Indemnity

Health Maintenance Organizations (HMO) Specified Diseases

Short Term and Long Term Care

Accident Only Policy

Dental

Vision

Home-Health Care

Limited Benefit

The different types of group health coverage include:

Fully Insured Employer Group

Small Employer Group

Large Employer Group

Health Maintenance Organization (HMO)

Self-Funded ERISA

Association Group

Group Managed Care

Preferred Provider Organization

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