Advice On Policies From Health Insurance Companies

Know your health insurance policy and don't forget to read the fine print.

Health insurance is purchased for security and when the insurance is most needed (as in a serious illness), the contract is all you have. It is best to know what is in the contract before a serious illness occurs; after a serious illness occurs, you are most likely stuck with the insurance you have at the time. Ask the health insurance companies you are considering to walk you through the policy.

Know Your Lifetime Limit
Most policies have a one or two million dollar lifetime limit. While this may seem like a lot of money (and it is!), it is quite possible to run out of one to two million dollars when fighting a serious illness. At that point, it is unlikely that you can obtain other insurance and you can count on the fact that health insurance companies are never going to pay more than its stated limit. You need a policy with at least a five million dollar lifetime limit.

Most policies pay what is "reasonable" and/or "necessary", which often leaves the policyholder responsible for a good percentage of the bill - much more than the 20% (for example). For example, if you have a $5000.00 outpatient surgeon's bill and the insurance company decides the reasonable rate is $4000, they will pay their 80% based on their "reasonable" assessment, or $3200.00. There is an $1800.00 balance due from the $5000.00 charge. Guess who ends up with the bill?

Read that Policy
Have you looked at your policy? Most people would honestly say it has never been read, but they know it is "filed somewhere". Dig it out and look at the areas mentioned. Then, when you need the coverage you have paid dearly for, you will know what to expect. Or, if you are appalled at what you find, you can switch to a company that gives you the security you really need now, before it is too late.

There are several questions which you must answer when checking your health insurance coverage:

Does your insurance provide coverage for only a specified amount per day, or does it cover usual customary costs?

Does the plan cover pregnancy?

For the unmarried, or only insured and/or spouse?

Does it cover newborns from birth?

Does it cover hospital costs for as long as the injured needs treatment?

Does it exclude coverage for specified illness or accidents?

How long does it cover the insured's children?

Does it pay for outpatient treatment and/or emergency treatment?

Is there a time limit on submitting claims?