Health Insurance

What is Health Insurance

Health Insurance is a type of insurance that covers the medical and surgical costs of the insured

It reimburses the full or partial amount of expenses due to illness or injury.

In this article we'll understand about Insurance plan.

Why Health Insurance is important in 2020?

Health Insurance is very important for today’s life because it can secure you & you’re Family financially. The increasing medical costs, this insurance policy and the coverage. it offers can provide several benefits to the insured and the insured’s family.

The importance of Health Insurance is a lot.It includes several aspects of medical treatment and other expenses which can reduce your savings. This insurance also provides tax benefits. If you’re wondering why this insurance is important, then you have to look these things.

1.     Provided Protection.

2.     Protects savings.

3.     Quality Treatment.

4.     Coverage your family

5.     Hospitalization Expenses

6.     Add-on Benefits.

7.     Changing Life style,

There are many Insurance companies that provide Health Insurance. The right type of health insurance plan assures you of a safer future in terms of both health and wealth.

These are Some Health Insurance Companies that give you better policies,

1.     HDFC Health Insurance

2.     Tata AigHealth Insurance

3.     Bajaj Allianz Health Insurance

4.     Religare Health Insurance

5.     Icici Health Insurance.

Health Insurances Plans.

Health insurance can be broken down into

two broad categories:

Traditional and Managed care. Within those categories, there are four basic types of plans:

1.        Traditional indemnity plans, which are now often called fee-for-service plans,

2.       Preferred Provider Organizations.

3.       Point-Of-Service plans.

4.       Health Maintenance Organizations.

What is Traditional Health Insurance

Up until about 30 years ago, most people had traditional indemnity coverage. These days, it’s often known as “fee-for-service.” Indemnity plans are a bit like auto insurance: you pay a certain amount of your medical expenses up front in the form of a deductible and afterward the insurance company pays the majority of the bill.

Advance-sin modern medicine increased the cost of providing health care and made it possible for people to live longer. Those advances caused many insurance companies to look for ways to reduce their costs of doing business, giving managed care the boost it enjoys today.

Fee-for-service

For years, indemnity or fee-for-service coverage was the norm. Under this type of health coverage, you have complete autonomy when it comes to choosing doctors,hospitals and other health care providers. You can refer yourself to any specialist without getting permission, and the insurance company doesn’t get to decide whether the visit was necessary. You don’t, however, have complete autonomy. Most fee-for-service medicine is managed to a certain extent. For instance, if you’re not already incapacitated, you may need to get clearance for a visit to the emergency room.

Ont he down side, fee-for-service plans usually involve more out-of-pocket expenses. Often there is a deductible, usually of about $200-$2,500 before the insurance company starts paying. Once you’ve paid the deductible, the insurer will kick in about 80 percent of any doctor bills. You may have to pay up front and then submit the bill for reimbursement, or your provider may bill your insurer directly.

Underfeed-for-service plans, insurers will usually only pay for reasonable and customary” medical expenses, taking into account what other practitioners in the area charge for similar services. If your doctor happens to charge more than what the insurance company considers “reasonable and customary,” you’ll probably have to make up the difference yourself. Traditionally, preventive care services like annual check-ups and pelvic exams haven’t been covered under fee-for-service plans. But as the evidence mounts that preventive care can prevent more costly illnesses down the road, some insurers are including them.

Fee-for-service plans often include a ceiling for out-of-pocket expenses, after which the insurance company will pay 100 percent of any costs. Needless to say, the ceiling is usually pretty high.

Ina nutshell, fee-for-service coverage offers flexibility in exchange for higherout-of-pocket expenses, more paperwork and higher premiums.

Managed Care

Managed care has been around in one form or another since the 1930s, but it really took off in the last 10 years. As it grew, it evolved, leaving us with three basic types of managed care plans. Today, the majority of people with private health insurance have some type of managed care.

Although there are important differences among the different types of managed care plans, there are some similarities. All managed care plans involve an arrangement between the insurer and a selected network of health care providers, and they offer policyholders significant financial incentives to use the providers in that network. There are usually explicit standards for selecting providers and a formal procedure to assure quality care.

Preferred Provider Organizations

One step over the managed care border is the Preferred Provider Organization. PPO shave made arrangements for lower fees with a network of health care providers. PPOs give their policyholders a financial incentive to stay within that network.

Exclusive Provider Organizations are PPOs that look like HMOs. EPOs raise the financial stakes for staying in the network. If you choose a provider outside the network, you’re responsible for the entire cost of the visit.

Point-of-Service

Point-of-service plans are similar to PPOs, but they introduce the gatekeeper, or Primary Care Physician. You’ll need to choose your PCP from among the plan’s network of doctors.

As with the PPO, you can choose to go out of network and still get some kind ofcoverage. In order to get a referral to a specialist, though, you usually must go through your PCP. You can still choose to refer yourself, but it’ll mean more hassles and more money coming out of your pocket. If your PCP refers you to a doctor who is out of the network, the plan should pick up most of the cost. But if you refer yourself out, then you’ll probably have to deal with more paperwork and a smaller reimbursement. You may also have to pay adeductible if you go outside the network.

POS plans may also cover more preventive care services, and may even offer health improvement programs like workshops on nutrition and smoking cessation, and discounts at health clubs.

Health Maintenance Organizations

Most of the time, when you talk about HMOs, you’re really talking about closed-panel HMOs — the least expensive, but least flexible type of health plan. They also tend to be geared more toward members of group plans than individuals.

Inexchange for a low co-payment (or sometimes no co-pay at all), low premiums and minimal paperwork, an HMO requires that you only see its doctors and that you get a referral from your primary care physician before you see aspecialist. If you can still pick up the phone, you’ll probably need to get clearance before you can visit the emergency room.

Now Most Important Question Is Health Insurance Cover Corona Virus?

Yes, As per the guidelines of IRDAI, those health insurance policies which offer 

hospitalization cover will also offer cover for medical expenses related to 

corona virus. The expenses will be settled on the basis of the terms and conditions of the policy.