Medical insurance pays for the expenses incurred when the insured got sick. A person can avail of an insurance benefits if he opts to be a member of a particular insurance company. If he is self employed, his membership could be voluntary, but if he is employed, he can be a member of the group medical insurance, which his office or the company where he is connected pays for the insurance of their members. Making yourself a member of a reliable and trustworthy insurance is a wise move not only to yourself, but to all the members of your family. After enrolling in an insurance company you automatically become a member of the insurance company and your family becomes your beneficiaries. The group medical insurance is provided by the employer and will cover all the members enrolled in the group in a single policy. A group insurance plan has lower premiums for participants compared to individual plans, yet it has the same benefits to its members.
If you’re working in the United States of America, your employer will pay for your medical/health insurance. In most cases, the employer will get a group medical insurance since the premiums that should be paid for the group insurance is lower compared to the individual plan.
After complying with the requirements needed to apply for a group insurance, the insurance company will give you a health insurance policy which is a contract between the company and the person insured. Before coming up with the health insurance policy, it is important to know the different terms of the health insurance plans like:
- Premium- amount which the policy holder should pay for the health insurance every month. In most cases the employer’s share is 80% and the employee’s share is only 20%. The amount of the premium will depend on the plan which can either be an individual plan or a family plan.
- Deductible- is the out of the pocket payment that the policy holder must pay before the health plan pays.
- Co-payment- is also the out of the pocket payment that the policy holder must pay for the doctor’s services.
- Co-insurance- the amount that the policy holder should pay over the total amount due. The amount that should be considered represents a certain percentage of the total amount incurred for services received. For example: the policy holder should pay 20% of the amount due after surgery has been performed. The remaining 80% will then be charged to the health plan.
- Exclusions- The health plan does not cover all services. In the event that the policy holder has received some services which are not covered by the plan, he will have to pay personally for the services he has received.
- Coverage limits- The health plan coverage has limits, hence, the policy holder is expected to pay any excess charges.
- Out-of –pocket maximums- after the policy holder have exhausted his personal limit the health plan then pay the other costs.