Mental Health Alliance

Archive for the ‘Medical Insurance’ Category

Purchasing medical insurance fills you with a sense of security and confidence that you and your family are well covered. But your responsibility does not end with purchasing a medical insurance policy. Any financial product comes with a number of features and benefits, and you should take the time to understand what benefits and facilities you are entitled to receive from your medical plan. If you are fully informed about your medical plan you will be able to use it to your full advantage. Here are some tips to help you accomplish that goal:

Go Through Medical Insurance Policy In Detail

Carefully go through the policy and member handbook to learn about the benefits, coverage, and limits. It is a good idea to subscribe to a magazine or newsletter published by your insurer. These resources are particularly helpful in familiarizing yourself with the plan and company policies. Also, make sure that you are notified every time there is a change in the network of providers or covered services. You can also consult the Summary Plan Description (SPD) of the policy for additional information.

Always Maintain Records

Maintain a separate file to keep all the medical insurance related documents. Don’t throw away the plan brochures and other documents. Keep all the memos along with correspondence from your employer relating to health benefits. Also save the SPD.

Medical Insurance And Hospitalization

Even though you are in perfect health right now does not mean that you will never need hospitalization in the future. So go through the policy to find out what hospitals fall under the network of your medical insurance plan. It is also important to learn beforehand as to what sort of medical conditions are defined as a health emergency, and whether these health emergencies are covered by the medical insurance policy. If your primary care doctor does not provide you with a certificate for emergency medical care, your hospital expenses will not be covered by the policy.

What To Do If Dissatisfied With Medical Plan?

In addition to being fully aware of your benefits and rights as member of a medical insurance network, you should also learn what your options are in case of any dissatisfaction or grievance with the service or care provided. As a policy holder you are entitled to get copies of your medical test results and other information. You can also request to change your primary care doctor if you do not like the treatments or care received. All policies come with an appeals process, which can be used to appeal the insurer’s decision in case you or your doctors do not like it.

Lastly, do not shy away from contacting EBSA for customer service assistance if you do not receive satisfactory response to your grievances.

International Medical Insurance

Travel can be a wonderful experience, provided you aren’t unfortunate enough to become ill or suffer an accident that is. If you travel outside your own country, and do not have adequate visitor’s medical insurance, it could turn out to be one of the biggest mistakes in your life. Not only could it end up costing as much as a condo, it may even put your health and wellbeing into serious jeopardy. Today, visitors insurance has never been so easy to find, or affordable. So why take the risk?

What‘s covered?

Policies can cover a range of types of treatment. Primarily, your concern should be whether consultations, urgent care or emergency treatment is included. Consultations refer to visiting a medical practitioner, usually, at a medical centre. Urgent care involves more serious conditions, like a fever, a bad cut or even a fracture.

Anything which needs medical attention quickly.  Emergency treatment means any medical condition considered life threatening or any illness which could cause permanent physical damage, if treatment was delayed. As would be the case with a heart attack, stroke or any serious accident.

Pre-Existing Conditions

Most insurance companies will not cover any medical expenses incurred, for any pre-existing medical conditions. This means, any illness or condition you are currently receiving medical treatment at home for. This would include pregnancy, angina, high blood pressure, even AIDS. It is important to be honest with the insurance company before taking out any policy.

If you don’t tell them about a condition, they will find out, in the event of any claim being made. You will only be getting yourself into hot water, and, you never know, your particular type of illness may not be excluded. Every insurance company will have different exclusions in place.  When it comes to providing them with the necessary information, honesty is definitely the best policy. Often, it’s simply a matter of shopping around.

Who’s Covered?

A medical examination is not normally required by most insurance companies. Just about anyone can get some kind of personal visitor’s medical insurance. It is also possible to take out a policy for more than one person and some companies do offer ‘family policies’. A perfect solution for couples with young children.

Usually only one passport number will be required. Don’t worry that other members might not be covered, simply because the company only has one passport number. This is normal procedure for many companies. Usually, the only form of identification needed is a passport, although companies can vary.

Checking Your Policy

If you have made a mistake, the company does not have the correct details stated within the policy or you do not have the correct cover, you must contact them immediately. They can arrange for the necessary changes to be made.  If you choose to buy insurance online, a confirmation email is usually sent straight away. This will include all the important details.

Check it carefully, if there are any mistakes, now’s the time to let the company know. If everything is in order, keep a copy safe, and a hardcopy is always a good backup to have. Your visitor’s medical insurance card should be in the mail soon afterwards.  This will also have important details on it and should be kept in a safe place on your travels. It could turn out to be as essential as your passport.

There are many options for you in medical insurance and you’ll find that there is no one plan that offers everything you will need. All plans differ in what is offered, what you have to pay, and how easy the services are to access. However, the following information will help you to determine what is the best medical insurance coverage for you and your family.

First of all, you will find that medical insurance plans are either that of indemnity, which are basically fee-for-service plans or managed care, which is basically an agreement to have a certain doctor look after your needs. Both of these plans have a different approach to your medical insurance.

With medical insurance under an indemnity plan, you’ll find that you will have much higher costs out of your pocket and how you pay the bill. Many of these types of medical insurance plans will not pay their share until they actually receive the bill from you. The best thing about this type of service is that you will have more options in your choice of doctors, including any specialists you may need during the course of any medical treatments you may need.

On the other hand, with managed care, you will have to pay less out of your pocket, but you are very limited in your choice of doctors. This type of medical insurance will have agreements with many different health care providers to give you service at a reduced cost. This, however, is one of the main reasons why many do not like the managed care plan of medical insurance. It does not necessarily allow one to have the doctor of their choice treating them.

As the medical insurance plans change, however, many of them become very similar. There are some types of medical insurance plans that are indemnity plans but offer managed care options, as well. Under managed care, you’ll find there are generally three different types:

The Preferred Provider Organization or PPO makes an agreement with health care providers to get lower fees for providing you with their service. You will have lower costs and you and your health care providers can refer yourself to another doctor should it be necessary. However, if you go outside for a referral, you will have to meet a deductible, instead of just paying for normal co-payment and you may pay a difference between the cost and what the provider will pay.

The Health Maintenance Organization or HMO is the oldest type of the medical insurance falling into the managed care plan. They offer many benefits, including preventive care, for one monthly fee. With this medical insurance, you will have to choose a primary care physician and you can only be referred to a specialist should your primary care physician deem it necessary. Some HMOs require a co-payment, while others do not. The downside to the HMO is that you can only receive coverage for services rendered by your primary care physician or a referral by them.

POS- The Point-of-Service plan is also under the HMO and allows the individual the ability to see a specialist, as long as they are an approved provider of the coverage. Your primary care physician can make a referral outside the approved provider list and you will be covered, but if you do this yourself, you will have to pay for the services provided by paying coinsurance.

The most important thing you can do when researching medical insurance options for you and your family is to ask questions and make certain you understand the coverage before you commit yourself to such an important part of your health care.