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Health Insurance Logically Explained

By: Chris Channing

Health insurance is the type of insurance that pays for a person's medical expenses. It is paid for individually as premiums in order to defend the holder from large medical expenses due to injury or illness. A person can purchase social insurance which is sponsored by the government can be employed, or a customer can employ a private insurance company. These plans can be bought on a single plan basis, or in group plans, such as a benefit company purchase for their employees.

Health insurance was founded by a man named Hugh Chamberlen in 1694. Health insurance was originally called accident insurance. It was run similarly to today's disability insurance.

Health insurance works by a person buying a policy from the insurance company. A policy is the contract agreed upon by the insurance company and the policy holder. The contract can be paid for monthly or annually. The amount paid by the insurance holder to the company is called the premium.

The amount the insurance holder is forced to pay before the insurance company will pay their share is called the deductible. In some cases a co-payment must be paid by the holder out of their own pocket. This can be done each time the policy holder goes to the doctor for a visit. This can all be avoided by the policy holder purchasing coinsurance. This plan allows the holder to pay only a certain percentage of the total cost of their medical expenses.

The amount the holder of the insurance must pay in order for the company to pay its share is called a deductible. In some cases a co-payment must be paid by the holder with their own money. This could be done each time the insurance holder has to go to a doctor for a checkup. This can all be avoided by the insurance holder by purchasing coinsurance. With this plan the holder pays only a certain percentage of the total cost of their medical expenses.

All policies have limits and exclusions. Not all services are covered by the insurance company. If a situation in which a medical expense is not covered the policy holder will be forced to pay the bill with their own money. When the medical expenses of the policy holder surpass the amount agreed upon in the policy the holder will be forced to pay the remainder of the bill.

Out-of-pocket maximums are almost he opposite of coverage limits. This maximum is the amount that a policy holder is allowed to pay out of pocket, after this amount is exceeded the holders obligation stops. Capitation is the amount of money paid by the insurance company to the health care provider. A provider on a list of healthcare providers that are selected previously by the insurance company is called an in-network provider. When a healthcare provider is used that is on the list the policy holder can receive discounts or additional benefits to their policy.

One problem that the insurance company and the insurance holder must be wary of is moral hazards. Moral hazards occur when the health care provider and insurance holder agree to tests on the patient deemed unnecessary by the insurance company. In most cases the insurance company will be forced to pay for the expenses as long as they are covered by the insurance holder's policy. There is a growing demand for insurance companies to fight moral hazard and will probably become a greater issue in the future.

Article Source: http://www.articleselections.com

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