A health insurance policy is often described through a ream of paper and the kind of language it uses (with all that technical jargon) it may become very difficult for you to review it without the help of your insurance agent. However, if you keep in mind the following things, you can definitely review it yourself. You may not necessarily find all the facts in your policy (especially if it is provided by your employer), but you must know how to work with the facts that are available to you.
What And Where?
When it comes to reviewing a health insurance policy, the first thing that you have to do is to examine the types of services that you can use and where you can use the same. The basic idea is to get a feel for the key points that are covered. Will you be able to use your policy if you are out of station? Which places are covered and which are not? Where are the hospitals located? Is there a specific network of doctors you need to visit or can you use the services of your preferred doctors? Is your physician listed in the network of doctors that the policy covers?
Summary Of Benefits
Instead of reading the entire pile of papers that a health insurance policy contains, you can effectively review the facts just by examining the summary of benefits. For example, you should check how much the annual out-of-pocket maximum is for families and individuals. Likewise, the amount of annual deductible is also important. In most policies, these amounts are shown as percentage of the total value of the policy. Calculate the actual amount and see if you can afford to pay the same. For example, is 20% deductible on a policy of $100,000 feasible for you? Besides that, you will also have to make sure that you are not obligated beyond the maximum annual-out-of-pocket expenses.
Outpatient And Inpatient Services
While examining the outpatient and inpatient services in a health insurance policy, you should check the fees for day surgery and the office visitation fee. The fee can be mentioned either in a dollar amount, such as $50 or as percentage, such as 20%. Now, calculate the fee after taking into consideration the amount of deductible. In any case, make sure the final amount is limited by the annual total of out-of-pocket expenses. When the amount crosses that annual maximum, the expenses will be covered under the Major medical coverage.
Exclusions also make a key element in a health insurance policy. Exclusions may include various services, such as cosmetic procedures, genetic testing, elective treatment or surgery, weight reduction surgery, or others. Before you read the exclusions, you should examine the health condition of your family including you. Make sure that the exclusions do not include a service you definitely need.
What And Where?
When it comes to reviewing a health insurance policy, the first thing that you have to do is to examine the types of services that you can use and where you can use the same. The basic idea is to get a feel for the key points that are covered. Will you be able to use your policy if you are out of station? Which places are covered and which are not? Where are the hospitals located? Is there a specific network of doctors you need to visit or can you use the services of your preferred doctors? Is your physician listed in the network of doctors that the policy covers?
Summary Of Benefits
Instead of reading the entire pile of papers that a health insurance policy contains, you can effectively review the facts just by examining the summary of benefits. For example, you should check how much the annual out-of-pocket maximum is for families and individuals. Likewise, the amount of annual deductible is also important. In most policies, these amounts are shown as percentage of the total value of the policy. Calculate the actual amount and see if you can afford to pay the same. For example, is 20% deductible on a policy of $100,000 feasible for you? Besides that, you will also have to make sure that you are not obligated beyond the maximum annual-out-of-pocket expenses.
Outpatient And Inpatient Services
While examining the outpatient and inpatient services in a health insurance policy, you should check the fees for day surgery and the office visitation fee. The fee can be mentioned either in a dollar amount, such as $50 or as percentage, such as 20%. Now, calculate the fee after taking into consideration the amount of deductible. In any case, make sure the final amount is limited by the annual total of out-of-pocket expenses. When the amount crosses that annual maximum, the expenses will be covered under the Major medical coverage.
Exclusions also make a key element in a health insurance policy. Exclusions may include various services, such as cosmetic procedures, genetic testing, elective treatment or surgery, weight reduction surgery, or others. Before you read the exclusions, you should examine the health condition of your family including you. Make sure that the exclusions do not include a service you definitely need.