Normally, the only time that a person concerns himself with getting the details is when there is a medical catastrophe. Of course, a crisis isn't the best time to find out that you have a $2,500 deductible or that a wheelchair isn't covered under your policy. So it's important to review what most health insurance policies cover and get the most out of them.
Types
Emergency services are covered by most health insurance policies. When you go to the emergency area of a hospital, check-in and receive treatment, the cost will be covered under your healht insurance policy, minus your deductible. And yes, there is a basic deductible for emergency room treatment normally starting at $50 or more. However, before you plan to run to the emergency room for all of your aches and pains, the majority of health insurance policies will only pay for injuries that are deemed emergency So if you have a cold, take an aspirin and sip on a bowl of soup. Don't run to the emergency room unless you have a fever that is so high that it really needs urgent care.
Features
Routine services are covered by most health insurance policies. They include annual check-ups such as pap smears and physicals. The majority of health policies will pay for a certain amount of these kinds of services every year, ranging from one every six months or two per year. If a person has an HMO, normally these services are paid for by the health policy with only a co-pay starting at $15 per visit. On non-HMO policies, a deductible may apply. This is especially true of castastrophic health polices that are designed to only cover medical emergencies. Deductibles on these kinds of polices can start at $1500 or higher. So, a person who needs to go to the doctor several times a year should opt for a more comprehensive health insurance policy with a lower deductible.
Benefits
Vision services are covered under health policies. Normally, it includes one visit a year to an eye doctor. Unfortunately, contacts and glasses are not always covered. This is especially true of basic health policies. So, it is important for anyone who wears glasses to buy a health policy that includes the coverage of hardware. These kinds of policies will offer set dollar amounts for the purchasing of glasses and contacts.
Significance
Reasonable diagnostic services are covered by most health insurance policies, minus the deductible. These services are X-rays, CT-scans and other procedures that help diagnose a disease or condition. Of course, what a patient feels is reasonable might be different from the opinion of a doctor or a health insurance company. So, before you ask for a special test, call your insurance company and find out if the symptoms you are experiencing will be deemed serious enough for you to qualify for coverage.
Considerations
Surgeries are paid by health insurance policies. Of course, because of their costs, a person normally has to get pre-authorization from his health insurance company. This pre-authorization request is normally sent by the doctor once he sees surgery is necessary and can take up to 24 hours to 30 days to get an answer. However, once the green light is given by the health insurance provider, the patient will be able to get a breakdown of the costs.
Warning
It is important to note that most health insurance companies don't pay 100 percent of medical treatment. The ones that do are usually self-insured policies managed by a company. The average person can expect to fork out a co-pay of ten to 50 percent of each bill. For this reason, one thing to consider before you buy a health policy is how much are you willing to pay out of pocket for a service. If it isn't much, then it's best to buy a standard or above health insurance policy that will give you the maximum coverage.
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