Back to Main

Affordable Health Plans - FREE Instant Quote!

The Types of Insurance Benefits
Most plans provide basic medical coverage, but the details are what counts. The best plan for someone else may not be the best plan for you. For each plan you are considering, find out how it handles

In general, seven different types of health insurance benefits may be offered on separate contracts or in different combinations on a single contract.

Hospitalization provides for daily room and board charges; routine nursing care; hospital expenses, such as x-rays, anesthesia, medicine, and operating room; and other services relating to medical care and treatment of patient while in the hospital. The agreement may set dollar allowances for the different items or provide full service. Hospital expense insurance is the most widely used type of health insurance.

Surgical provides payment in accordance with a schedule of fees, fixing maximum reimbursement for each type of operation. Fees for office calls made before and after the operation may be included. The cost of the policy bears a direct relationship to the maximum the company contracts to pay.

General medical covers medical expenses other than surgery. It pays for doctor visits at the hospital, office, or home with certain limitations on the number of calls and the fee per call. The benefits and coverage vary with the policy. This is normally written with other types of health insurance, not as a separate contract.

Major medical helps meet the large costs of serious (catastrophic) accidents or prolonged illness. It is a form of protection against large medical bills not covered by hospital- surgical plans. It does not specify the exact amount for various services, but shares with you the expense of major medical insurance. There are 1) high maximum limits; 2) a deductible provision, similar to that found in most automobile collision insurance; and 3) a co-insurance clause. This requires the insured person to pay part of the total bill, over and above the deductible.

Comprehensive expense insurance is a health plan that combines features of the four insurances listed above (hospitalization, surgical, general medical, and major medical). It generally has a co-insurance provision and a deductible clause. Maximum benefits on these plans are generally high.

Dental expense insurance is coverage that helps pay for normal dental care as well as damage caused by accidents. This type of insurance is generally available through group insurance plans and sometimes offered by employers as a fringe benefit. Almost all policies cover oral exams, x-rays, fillings, cleaning, extraction, bridge work, dentures, oral surgery, root canal, etc. There is usually a deductible, and usually a co-insurance feature requiring the insured to pay from 20 to 50 percent of the cost above the deductible.

Loss of income or disability provides benefits when you cannot work because of sickness or accident. The terms of the policy determine: 1) the length of the waiting period before payment is made, 2) the amount of regular cash benefits, and 3) the number of payments to be made. An individual policy insures up to a certain percentage of a person's gross earnings and provides benefits, often for a lifetime. Loss of income is the oldest kind of health insurance.
Also ask about:

Care and counseling for mental health.
Services for drug and alcohol abuse.
Obstetrical-gynecological care and family planning services.
Ongoing care for chronic (long-term) diseases, conditions, or disabilities.
Physical therapy and other rehabilitative care.
Home health, nursing home, and hospice care.
Chiropractic or alternative health care, such as acupuncture.
Experimental treatments.

==

Back to Main

Affordable Health Plans - FREE Instant Quote!