Health Insurance Logically Explained
May 13th, 2008Health insurance is an insurance that can be used to pay for a person’s medical expenses in the case of an accident or illness. Health insurance is purchased as premiums. A person can purchase insurance sponsored by the government as social insurance, or receive insurance from a private company. Plans can be purchased by individuals or in groups, such as when company’s use insurance as benefits for the employees. Health insurance prices are estimated by the likely hood an insurance holder has to be in need of medical help. For example a healthy young insurance holder will probably pay less for insurance than an older or sicker insurance holder.
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 was first thought of by Hugh Chamberlen in 1694. It was first known as accident insurance. It functioned much like disability insurance does today.
The process of health insurance works by an insurance company selling a policy to the insurance holder. A policy is the contract between the insurance company and the individual purchasing the insurance. The contract can be renewed monthly or annually. The amount paid by the insurance holder to the company is called the premium.
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 exclusions and limits. Not all services are covered by the insurance company. If a situation occurs in which the medical expenses are not covered the insurance holder will be forced to pay the entirety of the bill out of pocket. When the medical expenses of the insurance holder exceed 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 of the largest problems with health insurance is the moral hazard issue. Moral hazard occurs when the healthcare provider and the insurance holder agree to tests that are deemed unnecessary by the insurance company. Most of the time the insurance company is still forced to pay for the expenses but this can cause problems between the company and the insurance holder in the future.
























