Health Insurance

   

 

 

 

Health insurance is a type of insurance whereby the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. The insurer may be a private organization or non-for-profit organization (Blue Cross, et. al.). Governmental agencies may offer health plans, but generally are not insuring anything and are self/publicly funded. Market-based health care systems such as that in the United States rely heavily on private and not for profit health insurance.
A Health insurance policy is an annually or monthly renewable contract between an insurance company and an individual. With health insurance claims, the individual policy-holder pays a deductible plus copayment (for instance, a hospital stay might require the first $1000 of fees to be paid by the policy-holder plus $100 per night stayed in hospital). Usually there is a maximum out-of-pocket payment for any single year, and there can be a lifetime maximum, or the upper limit of what the insurance company will pay over the covered individual's lifetime.

Prescription drug plans are a form of insurance offered through many employer benefit plans in the U.S., where the patient pays a copayment and the prescription drug insurance pays the rest.

Some health care providers will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay, as the insurance company pays according to "reasonable" or "customary" charges, which may be less than the provider's usual fee. The "reasonable" and "customary" charges can.

Health insurance companies also often have a network of providers who agree to accept the reasonable and customary fee and waive the remainder. It will generally cost the patient less to use an in-network provider.

Health Insurance companies are now offering Health Incentive accounts (HIA), to reward users for living healthy and making healthy

 

 

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