Health insurance provides compensation when they face health issues and desperately require financial assistance. Health insurance covers most of the medical expenses which are needed in the time of hospitalization, follow-up, diagnosis, consultation and different examinations. Health insurance agencies might be publicly owned privately owned or might be possessed by associations but all these organizations provide insurance policies for individuals or groups. Health insurance may be a program sponsored by a company to the workers or even an individual may make an medical insurance plan for his or her dependents and him. Many developed countries provide health insurance assistance to the public through their programs sponsored by the authorities for example United States Mediaid program. The insured must pay some expenses to acquire benefits and the coverage such as some expenses, deductibles, premium and fee.
The concept of health insurance was founded by Hugh the Elder Chamberlin in 1694 due to the frequency. He observed that people turned disabled on account of the injuries they came across. Health insurance has been the claim when the injuries occurred and policy for medical therapy was required paid. Health insurance was called accident insurance. Some companies such as Franklin Health Assurance Company worked to supply the insured against steamboat accidents or the road or railroad mishaps with claims. Gradually health insurance companies introduced policies which covered the costs for other examination, followup, diagnosis, along with patients. During the 1920’2 such insurance companies started to operate.
There are many theories of health insurance before establishing an insurance plan, that a individual should know. Everybody knows that health insurance is a contract between an insurer and an insured. May be for short-term or long-term.
An insured must cover a particular amount of fee to claim in the future which may be monthly, quarterly or annual to receive the benefits in the future known as ‘premium’. The insured must also pay his pocket is formed by sum that is particular up to a certain limitation when he attends the clinic, undergoes therapy, evaluation or identification before receiving his policy’s benefits which is called ‘deductible’. The company decides the amount which needs to be paid deductible at the time of signing the contract. The insured should pay a certain sum every time that he follows to clinic that’s known as ‘co payment’ before receiving the insurance benefits. In order to treat the dependents of the insured the insured pays to the insurance company a fee called ‘capitation’. Some companies provide the hospitals with a document that they will pay a particular amount as reimbursement to the insured and the hospitals ought to treat the individual taking into consideration the payment made from the insurer which is known as ‘consent ‘.
Insurance plans may be comprehensive or scheduled. Comprehensive programs are percentage of fees that are paid into the hospitals following the deductibles are paid by the patient. The comprehensive programs are paid in lump sum amount. The scheduled plans are the programs that are covered by the insurance companies to the insured to meeting the routine expenses related to hospital care such as money for prescription etc..
Mainly there are two forms of medical insurance. One of them is Fee for support and another one is Managed care. Both policies are different from one another and also comparable from each other. Under ‘Service for Fee’ program, the patient visits the doctor for other follow-up that is routine or check-up and files the fees to be paid to the clinic. The charges that should be compensated for providing the patient with service may be also filed by the service organization. Under Managed Health care there are three kinds of plans HMO, PPO, POS. Schemes are offered for the three type of plans. These programs could be scheduled or comprehensive.
Under HMO plan the insured has a wide choice to select his own doctor or a medical organization. In the majority of the HMO programs the insured should pay a particular amount of fee before hiring service by the medical practitioner per trip known as ‘co payment’. Before receiving the coverage the majority of the expenses are incurred from the patient and laboratory tests should be paid for by the patient . Under the PPO plan the physician is not preplanned, the patient signs a contract with the hospitals and less commission charges from the insurance providers. Certain points should be considered before choosing for PPO network like the doctors who are insured under PPO, hospitals that have introduced PPO program, etc.. Under the POS program the doctor is chosen from a community of service providers that are covered under POS plan. Your doctor is referred by the insurance company and you should avail services out of their company.