Hassle-Free Health Coverage: How to Buy the Right Medical by Silver Lake Editors

By Silver Lake Editors

Either a primer and a dealers consultant, it bargains updated details and useful recommendation.

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This care would include administering prescription drugs, medical diagnosis, minor surgery, etc. A Skilled Nursing Facility is a facility, licensed by the state, which provides 24-hour-a-day nursing services under the supervision of a physician or registered nurse. 32 CHAPTER 2: KEY HEALTH INSURANCE TERMS AND DEFINITIONS U T I L I Z AT I O N REVIEW This includes the various methods used by health plans to measure the amount and appropriateness of health services used by its members. These checks can occur before, during and after services have been sought or received from health professionals.

Under this type of plan, your insurance company pays all or part of the bill for any doctor, hospital or other health care provider that you may choose. With traditional insurance, also called indemnity insurance, you are free to visit the doctor of your choice. You can change to another doctor at any time for any reason. And you can use any hospital or licensed medical facility you choose. Indemnity plans existed before the rise of HMOs, PPOs and other types of managed care plans. How- 35 HASSLE-FREE HEALTH COVERAGE ever, indemnity plans—with their focus on flexibility—aren’t very effective at controlling costs.

And it uses deductibles and absolute dollar limits differently than traditional indemnity insurance. Major medical can be sold on an individual and group basis—and is sold aggressively to both. It provides benefits up to a high limit for most types of medical expenses incurred, subject to a large deductible. The contract may contain limits on specific types of charges, like room and board, and a co-insurance clause. 51 HASSLE-FREE HEALTH COVERAGE These policies usually pay covered expenses whether an individual is in or out of the hospital.

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