Paper Peviews

Individual health insurance offers benefits for health care. Prescription assistance programs can be included in some policies. Various policies might provide for payment of medical charges incurred on a reimbursement basis by paying benefits to the plan owner, payment on a service basis by paying those who provide the services directly, or payment of an indemnity by paying a fixed amount regardless of the amount charged for medical expenses. Medical expense or hospitalization insurance may well be written on an individual or group basis. A few of these plans will provide prescription help.

Although there are countless types of benefits offered, private medical expense coverage might usually be categorized as basic health expense insurance, major medical coverage, comprehensive medical coverage, and special policies. These Programs should cover prescriptions because prescription drugs help so many patients. Nearly all of these plans have largely been replaced by managed care policies and are no longer available as stand-alone policies. These types of plans have been adapted and replaced in response to changes in the health care field relative to cost control and market competition.

Basic medical insurance provided by a private health expense plan includes hospital expense, surgical expense and medical expense. These 3 basics may possibly be sold as one or individually. Often this is written as “first dollar” insurance, which means it does not possess a deductible.

As the name implies, hospital expense medical insurance offers benefits for expenses incurred throughout hospitalization. Hospital indemnities are by and large classified into two broad groups:

• Room and board, as well as nursing care and special diets

• Miscellaneous medical expenses, including x-rays, laboratory fees, drugs, medical supplies, and operating and treatment rooms

In some cases, surgical benefits could be included for certain types of surgery and related costs. Hospital expense insurance provides benefits for daily hospital room and board and various hospital charges while the insured patient is confined to the hospital. The plan could provide for a particular dollar amount for the daily hospital room and board benefit, though the movement is in the direction of coverage of not more than the semiprivate room rate unless a private room is medically required. The room and board benefit can be paid on either an indemnity basis or a reimbursement basis, depending on the particular plan.

Indemnity plans are from time to time called dollar amount plans. Room and board rates fluctuate by geographic location, however it is not unusual to find room and board rates ranging from $300  to $700  per day or more.

In general, the maximum number of days is from 100  to 450 . More commonly, room and board charges are paid on a reimbursement basis. This is frequently called a expenses incurred basis. Under this plan, the plan will reimburse in one of two methods.

• The actual bills for a semiprivate room are covered.

• A percentage of the actual charge is paid, with no explicit dollar limit.

Under the first reimbursement option, the medical insurance company will pay the full actual semiprivate room rate, regardless of what it is. Under the second reimbursement option, the health insurance company pays a specified percentage, regardless of what the actual charges are. A usual percentage is 80%.

To summarize, under the actual charges kind of reimbursement policy, the policy will pay the actual amount billed for a semiprivate room without regard to a specific dollar limit. Under the percentage type of reimbursement health insurance, the program might pay a certain percentage of the actual bill.