Archive for: October 2009

Personal medical coverage provides benefits for health care. Prescription assistance programs can be included in some plans. Several plans may possibly provide for payment of health bills incurred on a reimbursement basis by paying benefits to the plan owner, payment on a service basis by paying those who supply the services directly, or payment of an indemnity by paying a fixed amount regardless of the sum charged for medical expenses. Medical expense or hospitalization coverage could be issued on an individual or group basis. Some of these programs will provide prescription help.

While there are lots of types of benefits offered, private medical expense coverage can by and large 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 people. A large amount of these plans have for the most part been replaced by managed care policies and are no longer available as stand-alone policies. These types of policies have been adapted and replaced in response to changes in the health care field relative to cost containment and market competition.

Basic health insurance provided by a private health expense plan includes hospital expense, surgical expense and medical expense. These 3 basics may perhaps be written as one or separately. Frequently this is issued as “first dollar” insurance, which means it does not have a deductible.

Like the name indicates, hospital expense coverage provides benefits for visits incurred throughout hospitalization. Hospital indemnities are mostly classified into 2 general groups:

• Room and board, including nursing care and special diets

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

In some cases, surgical benefits may be included for several types of surgery and related expenses. Hospital expense medical insurance offers benefits for daily hospital room and board and miscellaneous hospital bills whilst the insured individual is confined to the hospital. The plan possibly will provide for a specified dollar amount for the daily hospital room and board benefit, although the trend is toward health insurance of not more than the semiprivate room rate unless a private room is medically needed. The room and board benefit may be paid on either an indemnity basis or a reimbursement basis, depending on the particular plan.

Indemnity policies are at times called dollar amount policies. Room and board rates change by geographic location, however it is not atypical to find room and board rates ranging from $150  to $600  per day or more.

Usually, the maximum number of days is from 70  to 600 . More commonly, room and board charges are paid on a reimbursement basis. also called an expenses incurred basis~This is commonly called a expenses incurred basis~This is frequently called a expenses incurred basis}. Under this plan, the plan will pay in one of two methods.

• The actual charges for a semiprivate room are covered.

• A percentage of the actual cost is paid, with no particular 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 medical insurance carrier pays a specific percentage, regardless of what the actual charges are. A usual percentage is 80%.

To recap, under the actual expenses type of reimbursement policy, the insurance will pay the actual amount charged for a semiprivate room with no regard to a specific dollar limit. With the percentage style of reimbursement policy, the plan might pay a certain percentage of the actual charges.