Health Insurance

Medical Insurance

Medical insurance is a type of insurance coverage that covers the cost of an insured individual's medical and surgical expenses. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider.

In health insurance terminology, the "provider" is a clinic, hospital, doctor, laboratory, health care practitioner, or pharmacy. The "insured" is the owner of the health insurance policy; the person with the health insurance coverage.

In countries without universal health care coverage, such as the USA, health insurance is commonly included in employer benefit packages and seen as an employment perk.

Dental Insurance

Dental insurance policies help many people effectively budget for the cost of maintaining a great smile. Compared to medical insurance, understanding dental insurance policies is a breeze. Most policies are straightforward and specific regarding what procedures are covered and exactly how much you have to pay out-of-pocket. Dental insurance is available as part of medical insurance plans or as a standalone policy.

Waiting Period for Dental Insurance

Most dental insurance policies have waiting periods ranging from six to 12 months before any standard work can be done. Waiting periods for major work are typically longer and can be up to two years. These periods are set in place by insurance companies to guarantee they profit off a new account and to discourage people from applying for a new policy to cover impending procedures.

Deductibles, Co-Pays and Co-Insurance

An insurance deductible is the minimum amount that must be paid before the insurance policy pays for anything. For example, if the deductible is $200 and the covered individual’s procedure is $179, the insurance does not kick in and the individual pays the entire amount. Co-pays, which are a set dollar amount, may also be required at the time of the procedure.

Once a deductible is met, most policies only cover a percentage of the remaining costs. The remaining balance of the bill paid by the patient is called co-insurance, which typically ranges from 20% to 80% of the total bill.

Vision Insurance

A financial protection plan that requires the policyholder to pay a monthly fee in exchange for reduced-cost fees on some eye health and vision correction services and products. Vision care insurance will often cover routine eye health expenses such as eye exams, contact lens fittings, contact lenses and eyeglass lenses and frames and may provide a discount on LASIK procedures. The plan may cover the cost of these items in full, up to a preset limit, or may require the policyholder to pay a flat fee or percentage fee to share the expense with the insurer.

BREAKING DOWN 'Vision Care Insurance'

Vision care insurance tends to be inexpensive compared to other types of insurance, because many of the covered costs are predictable and expensive claims are rare. In fact, it more closely resembles a discount plan than a true insurance plan, because insurance is meant to protect against unforeseen and potentially catastrophic expenses.

Although vision care insurance is inexpensive, it may not be a good deal for the consumer if the costs of premiums and copayments under the plan are higher compared to the costs of paying for vision care expenses out of pocket. Eye diseases, which are unpredictable and can be expensive to treat, will generally be covered by health insurance, not by vision care insurance.

Temporary health insurance

Designed for healthy individuals and families, short-term policies provide an affordable safety net while switching from one life event to another without a health plan. Lose your job, recent college graduate, divorced, or retired and not quite eligible for Medicare? Then consider short-term insurance (but remember that most of those scenarios are qualifying events, which means you’d be eligible to purchase an ACA-compliant plan instead – so check those options too.)

Short-term plans are not regulated by the Affordable Care Act (Obamacare), so they are still available year-round. For people who missed open enrollment and do not have a qualifying event that allows them to purchase an ACA-compliant plan, a short-term policy can be a good solution to bridge a short gap until general open enrollment begins again, or until an expected qualifying event.

Short-term plans are available in nearly every state, but as of April 1, 2017, new short-term plans are limited to durations of less than three months (90 days), as the Obama Administration was trying to ensure that people are not using short-term health insurance as a relatively long-term substitute for ACA-compliant coverage.

Disability Insurance

A program managed by the Social Security Administration that insures a worker in case of a mishap. Disability insurance offers income protection to individuals who become disabled for a long period of time, and as a result can no longer work during that time period. Employees who've paid the Federal Insurance Contributions Act (FICA) tax for a certain amount of time, are eligible to receive the Social Security disability income insurance.

The Federal Insurance Contributions Act (FICA) is a United States law that requires employees to contribute a part of their earnings to fund Medicare and Social Security. Employees who have become disabled can receive this income insurance for at least one year. Income insurance payments begin on the sixth month of disability.

Travel Medical Insurance

Travel medical insurance is for travelers who are leaving their home country. It provides coverage for medical emergencies and evacuations. Depending on the company selling it, it is sometimes called International Medical Insurance, International Travel Insurance, or Worldwide Medical Insurance.

How is Travel Medical different from other types of insurance?

These plans are for travelers leaving their home country that are concerned with coverage abroad. Many insurance plans don’t cover you once you leave the US, and an accident or illness abroad would not be covered.

Biggest difference: It focuses on emergency medical/evacuation vs trip cancellation coverages

With a travel medical plan, the focus is on emergency medical and evacuation costs.

If you are abroad and have an accident or become ill, it would cover medical costs for you. Emergency dental treatment is usually included and emergency transportation (ambulance, air lift) services are also covered.

Emergency medical evacuations will get you out of a remote area and transported to a place where you can receive proper medical care. If you are killed or die on your trip, the repatriation coverage will ensure your body is properly transported home or to a funeral home nearby.

Travel medical plans often include some Accidental Death and Dismemberment (AD&D) and/or term life benefits which are paid regardless of any coverage you may have back home for a covered injury. This coverage can fill out your life insurance benefits and provide extra coverage for you or your family in the case of a serious accident.

It is cheaper than trip cancellation insurance Medical plans are priced based on age, trip length, and coverage amount. This usually adds up to a few dollars per day, so it is a very economical way to get emergency medical coverage abroad. Trip insurance with cancellation, interruption, delay, baggage coverage, etc, are based mostly on the cost of the trip. It usually costs 4-10% of the insured trip cost, so these plans can easily be in the hundreds of dollars.

It has some trip insurance benefits in some plans Some medical plans offer a few trip insurance-like benefits such as minimal trip interruption coverage, coverage for lost or delayed baggage and even trip delays.

This is a nice additional benefit, but if you are looking for true trip insurance benefits you should look at that type of plan.

Supplemental Health Insurance?

Supplemental insurance is extra or additional insurance that you can purchase to help you pay for services and out-of-pocket expenses that your regular insurance does not cover.

Some supplemental insurance plans will pay for out-of-pocket medical expenses, such as deductibles, copayments, and coinsurance. Other supplemental plans may provide you with a cash benefit paid out over a period of time or given to you in one lump sum.

The cash can be used to cover lost wages, transportation related to your health condition, or used to pay for food, medication, and other unexpected expenses you have due to an illness or injury.

Group Health Insurance

A group health plan is an umbrella term, encompassing a number of different kinds of employer-provided benefit plans.

A group health plan is defined as an employee welfare benefit plan established or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for participants or their dependents directly or through insurance, reimbursement, or otherwise.

Most private-sector group health plans are covered by the Employee Retirement Income Security Act (ERISA). Among other things, ERISA provides protections for participants and beneficiaries in employee benefit plans (participant rights), including providing access to plan information. Also, those individuals who manage plans (and other fiduciaries) must meet certain standards of conduct under the fiduciary responsibilities specified in the law