Thursday

What to Look Out for In a Health Insurance Contract

By Terry Yahzik

Let's face it: that reading through and making sense of health insurance contracts can be a daunting one. After all, health insurance contracts are typically written in the kind of legalese that only a lawyer would be comfortable reading through, with most of the information that has the greatest effect hidden deep into the fine print.

Yet failure to understand a health insurance contract can turn out to be a very big blunder, like when one is told that they will have to foot their medical bill for one obscure reason or another, with an even more obscure clause (in the health insurance contract they got themselves into) being quoted as the reason for their being denied coverage.

To avoid such inconveniencing and potentially embarrassing situations, it is important to make an effort to understand at least some three crucial things in your health contract, before signing on the dotted line.

The first thing you need to be very clear about before signing onto a health insurance contract is the 'extent of coverage.' As it turns out, a health insurance policy - whatever its value - is never a panacea for all medical bills, and therefore every health insurance policy is bound to have limits with regard to the medical conditions it covers and the maximum amount of hospital bills it will pay for. The people offering health insurance are, in any case, business-minded people in most cases, and they simply cannot afford to cover everyone who signs up with them for everything. The worst thing that can befall you if you are not aware of the limits of your health insurance policy is to check into a health facility with a given condition, incur a hefty medical bill, only to be told that your condition (or amount of your hospital bill) is not covered by your health insurance - which in the worst case scenario could see you being detained at a health facility for non-payment!

The second thing you need to be very clear about before signing onto a health insurance contract is 'when the health insurance coverage takes effect.' As it turns out, in most cases, health insurance policies don't take effect immediately you sign on the dotted line, and you could therefore find yourself having to pay (from your pocket) medical bills you incur between the time you sign a health insurance contract and the time the cover takes effect, while all the while thinking that you were covered.

And the third thing you need to make an effort to understand in your health insurance contract is what types of healthcare facilities claims on it can be made, and which healthcare facilities don't qualify for reimbursement under the contract. As it turns out, healthcare providers tend to be choosy when it comes to healthcare providers to work with, with many opting not to pay for healthcare bills incurred in some facilities. - 26706

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