Medical Insurance Blog

Understanding your health insurance medical plan

Health insurance is medical cover against the risk of incurring medical expenses at an untimely season. The elderly are particularly well advised to take up a health insurance medical plan as the incidence of illness increases with age. The increasing incidence of illness is reasonably offset by a good cover even as one faces higher medical bills that often come with the ageing process. A cover works very well for the average worker who for some reason is unable to pay for an incidental health...

Individual Health Insurance: Medical/Surgical Coverage

The Base Plan: What is a Schedule Contract on Medical/Surgical Coverage? The limitations on your individual health insurance policy can be very confusing. Less common today than UCR formulas for medical/surgical reimbursement are schedule contracts. These state a fixed maximum dollar amount that the policy will pay for each medical and surgical procedure. The payments to be made are not varied according to statistics on doctors' customary charges or costs. Thirty years ago, schedule contracts...

How Group Health Insurance Plans were Developed

Why was discount group health insurance plan developed? Group health insurance plan was originally developed to provide per-sons with financial protection from the expenses related to hospital confinement. The 1911 National Health Insurance Act of Great Britain made the United States aware of the concept of providing medical benefits to a group. In the following decade, several U.S. hospitals offered hospital expense benefits on an individual prepaid basis. Baylor University Hospital in...

Group Health Insurance Plan Underwriter

What is a group health insurance plan underwriter? A group health insurance plan underwriter is a risk evaluator, in that he or she analyzes each individual group to determine the financial risk it represents for the insurance company. To determine the acceptability of the risk a particular group represents, the under-writer examines the composition of the group as it relates to age, sex, prior claims experience, and the desired plan design. A recent trend in risk evaluation is "life...

The Norris Case Effect on Health Insurance Plans

The Effect of the Norris Case on Low Cost Health Insurance Plans The effective date of the Norris ruling was August 1, 1983. Since it is not retroactive, it did not apply to women who had already retired or to women workers' contributions that had been made to their retirement plans prior to August 1. The ACLI had argued that including those two groups would have cost the industry between $85 and $676 million a year for at least the next fifteen years, depending on the method used for adjusting...

What are BC/BS Health Insurance Plans

Blue Cross/Blue Shield Health Insurance Plans Most people are surprised to learn that Blue Cross/Blue Shield is not a single company but rather a kind of trade association to which a number of autonomous companies belong. On discovering this the consumer might then assume that the Blues are a kind of franchise operation, each individually owned but with the right to use a common name and trademark, with rules and regulations formulated by a parent company and with a strictly predetermined...

The “BETTER” Health Insurance Plans Scam

How to Avoid The "BETTER" Health Insurance Plans Scam Policies change so often these days that it is possible yours is out of date and could be better. You should look over all your policies every so often and listen if your regular agent suggests you might want to make a change. Be careful, however, to change for a good reason and to know the disadvantages. Some agents make a good business out of getting their customers to switch policies every time the six month preexisting...

Advantages of a Group Health Insurance Plan

Advantages You should Get from your Group Health Insurance Plan 1. Lower premiums Compared to any policy an individual can buy, a group policy premium will be much lower. In addition, your employer may pay part of the premium. This varies; some employers pay nothing, some pay up to 50 percent; a few may even pay 100 percent, but this is becoming less and less common. 2. Higher benefits Because group policies usually cover large numbers of young, healthy, low-risk males people...

Group Health Insurance Plans Disadvantages

Disadvantages of a Group Health Insurance Plans and What to Do About Them Since it is generally understood that group policies offer vastly superior coverage compared to individual policies, I am reversing the usual order of things by considering the negative before the positive; it might be supposed that group policies have no disadvantages, and that is not the case. Involuntary loss It's bad enough to lose your job; it could be devastating to lose your health insurance at the same...

HMO Health Insurance Plans – Who Can Join?

Eligibility for HMO Health Insurance Plan Theoretically, anyone of any age or state of health can join. An HMO health insurance plan is supposed to be open to everyone and not to turn away a person because of poor health. This has not always been the case. In December 1980 a packet from the Connecticut Health Plan included a sheet headed "HEALTH STANDARDS FOR INDIVIDUAL ENROLLMENT." The sheet said: Eligibility for individual (direct) health insurance plans membership in Connecticut Health...