Health Insurance
Illness for non-work
related injuries can be financial devastating. Insurance can
help protect against disastrous health care expenses and lost
wages. If you have a job, your employer may make medical and
disability income benefits available to you. You can also
purchase these coverages privately or through an insurance
agent who is licensed by the State to sell health insurance
products.
Types Of Health
Plans and How They Operate
Medical Expenses Plans
Pay expenses incurred for diagnosis and treatment of medical
conditions.
Reimbursement
and Fixed Allowance Insurance Plans (Department of Insurance
Jurisdiction)
Full freedom-of-choice plans allow you to choose any doctor
and hospital. You can also choose the amount of the "deductible"
you must pay before the plan pays anything. After the deductible
is met, a percentage of all your expenses is usually covered.
The difference between the percentage the plan pays and the
amount charged is the "co-amount" that you must
pay. The policy or employer benefit booklet will spell out
the terms and conditions of what is covered and what in not
covered. Read this contract before you need to use the plan
and ask your agent or employer to explain anything which is
unclear to you. Preferred Provider Organization (PPO) Plans
allow you to choose a doctor or hospital from a list
of "preferred" providers in order to receive full
benefits. If you go to a doctor or hospital who is not on
the list, the plan may cover a smaller percentage or none
of your costs. Check with the insurance carrier before you
use the plan to make certain your physician or hospital is
a contracting provider.
Make certain your doctor refers you to other providers who
are on the list, or who the carrier agrees to pay at the "preferred"
rate. Individual Plans are a good alternative if you are not
able to get coverage through your employer. A pre-existing
condition, such as a past illness, must be covered after one
year. However, the insurance company will decide on
the basis of your health history if they will issue
the coverage. Multiple Employer welfare Arrangements(MEWA)
may be insured or partially -insured plans. They are typically
marketed to self-employed individuals or small employers through
membership in a trade or other association. The California
Insurance Code now requires MEWA’s to obtain a "Certificate
of Compliance" and to set aside financial reserves to
operate. They must comply with the health care reforms effective
after July 1993. These plans can only be sold through a licensed
life insurance agent.
Disability Income Policies
Health Insurance California 1
Health Insurance California 2
Health Insurance California 3
Health Insurance California 4
Health Insurance California 5
Health Insurance California 6
Health Insurance California 7
