underwritten individual policy/HMO.
Questions & Answers
Q.When I apply for insurance,
what will they ask?
A.Personal information to determine your
eligibility. Companies screen applicants for individual
health insurance, so you’ll fill out an application and
answer questions on your medical history. If your information
is incomplete or inaccurate regarding health history or
age, the company may deny benefits or rescind your coverage.
Companies frequently ask physicians for medical records
and may require you to take additional physical exams or
blood tests However, they cannot ask you for an HIV test,
except for disability income and life insurance. People
with anything serious in their medical background may be
charged a higher price for coverage or may be unable to
find individual health insurance at any price
Q.Can I return my policy?
A.Yes. If you are accepted for individual
coverage by an insurer, you have a "free look"
or review period which varies from 10 to 30 days. If you
decide you do not want the policy, return it by certified
mail within the required period of time and request a full
refund of the premium paid. Employer group plans do not
have a "free look" period.
Health Insurance Terms
Assignment Of Benefits
When you assign benefits,
you sign a paper allowing your hospital or doctor to collect
your health insurance benefits directly from your insurance
company. Otherwise, you pay for the treatment and the company
reimburses you.
Claim
Notification to the insurance company from
the insured or health provider (if you have assigned benefits)
that a payment is due under provision of the insurance policy.
Co-Payment
The portion charges paid by the patient in addition
to any deductible for covered services and supplies.
Deductible
A fixed amount which is deducted from eligible expenses
before benefits from the insurance company are payable. You
may choose a higher deductible to lower your premium.
ERISA
Employee Retirement Income Security Act (of 1974),administered
by the U.S. Department of Labor, ERISA regulates employer-sponsored
pension and insurance plans for employees.
Grace Period
A specified period immediately following premium due
date, during which payment can be made to continue the policy
in force with out interruption.
Guaranteed Issue
The coverage is available regardless of prior medical
history.
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