By Terry Yahzik

Before getting into a discussion on what to look out for in a health insurance contract, it is important to first to appreciate the fact that reading through contracts is quite an unpleasant task to most of us, as most of these contracts are typically written in a language we don't particularly like called legalese, with most of the details further hidden in the contracts' fine print. Perhaps, someone might argue, the lawyers who develop contracts do this deliberately, to make room for disputes and thereby make work for themselves, as most disputes arising out of not reading contracts carefully will typically be resolved in courts - with aid of lawyers, of course.

Yet in spite of the difficulty of the task which is carefully going through a health insurance contract, you simply cannot afford to get into any such contract without going through it with a toothcomb. The adverse effects of getting into a health insurance contract without examining it carefully can include anything from going into a healthcare facility, incurring a bill and being told to you have to foot it from your pocket because your health insurance provider 'does not cover that' to actually getting detained the healthcare facility in question for non payment if you happen not to have any alternative way of footing your bill there.

Failure to read through your health insurance contract carefully could see you get into a situation where you health insurance provider won't pay for your medical bills - in spite of your having a health insurance cover with them, which can be a very maddening affair.

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 should make an effort to understand in your health insurance contract is the point in time when the policy takes effect, because most health insurance policies tend to be structured in such a way that their coverage only takes effect a considerable period of time after getting into the contract, again a fact that is typically hidden in the fine print.

And in the same spirit of knowing the major components of your health insurance contract, ensure too, that you are very clear about what health facilities the insurance covers bills in, and those that it doesn't. Most health insurance covers, as you will learn in the process, only pay for bills incurred in certain (select) healthcare facilities, while leaving it up to you to foot your healthcare bills if you happen to incur them at certain other facilities.

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2 comments:

Raizu said...

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Betty said...

All the points that you have mentioned about health insurance policy are very important. You have clearly explained each of them. I will consider all these things when buying a health insurance policy. Thanks.
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