Tag Archives: Health Insurance

The benefits of health insurance in the future

Health insurance

Health problems can occur unexpectedly. Usually when things like this happen, a feeling of confusion is the family who were surprised about the cost to be borne. As we all know, now is the cost to support health can not be said to be cheap, one could even say very expensive. To overcome such difficulties in the future, we need health insurance.

Health insurance is one of the types of insurance products that ensure the availability of funds if the holders of health insurance have health problems. By having health insurance, all sorts of health-related in the form of hospital costs, physician costs, drug costs, and even the operating costs will be borne by the insurance company. Of course it all depends on the terms and conditions stipulated by the insurance company in the agreement.

benefits of health insurance, health insurance in the future

Many benefits can be obtained by having health insurance such as outpatient benefits, hospitalization benefits, and dental benefits. In general, outpatient benefits covered by insurance companies such as consulting fees in both general practitioners and specialists, the cost of medicines prescribed by the doctor, the cost of preventive measures. As for hospitalization benefits, the cost of which is borne by the insurance company covers the cost of hospital, laboratory costs, emergency service costs, including birth costs.

Besides the two above benefits, there is also the dental care benefits including cost of dental care basic and complex and cost of dentures installation. To get all these benefits, of course, we must pay a premium to the insurance company that bore us.

When we are in good health and we must pay a premium to the insurance company, the premium as if the money spent with useless but then when we unexpectedly experienced health problems that require treatment cost, insurance coverage we will receive from the insurance company will greater than the value of the premium has been paid.

Despite maintaining health care, diseases can come without warning due to variations in the number and type of disease that is increasingly growing in number. Traffic accidents are also an event that is often experienced by many residents and families.

Regularly pay a premium, if it falls ill be assisted health insurance that does not burden the family expenses. Often the stories and testimonies that reveal many families go into debt to pay for the hospital.

Actually, health insurance has service offers are pretty good and complete. Support health insurance will depend on the agreement between the customer and the insurance company. The greater the premium paid it will be more complete support for health insurance.

Tips for filing a claim health insurance

Health insurance

Health insurance is one of the insurance products that specifically guarantees for health care or the care of the members of such insurance if they fall ill or have an accident. Understanding tips filing health insurance claims to prevent unnecessary hassles and increase your chances of getting a replacement. There are things you need to do when asking health insurance.

How to submission of health insurance

1. Read certificate / your insurance policy; Before undergoing treatment at the hospital, learned all the provisions of the policy benefits. If you are a collection of health insurance, you are usually given a list of benefits of the policy. You can also ask the personnel to know the limits of the policy benefits according to the parent company. For your individual policy holder, you can ask the agency and part of the ministry claims your health insurance company.

claim health insurance, submission of health insurance, filing health insurance, benefit of health insurance

The things you need to know from a certificate and your policy:

  • The benefits of health insurance are paid, the maximum limit for each item of treatment and rest limits you have
  • Exceptions, the type of disease or what treatment methods are excluded, such as congenital disorders, cosmetic surgery, disease existing before the policy is effective (pre-existing disease), etc..
  • Claims procedures, including how well the types of documents must be completed. If your insurance company provides superior partner (provider), you have to know which hospital in your town who are the partners. The benefits of treatment in hospital partner is you do not need to spend money on insurance and pay the cost of care in advance.

2. Learn carefully hospital bills; At the time of leaving the hospital, the hospital will ask you to sign the details of maintenance costs will be billed to the insurance company or to you.

  • Make sure that the data is comprehensive care, including diagnosis, type of action, the cost for each item, the date of treatment, doctor’s name and data policy relevant. Little mistake in the writing of the name, could result in delayed payment of your claim.
  • Pay attention to word choice in the diagnosis. Handling the same but with a different diagnosis can get approval different claim. For example, if the diagnosis suggests that the disorder is congenital (inborn) although the trigger is a new disease, your claim may not be paid. Similarly with dental rehabilitation operations or parts of the face that are considered cosmetic. When you see there is a “gray area” in your policy, talk to the hospital and the insurance for interpretation does not harm you.

3. Ask a claim file as soon as possible; For insurance reimbursement without going through the provider, the claim must be filed after the completion of treatment. Insurance companies generally have a claim period expired. If it passes that date, your claim may not be paid. In addition, the submission also allows insurance faster to communicate with the hospital because the information is still fresh. Even more importantly, the sooner filed, the sooner you will get your money back.

4. Duplicate files your claim (proposed); you never know how good the quality of the administration of your insurance company. If for some reason you lose your files, you’ll be grateful because it has been a copy.

5. Do not immediately accept the claim denial; If you receive a rejection letter, learn why, compared with provisions of the certificate / policy. As far as the refusal is not because of something that was clearly stated in the policy, you are entitled to file a complaint. Tell your appeal orally or in writing to the insurer. In many cases, insurance companies are willing to budge or give partial compensation. In fact, almost every company there’s always insurance claims payments that are ex-gratia, the payment of claims that are not guaranteed in the policy. Ex-gratia payments are usually based on customer service and business considerations (sustainability policy).

6. Hire a lawyer; when the number of claims rejected is very large, there may be a benefit to you to hire a lawyer. The insurance company will respond to the very serious when you hire a lawyer. In addition to strengthening your bargaining position, the presence of lawyers also make the health insurance company worried because of its impact on the reputation of the company if the case spread into the community.

Resolve the problem if you have multiple health insurance

Resolve the problem if you have multiple health insurance. Health insurance is the most important insurance to your have. Costs of expensive health care can be very costly if you are not insured by the insurer. Not infrequently there are people who have to sell his goods to bear the cost of hospital care. You do not have to like it if you have health insurance.

Health insurance can be obtained in various ways. You may automatically get it as a child, a wife, or as an employee in a company. You may also be insured by professional associations or societies. In other words, you get it without buying their own. Therefore, there is a possibility you overinsured. For example, as an employee you get health insurance from your employer. However, as your wife also get a guarantee from the company where your husband works. Though both may be cover the same health risks.

multiple health insurance, double claim of health insurance

You can claim the cost of your care at two insurance companies at once. However, in accordance with the principle of health insurance in which clients only receive a maximum reimbursement of costs incurred claims, both health insurance firms will be coordinated so that no double payment. The mechanism in which the insurance companies to coordinate the claim is called COB (coordination of benefits).

In the scheme of COB, you can simply make a claim to one insurance company, for example from your office. The insurer will calculate total cost that covered appropriate your policy. If there are costs that are not covered by insurance because limit is exceeded or included in the exemption policy, you can ask the insurance company to coordinate with the insurance company of the husband’s office. The insurance company will first send the original claim to the second insurance company with the details of the total of claims that have been approved to be paid. The second insurance company will analyze claims and pay the deficiency, in accordance with policy benefits.

To facilitate the process of your claim, you should first notify the insurance company when filing a claim that you are covered as a participant in any other insurance. Thus, since the beginning they had to communicate with the other insurers if your claim exceeds of the limit benefit in your policy.

Double claims and coordination benefits in health insurance

Double claims and coordination benefits in health insurance – dmatxi. In terms of health insurance known double claims and coordination of benefits. Regulations at Manulife allow double claim with another insurance company. So if you have health insurance from Manulife and health insurance from another company, you can file a claim to Manulife with photocopy of receipts that have been legalized.

To be able to double claim, you must use the reimbursement system to pay hospital bills so you have the original receipts and invoices that have been legalized. In a claim payment system the reimbursement is insured must pay in advance the cost of a hospital of private money. Then the bill is submitted to the insurance company by attaching down the receipt to get a replacement.

Double claims health insurance, coordination benefits in health insurance

Excess of the reimbursement claims payment system, the insured can choose any hospital for treatment, not just limited to being a partner hospital insurance company. Benefits of health insurance for health insurance policy holders is that the costs associated with health such as hospital costs, physician costs, drug costs, and even the operating costs will be borne by the insurance company, and tailored to the content of the agreement contained in the policy.

While on a cashless payment system claims, the insured need only show a card from an insurance company without the need to make the payment in cash. Furthermore, the hospital will contact the insurance company to take care of the payment. The benefits received by the hospital must also conform to the platform owned health insurance.

This cashless system is more practical than the reimbursement system but are usually more expensive premiums (no extra charge for this facility) and the hospital was limited who are the partners of the insurance company. If the other insurance company Manulife allows the double claim for health insurance policies that are equally from Manulife valid is coordination of benefits.

Benefits received by the insured can not exceed the total bill has been paid. Suppose the total hospital bill of 10 million. If appropriate platform first health insurance has been replaced by 6 million, the second health insurance will only pay the shortfall remaining bills which amounted to 4 million.

Further, when the first insurance claims totaling 10 million has been paid then the second insurer will not reimburse claims happened. This is because the total bill there has been replaced fully by insurance first.