Ababinews - By definition, citing Investopedia (2019), health insurance is a type of insurance coverage that pays for medical, surgical, or related health care costs as stated in the insurance policy. Insurance companies that issue health insurance policies can reimburse the insured for expenses incurred due to illness or injury, or pay for medical expenses directly.
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Health Insurance In USA |
Companies usually provide insurance packages for their employees as a form of protection guarantee. Premium payments vary, some are paid by the company, some are deducted from the employer but are often also deducted from the employee's salary. The cost of health insurance premiums is deductible to the payer, and benefits received are tax free.
Health insurance definition
In particular, the definition of health insurance is a type of insurance product that covers the health or care costs of insurance participants if they fall ill or have an accident. In health insurance, there are two types of treatment offered by insurance companies, namely in-patient treatment and out-patient treatment.
Some insurances also cover costs for room accommodation, ICU accommodation, doctor consultations, specialist doctor consultations, surgery, outpatient care, home care, ambulance services, dialysis, and others. Some insurers also provide cost facilitation for critical illnesses.
Why do we need health insurance?
You may think that the insurance premiums are too expensive. You may think you will never use it. However, not to say "no", you must have insurance. Would you believe if someone mentions that one of the things that can make people worse off and even go into bankruptcy is when they have to drain their savings or assets for medical expenses? The fact is so.
The guarantee or protection benefit that you get is greater than the premium you pay in the event of a risk. As stated above, one of the reasons for the need to have health insurance is the high cost of treatment. Right now you are in good shape, but no one can predict what will happen to you in the next few years. With increasingly diverse health threats, having guaranteed protection is one way to ease the burden when that risk occurs. At least, you do not burden the family to think about the cost of treatment and care if you are sick.
Who should have health insurance?
Be a smart consumer, including buying insurance products. Many Financial Planner from Finansia Consulting reminded, buy insurance products because you realize that you need them, not just want to, let alone join in.
- Pay attention to the following things before deciding which health insurance product to choose:
- Know the purpose of insurance
- Track record of insurance companies With today's technological advances, it is not difficult for you to trace the track record of an insurance company. There are company websites as well as search engines that can help you find the information you need. Choose an insurance company with a good track record.
- Learn carefully about the insurance product that you buy
Understand insurance policies. This includes the claim mechanism, benefits obtained, and others.
Health Insurance Benefits
Talking about benefits, health insurance is a program that has many benefits. Starting from reimbursement of money or provision of health services, caused by illness, work accidents, personal accidents other than work accidents, to compensation for lost income due to suffering from an illness or experiencing an accident. Health insurance is usually also bundled with life insurance which can provide compensation if someone dies.
This means that all health-related costs such as hospital fees, doctor's fees, drug costs, and even surgery costs will be borne by the insurance company, which is adjusted according to the contents of the agreement stated on your health insurance policy.
Some other health insurance benefits are outpatient benefits, hospitalization benefits, and dental care benefits (adjusted). For outpatient benefits, usually covered by insurance companies are health consultation fees, drug costs according to doctor's prescriptions, as well as costs for preventive and other measures.
Meanwhile, for hospitalization benefits, usually the costs borne by the insurance company include hospital fees, laboratory fees, emergency service fees, and delivery costs. Meanwhile, additional dental benefits usually cover the cost of basic and complex dental care, as well as the cost of installing dentures.
Health insurance benefits are not only a means of protection related to health conditions, when sick, but also include the following beneficial things:
1. Provides a sense of calm and security
The first benefit of health insurance is that it can provide a sense of calm and security. This is because insurance can provide a guarantee of protection against various risks experienced by policyholders.
2. Can Be Used as Savings in the Future
The next benefit is the sum insured, which is paid monthly to the insurance company, which can be used as savings in the future. However, not all insurance policies have this facility. So, you have to buy a rider product or additional insurance, in the form of an investment.
3. As a Savior from Bankruptcy and Other Financial Risks
Health insurance benefits that are no less profitable are that they can be used as saviors for policyholders, from bankruptcy to the risk of other financial losses.
The reason is, the cost of hospital treatment every year, always increases. So, to anticipate and minimize financial losses due to illness, having health insurance is very important.
4. Finance Easier to Manage and Targeted
The next benefit is that the family's financial condition can be more easily managed. This is because the premiums paid each time will not make you prepare a reserve fund.
You will also find it easier to allocate other funds for household needs.
How to claim insurance
In general, there are three insurance claim payment systems that can be done, namely reimbursement, cashless, and compensation.
The reimbursement system is a health insurance claim facility where the insurance participant must pay or cover existing medical costs from your personal money first. Only then will these costs be billed to the health insurance company by attaching the payment receipt received from the hospital.
Meanwhile, the insurance claim with the cashless system is that when you want to pay fees, you only need to show your insurance participant card to the hospital that is a partner of the insurance company where we are members.
Furthermore, the hospital will forward the bill to the relevant health insurance company. However, usually health insurance premiums with a cashless system are slightly more expensive than the reimbursement system.
Furthermore, the compensation claim system is where the Indonesian insurance company will provide daily compensation while you are hospitalized. The amount of compensation is usually agreed upon in advance between you and the insurance company.
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