If you are planning to buy a medical insurance plan, it is important that you first understand how the medical insurance system works. It is necessary for you to study the medical insurance plan, the insurance companies that offer these services and the way they work. As this is a contract, there is a give and take relationship.
Health insurance premium
Your insurance company agrees to pay for your medical expenses and in return you have to pay a fee for availing their service. This is called the medical insurance premium. Different insurance companies and medical insurance plans have different ways of paying the fees. In some cases, you might have to pay a monthly premium, or every year, depending on your insurance plan.
While your medical insurance company covers the cost of your health services, there are some other costs that you need bear for their services. One of the main such payment is deductibles. Others include copayment and coinsurance.
The types of payment and the terminologies may differ in different countries and also with different insurance companies. It is therefore necessary for you to understand the guidelines in your country and also the specific guidelines of your insurance policy.
Network and non-network hospitals
Health insurance companies have a list of doctors, hospitals, diagnostic centers, etc that are tied to them as their panel and are commonly termed as network doctors or hospitals. The other hospitals and doctors that are not listed by the insurance company are called non-network hospitals.
In case of a medical illness, if you visit a network hospital, you can avail the healthcare services as a cashless facility. This means you do not have to pay any money and the insurance company bears all the expenses. However, if you visit a non-network hospital you will have to pay the charges for your medical needs and then claim for a reimbursement to your insurance company.
