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Health Insurance

Health Insurance Policies

Health Insurance Policies

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As part of most company's benefits package, many employers offer their employees health insurance. This type of insurance helps pay for medical services such as routine check-ups, outpatient surgery, hospital stays, prescription drugs and other types of medical expenses. Oftentimes, the employer pays a portion of the monthly premium for their employees and the portion the employee pays is usually deducted directly from their paycheck.

Health insurance companies are contracted with certain physicians and facilities. When medical services are needed, it is best to go to a contracted provider in order to get the best benefit. When the insured goes to the doctor for an office visit, the doctor's total billed charges might be $85. If they are a contracted provider, there is a discounted rate that the insured and the insurance company pays. If the contracted rate is only $60 and the insured has a copay of $25 then the insurance company is responsible to pay $35. The provider then has to write off the remaining $25.

Employers usually have a couple of different plans from which to choose. Most types of plans require the insured to meet a deductible first before the insurance company starts paying their share. Once the deducible is met, the insured only has to pay a certain percentage. This coinsurance gets applied to what is called the maximum out of pocket. Once the insured meets the deductible and the maximum out of pocket, the insurance company normally pays one hundred percent. Most plans also have copays which are payments made up front for certain services rendered, like for example a doctor's appointment. These copays usually do not apply to the deductible or out of pocket.

Many insurance companies are now mandated to pay for the total cost of preventative services. Even though the deductible and out of pocket amounts can be high, having a policy will make it so that the insured does not have to pay tens of thousands of dollars if something catastrophic happens. There are certainly many benefits to having insurance through an employer to help pay for medical expenses.



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