HEALTH INSURANCE:

• A policy that will pay specified sums for medical expenses or treatments. Health policies can offer many options and vary in their approaches to coverage.

• Protection which provide payment of benefits for covered sickness or injury. Included under this heading are various types of insurance such as accident insurance, disability income insurance, medical expense insurance, and accidental death and dismemberment insurance.

• Insurance against loss by sickness or bodily injury.

• A generic term applying to all types of insurance indemnifying or reimbursing for losses caused by bodily injury or sickness or for expenses of medical treatment necessitated by sickness or accidental bodily injury.

• Coverage for hospital, physician, and other medical expenses resulting from illness or injury.

• This term has become accepted by the industry for the branch which includes all types of loss of time and medical expense insurance. It is also known as accident and health insurance, sickness and accident insurance, etc.

• Insurance to cover cost of health care. Health Insurance can be privately managed or can be part of a government run scheme.

• Insurance that covers medical expenses or health care services.

• Protection that provides payment of benefits for a covered sickness or injury.

• It is also called accident and sickness insurance, medical insurance. In general, any insurance program covering medical expenses and/or income lost owing to illness or accidental injury. Such insurance may cover some or all of the expense of hospitalization; surgery; physicians’ fees; drugs and medicines; laboratory tests, X-rays, and other diagnostic procedures; radiation therapy; maternity and nursing care; eyeglasses, crutches, prostheses, etc. ...

• Commonly called accident and health insurance, protection against financial loss from a personal accident or illness.

• A contractual relationship whereby an insurance company (the insurer) agrees to reimburse the insured for health care costs in exchange for a premium. The contract (policy) generally stipulates the type of health care benefits covered as well as costs to be reimbursed.
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• Health insurance is a type of insurance whereby the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. The insurer may be a private organization or a government agency. Market-based health care systems such as that in the United States rely on private medical insurance.

Group health insurance:

• Health insurance written on a number of people under a single master policy, issued to their employer or to an association with which they are affiliated.

• Health insurance purchased through a group that exists for some purpose other than buying insurance, such as a workplace, labor union, or professional association.
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• Health coverage based on a collection of people, whether assembled by an organization or a business. The cost is spread out among the members of the group. Under federal guidelines, a “large employer” is one with 51 or more employees and a “small employer” averages 2 to 50 employees in a calendar year.

Do You Need Health Insurance?

The need for health insurance is as unique as the individual. The first step in identifying the type of plan that is right for you is to determine your needs. It is important to educate yourself on how health insurance works and how to choose health coverage that is best for you and your family. All health insurance plans are subject to state legislation and will vary by state.
Health care and health insurance are changing rapidly. State and federal regulations can dramatically affect health plans and how you receive care. Both insurance companies and employers are investigating new ways to provide health insurance coverage.
An overview of the available health insurance choices are listed below. It includes a shopping list that will help you compare health insurance plans. It includes resources to guide you to more detailed sources of information.
Health insurance provides financial protection against unexpected costs. Without it, an accident or major illness could put you in debt for years.
Most employers provide health coverage, either on a self-insured basis or through an insurance company. Self insurance is a type of insurance arrangement in which large employers pay for medical claims from their own funds rather than contracting with an insurance company for coverage.
Many employers pay part or all of the premiums for employees — although generally they are not required by any state or federal law to offer health benefits.
You may not have a choice of plans — your employer may provide only one health insurance option.

How To Identify Your Needs

A plan that is good for a single individual may not be the best choice for a family. If both you and your spouse can get group health coverage through your employer, find out how to get the best coverage least expensively. You may find that individual coverage for two individuals is less expensive than family coverage.
Determine what is more important to you: the freedom to choose any physician or health care provider, or the opportunity to save money? Managed care plans will usually be the least expensive option, but they limit your choice of providers.
You may need specialized health insurance, such as a plan to supplement Medicare or a plan that pays for long-term care services.

Shopping List For Health Insurance

Shop carefully, because premiums and benefits can vary widely.
• If you and family members to be covered are in generally good health, lower your premium — the amount you pay periodically for health insurance — by taking a higher deductible, such as 0. A deductible is the amount of money, or value of services (such as one physician visit), the insured individual must pay before the health plan begins to pay for covered services.
• Choose a guaranteed renewable policy; the company can raise your premiums but cannot cancel the policy as long as you pay the premium.
• Make sure the plan covers major medical and hospitalization, which can cost thousands of dollars.
• Verify that there is a “free look” clause. With most companies you have at least 10 days to examine the plan after you receive it. If you are dissatisfied, you can return it for a premium refund.
• Check policy exclusions carefully. You may be able to save by buying a policy that excludes many pre-existing conditions, although you will probably be required to have a physical examination. Be sure the policy will cover you if you develop one of those conditions later.

Comprehensive health insurance:
• Sometimes called "Comprehensive Major Medical." A form of health insurance that combines the coverage of Major Medical and Basic Medical Expense contracts into one broad contract that provides coverage for almost all types of medical expense with few internal limits, usually subject to a small deductible for some or all expenses and to a percentage participation clause (sometimes called "co-insurance") applicable to all or some of the covered expenses.

• In June of 2003, the Maine, USA Legislature passed a comprehensive health insurance plan, granting low-cost coverage available to all state residents by 2009. Through a semi-private agency, the state will provide coverage to uninsured residents, small businesses and municipalities and the self-employed.

Self-funded health insurance plan:
• A health insurance plan that is funded by an employer rather than through a health insurance company. A health insurance company will typically handle the administration of such a plan, but the cost of claims will be paid for by the employer through a fund set up for this purpose.