 
Health Insurance California >> Health Insurance >> Health Insurance Queries Health Insurance Queries Q.What I should know when buying health coverage? A. Your aim must be to insure yourself and your family against the most serious and the financially terrible losses that could result from an illness or accident. If you are offered health insurance benefits at work, cautiously review the health plans literature to make certain that one you select fits your needs. If you purchase individual health insurance plan, purchase a health policy that would cover major expenses and one will pay them to the highest maximum level. Save money on premiums, if necessary, by taking large deductibles and paying lesser expenses out-of-pocket. Q.When I apply for insurance, what will they ask? A. Personal information to verify your ability and eligibility. Health Insurance Companies tests applicants for individual health insurance, so you’ll fill out a demand and answer questions on your medical history. If you are not giving apt information, the Health Insurance Company may reject or withdraw your coverage. Health Insurance Companies commonly ask doctors for medical records and may need you to take further physical exams or blood tests. However, there’ll be no demand for HIV test by your health insurance company, apart from disability income and life insurance. Individuals with any serious remark in their medical backdrop may be charged a higher cost for coverage or may be not capable to find Individual Health Insurance at any price. People with anything solemn in their medical background may be charged a higher price for coverage or may be unable to find individual health insurance at any price. Q.What is health insurance? A. Health Insurance is 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. It is basically a insurance against loss by sickness or bodily injury. Q.What is the major purpose of health insurance? A. When use “machine” analogy in our introduction, health insurance is specially designed to cover your repairs, maintenance and any lost income while the machine is in “shop”. Q.What are the major types of individual health insurance policies? A. There are many varieties of health insurance plan available. But the two major and most commonly used insurance are medical and disability. You could choose any of them according to your need. Q.What is a PPO? A. PPO is stands for “Preferred Provider Organization” Basically, this is a network of health insurance providers who agrees to provide certain services at agrees-upon costs for individuals or groups whose coverage is a part of network. In PPO you are allowed to use any medical provider with in the network, and all will honor the agreed fees and services. Q.What is a HMO? A. HMO stands for “Health Maintenance Organization”. Same as PPO network of independent insurance providers, HMOs are typically fixed facilities, and also benefits are designed to cover services obtained at the HMOs facilities and supplied by the HMO personnel. HMO coverage plans should specify under what circumstances and how services may be obtained form non-HMO providers, and this information is very crucial for determining the value of the HMO under your circumstances. Q.Can I buy a single health insurance policy that would provide all the benefits I’m likely to need? A. No. Although you have an option to select a health plan or buy a health insurance policy that should cover most medical, hospital, surgical, and pharmaceutical bills, no single health insurance policy covers everything. Moreover, you might want to consider additional single-purpose health policies like long-term health care or disability income insurance. If you are over 65, you might desire a Medicare supplement health policy to fill in the gaps in Medicare coverage. Q.What if I want to go to any doctor or hospital I choose? A. You could buy health insurance which says “go to whomever you want and have them send us the bill”. Thus an indemnity policy could be readily available to you, but could be more expensive than a coverage insurance plan utilizing a PPO or HMO. Q.How can you conserve costs? A. Here are the some excellent ways; you could same money while purchasing health insurance that’s right for you. 1. You need not buy health insurance if you don’t need and need not buy more insurance than you need to provide for your loved ones. Q. Can I return my Health Insurance policy? A. Yes. Of course. Some few Health
Insurance Companies offers a “free Look” or evaluation period which varies
from 10 to 30 days (depends upon the health insurance company you choose).
If you are not comfortable with the policy you can return it back and
can request a full repayment of the premium paid. Health Insurance companies
offering employer group plans do not have a "free look" period.
Q.I’m planning to keep working after age 65. Will I be covered by Medicare or by my company’s health plan insurance? A. If you work for a company with 20 or more employees, your employer must offer you (through age 69) the same health insurance plan offered to younger employees. After you reach age 65, you might select between Medicare health policy and your company’s health insurance plan as you are the primary insurer. If you choose to remain in the company health insurance plan, it would pay first—for all benefits covered under the health plan—before Medicare is billed. In most instances, it is to your advantage to accept continued employer health plan coverage. But be sure to enroll in Medicare Part A, which covers hospitalization and can supplement your group health insurance at no additional cost to you. You could save on Medicare premiums by not registering in Medicare Part B until you finally retire. Remember, that delayed enrollment is more costly and entails a waiting period for coverage. Q.I’ve had a serious health condition that appears to be stabilized. Can I buy individual health insurance coverage? A. Depending on what your condition is and when it was analyzed and treated, you could probably buy health insurance coverage. However, the insurer might do one of three things: • Provide full protection but with a higher insurance premium,
as might be the case with a chronic disease, such as diabetes; Q.One of my medical bills was turned down by the Health Insurance Company (or health plan). Is there anything I can do? A. Ask your health insurance company why the claim was rejected. If the answer is that the service isn’t covered under your health insurance policy, and you’re sure that it is covered, check to see that the health provider entered the correct diagnosis or procedure code on the health insurance claim form. Also check that your deductible was in the approved manner calculated. Make sure that you didn’t skip an essential step under your health insurance plan, such as pre admission certification. If everything is in order, ask the insurer to review the claim.
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