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The Way Health Care Insurance Works

Health care insurance is a contract about between the policies holder and insurance company to cover several or full medication expenses with certain amount of premium payments. This definition can be applied in private company, where people pay certain amount of money to insurance company for premium health care coverage.

In public health care insurance, people who are registered as citizen, permanent resident or temporary residents who lives more than one year have rights to receive healthcare coverage where the fund are organized by federal, or provincial government. Some countries provide this coverage free of charges and no salary payment cutting, but several countries also cut small percent of salary and levy adjustments as the insured payment.

What should we know about health care protection?

Premium

Premium is certain amount of money that the insured or sponsor (for employee insurance) must pay for the health care coverage. The premium might vary depend on the coverage.

Coverage limits

The insurer has set the payment limit for coverage. This limit is a maximum fund usage for the insured for certain medical treatment and hospital services. The insurance company will stop paying after the insured reach maximum limit of medication coverage, and the insured should pay the rest of the expenses by themselves.

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Exclusions

It is a special case treatment which can’t be covered by the insurance companies. There are different standards for this exclusion depends on the premium payment and the insurance company. In general, aesthetic medication is applied as exclusion in most insurance policies.

Capitation

Is amount of money that insurance company should pay to medical or health care providers that provides the services noted in the policies agreements.

Deductible

It is a liability that insured must pay before the insurer pays the share. Deductible usually paid annually, or depends on the agreement. In some countries, the deductible lasts for 3 months. After that, the insured can use this insurance as their health care coverage, while in others deductible might last for a year.

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