Insurance plans that cover weight loss surgery
This article is about the risk management method. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain. annually, monthly) or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. The amount of money charged by the insurer to the insured for the coverage set forth in the insurance policy is called the premium. e. A co-payment must be paid each time a particular service is obtained. By estimating the overall risk of health care and health system expenses, among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. Health insurance is insurance against the risk of incurring medical expenses among individuals. Separate insurance contracts (i. The Babylonians developed a system which was recorded in the famous Code of Hammurabi, c. g. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. The specific benefits or coverage details are found in the Summary Plan Description (SPD). an employer) pays to the health plan to purchase health coverage. Property insurance as we know it today can be traced to the Great Fire of London, which in 1666 devoured more than 13,000 houses. Insurance is a means of protection from financial loss. g.
, insurance policies not bundled with loans or other kinds of contracts) were invented in Genoa in the 14th century, as were insurance pools backed by pledges of landed estates. Insurance became far more sophisticated in Enlightenment era Europe, and specialized varieties developed. The loss may or may not be financial, but it must be reducible to financial terms, and must involve something in which the insured has an insurable interest established by ownership, possession, or preexisting relationship. Merchants have sought methods to minimize risks since early times. 1750 BC, and practiced by early Mediterranean sailing merchants. This allowed groups of merchants to pay to insure their goods being shipped together. An advertising poster for an insurance company from ca. Premium: The amount the policy-holder or their sponsor (e. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity. A person or entity who buys insurance is known as an insured or policyholder. 1900-1918 depicts an armoured knight. ERISA plans are governed by federal law under the jurisdiction of the US Department of Labor (USDOL). An entity which provides insurance is known as an insurer, insurance company, or insurance carrier. Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. The contract can be renewable (e. The company generally advertises that they have one of the big insurance companies. If the insured experiences a loss which is potentially covered by the insurance policy, the insured submits a claim to the insurer for processing by a claims adjuster. The insured receives a contract, called the insurance policy, which details the conditions and circumstances under which the insured will be financially compensated. Therefore, ERISA plans are not subject to state laws.
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