Health Insurance: It's Important To Know What's Not Insured!

Friday, October 15, 2010

Health Insurance: It's Important To Know What's Not Insured!

About 7 million people in Britain are by health insurance, mostly covered by their employers. The problem is that few have really studied their policy documents and much to understand what is covered. And perhaps as important, what is not. If you plan to pay health insurance for all health care costs, you're wrong.

Health insurance is designed to provide protection to the problems of healing, provide short-term health and go up a policyholder to the NHS queues to see consultants diagnosed, by surgery or treatments. Sounds good, but before you buy what you about treatments and situations that are beyond the scope of coverage must enjoy.

But first a warning. This article does not refer to a specific policy and terms of individual insurance companies issued point vary. So please remember to consult the guide. After reading this article you will know what to look!

Sorry - is a chronic disease

If a disease is curable and is not a problem in the long run, your insurance should be classified as property and to cover the costs. If your problem is incurable, or is it a problem that be for a longer period despite appropriate treatment with you, then your insurance will be classified as chronic - and no, it will be covered.

However, drawing a clear line between what is serious and what is problematic chronic and leads to the largest area of conflict between the insurer and the insured.

Everyone agrees that diabetes and asthma are chronic diseases and likely to suffer from them for the rest of his life. So what kind of conditions are not covered.

Problems arise when the medical team initially considered the disease a patient cured, but the condition deteriorated and the doctors later change their minds now become incurable. This can occur especially in the treatment of certain cancers.

Under these circumstances, the condition is initially defined as acute and thus insured, but deteriorates and becomes chronic - and outside of the plan. This is possible because the insurer the right to keep a state of acute to chronic classified during treatment.

Sorry - long term
The insurance will not pay for long-term treatment. But you should check your policy documents to see how you define "long term". You will find the situation where pay a number of drugs to extend the 12 months, but the insurer only for ten months.

Sorry - is preventive
Your insurance will pay for the treatment and cure of conditions when they occur. It is not designed for treatments that are used to pay in order to prevent disease.

Once again the problem arises from the definition. Sometimes one wonders whether a treatment is the cure or prevention. Take the drug Herceptin, for example. This medicine may in the early stages of breast cancer are used. Research shows that Herceptin can halve the incidence of recurrence of cancer in women with a particularly virulent form of cancer called HER2. In this situation, is Herceptin offers a cure or prevention?

Insurance companies are divided into the debate. Norwich Union, is WPA, BUPA and Standard Life Healthcare is not for Herceptin for HER2 patients pay Legal and General and Axa PPP.

Sorry - the product is not approved
Two of the main attractions make the health insurance: the queues at the NHS to jump, and get the latest treatments and medications. But he is a racer.

If the drug for use by the NHS in England and Wales for the Institute for Health and Clinical Excellence approved, your insurance is unlikely to approve its use. The problem is that the memory to decide on the institution is not simply whether a drug is effective, but carry on a cost-benefit analysis to ensure that the benefits outweigh the costs outweigh the nation's use in the NHS . This is a short and simple - and has placed the Institute under the control of the long delays in approving drugs.

Commitment by the Financial Ombudsman is concerned that if a health policy will not pay for the use of experimental treatments, he has admitted the cost of a conventional treatment with the insurance coverage will pay the bill for balance if the experimental treatment is more expensive.

Sorry - is a pre-existing condition

The basic principle is that if you suffer from a disease to initiate a policy, then the condition "pre-exists" the policy and the claims for its treatment are invalid.

For this reason insurance companies exist to complete an extensive questionnaire before they insure themselves. Finally, they need a clear idea of their health before they are cited. Writing for many applications, the insurer with its consent, even with your doctor for details of your medical history. They love to have a complete picture.

So let's say that a few years ago, injured his knee playing football. It seems to recover, but now he has torn cartilage and needs surgery. The insurer could argue that this is a pre-existing condition and you have to pay for his "treatment.

Some insurance companies try to take account of this gray area with a moratorium provision in your policy. These rules may say that if you are symptom free for two years in another state which has suffered in the past 5 years, then they will pay for further treatment. Not all measures that the moratorium provisions and conditions vary between insurers. You must read your policy.

Sorry - not your cover

Health insurance is an annual contract - just like your car insurance. So when it comes to renewal, the insurer is free to take into account not only the premium, but also the conditions under which coverage is provided.

So if your policy is renewed, halfway through a course of treatment, you may find that your new policy no longer covers that particular treatment. This means you will pay the bill for the balance of the treatment.

Moreover, with continued progress in medical research, the growing conditions are more treatable. This development has the effect of moving behind the line of demarcation between acute and chronic diseases.

He hits the pockets of the insurers in two ways. More could be reclassified as acute, the number of applications increases. And there is a tendency for more expensive new therapies - Herceptin is a good example. The result is that insurers find themselves paying much more. This topic has been moved back to you through increased renewal premiums. And in an attempt to reduce their risk, insurers tend to adjust their definitions and exclusions. This means that you read your renewal notice carefully before deciding on the extension.

So if you are considering health insurance, bear in mind that not everything is black and white. And if you require insurance and treatment, always by your insurance instantly and receive confirmation that your treatment is in fact covered.

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