Health Insurance- Coverage Types
health insurance is the best plan for most insured. In general no proof
of insurability is required to participate, where many insured may not
be covered otherwise. Under group plans the cost of services is negotiated
to be the lowest and the coverage is considered good
may or may not offer coverage for family members of the insured. It
is up to the group administrator or the employer benefit department
to set the coverage policy
group health plans cover medical services and prescription drugs. Dental
and Vision coverage may be offered as an additional benefit.
administrators may pay part of the premium cost as a benefit to the
group members, where the insured pay their share of the cost.
- When insured
terminates the relationship with the group, a special law allows keeping
the group plan with same coverage for a certain time. The insured has
to provide with the full premium cost.
Individual Health Insurance
health insurance is the alternative to the group health insurance. It
is offered to individuals and their families under certain conditions.
of individual health insurance are:
- The cost
of individual plans may be significantly higher compared to group insurance
plans, for the same coverage
drugs may be offered with additional cost
- The proposed
insured has to be medically qualified for the individual plan. Pre-existing
conditions (smoking, chronic diseases, medications taken, over weight,
pregnancy and many other conditions) may result in higher premiums or
- If insured,
pre-existing conditions are typically not covered for certain time or
may not be covered at all.
deductible fees are likely.
- If there
is a gap in health insurance coverage, it may result in rejection.
insurance may terminate coverage or raise premiums under the local state
regulations to insured with recently diagnosed medical conditions
Serving these areas: CA, DC, FL,
MD, NJ, NY, PA, TX, VA , WA