Medical Insurance 101: The Beginner’s Guide
Our ‘Oneplan’ is to ensure that you understand the world of health insurance so that we can provide you with the necessary coverage. Test your knowledge with the ultimate beginner’s guide to health insurance.
Deductibles, premiums and copayments. Welcome to the jargon-heavy world of comprehensive health insurance. Wow, and to think that we found AP maths difficult. The great thing is that we here at Oneplan don’t expect you to be an expert in health insurance lingo. That is our job! In fact, we prefer it that way. We have years of experience in this space, meaning we know our stuff. And it is time that you do too. So, let’s get started on the ultimate guide to health insurance. After all, knowledge is power, right?
What is health insurance?
In order to get a handle on health insurance, we need to understand what it is. Defining it seems like a good place to start. Health insurance is a type of insurance coverage (yes, there are types of insurance and we do more than one. Check them out here). Health insurance covers the costs of medical and/or surgical expenses that you may incur. Basically, all financial burdens that relate to your health are taken off your shoulders and put on ours. This form of medical servicing can be from dental to visual coverage and everything in between – we do it all.
So, you would essentially take out the amount of coverage that you would like, agree to a specific rate for that policy and voila. In return, we (the insurance company) will pay a percentage of your medical expenses. Why do we do this? Because you shouldn’t have to bear the costs of being sick. You should focus on your recovery. We’ll stress about the finances.
Do I really need health insurance?
You’re young, healthy and regularly make use of your gym membership. Not to mention that your grandparents are still thriving, even at the age of 80. So why would you bother getting health insurance? The odds seem to be in your favour.
Now while you may see this as an unnecessary expense, it is actually a necessity. Everyday healthy people experience health-related illnesses or injuries. Maybe you pulled a muscle showing off at the gym or need a few stitches or even surgery? You’ll want to have the peace of mind knowing that the medical bill is not your worry … that this bill is on us!
We have seen the stats, medical bills and the increasing amount of medical debt. It isn’t pretty. Even minor procedures can break the bank, and there is no reason for you to be dipping into your savings to cover these costs. To put it bluntly – choosing to opt-out of health insurance is an expensive choice. Our job is to ensure that you are able to manage the costs of healthcare.
Okay, I need it – so what do all those insurance terms mean?
You have decided to join the Oneplan health insurance family (congrats!) and you’re ready for our team to send you a personal quote. Now while we couldn’t be more excited, we promised to share a little more knowledge with you first.
Let’s look at the top 5 insurance terms that our team will be using most. They are obviously more than happy to explain these terms to you, and probably will, but it’s comforting knowing that you have prior knowledge. Also, brownie points for mentioning that you read our blogs.
Your premium is the amount that you will pay every month for your health insurance. It is important that you see this payment as more than just a monthly debit order. It is your means to exclusive private healthcare services. This premium also grants you access to some of the top medical practitioners in the country.
Premiums also work on a ‘what you put in, you get out’ basis. This means that the higher your premium, the more comprehensive your cover. The lower your premium, the more likely you will need to have some out-of-pocket funds.
Your deductible is the amount of money that you will need to pay out-of-pocket before your insurance kicks in. This amount is paid forward for covered procedures. Meaning that we will be covering the medical expense at the end. All you need to do is log the claim and we will take it from there! Again, the higher your premium, the lower the deductible and vice versa.
Your co-payment or “copay” is the fixed amount that you will need to pay for specific prescription medication or services. This is where we will split the cost with you once you have hit your deductible. Simply put, a copay is a form of cost-sharing between you and our insurance team.
We will let you know ahead of time, how much you will need to contribute and then we will take care of the rest.
This pretty much works exactly like your co-payment where we split the costs with you. The only major difference is that co-insurance is not a fixed amount. It is actually a percentage. Instead of a fixed amount, you will need to pay a percentage towards covered services. Need an example?
If your coinsurance is 30%, you will contribute that percentage of the service costs up until the point that you reach your out-of-pocket maximum.
Your insurance claim is, at its most basic level, a request for payments after incurring a medical expense. You will then file this claim, await the approval and then be reimbursed by our team. What’s better is that our claims process is incredibly simple and easy to follow. This ensures that you get your money back into your account – where it belongs.
One of the most important investments that you will make is in comprehensive health insurance. Make sure that you are able to rely on the support and knowledge of industry experts. Our team will work tirelessly to ensure that you make the best medical decisions of your life, without breaking the bank. Why? Because you deserve it.
Yours in affordable health insurance,