MEDICAL/ HEALTH INSURANCE

WHAT IS MEDICAL/HEALTH INSURANCE

As the cost of medical treatment escalates, it is advisable to transfer this risk to an insurance company which would take care of the treatment and drugs of your employees. The spouses and dependents i.e. either one or two children under 18 years are covered under this policy. Some insurers offer 100% refund for outpatient service and bear 75% of the cost for inpatient/ hospitalisation, whilst the remaining 25% is borne by the employer.

The level of benefits is fixed by the employer. Some insurers charge an additional 10% of the premium for pregnancy and related illnesses. The insurers retain a panel of highly qualified doctors and specialists and members of their schemes have access to a list of pharmacies.

It is also coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment.

The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.

Health Insurance is a contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (e.g. an employer or a community organization). The contract can be renewable (e.g. annually, monthly) or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans.

The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or "Evidence of Coverage" booklet for private insurance, or in a national health policy for public insurance.

TYPES OF INSURANCE

There are two main types of health insurance

• Private health insurance
• Public or government health insurance