jump to last post 1-3 of 3 discussions (7 posts)

The functions of a Health insurance policy

  1. laswi profile image60
    laswiposted 6 years ago

    A health insurance policy is designed by an insurance company for a particular period of time according to the requirements of the purchaser of the policy. It is renewable annually or monthly.


    A health insurance policy is a contract between the insurance company and an individual or his sponsor such as the employer or a provident or other fund etc. The type of expenses and amount of health care costs which will be covered by the insurance company and exclusions to the policy are specified in the policy document.

    http://hubpages.com/hub/Health-insuranc … w-it-works

    1. 59
      Patrick Oliverposted 6 years ago in reply to this

      I think the statement misses the point that an insurance policy is also designed to make profits for the Insurance Company.  Well, nothing wrong with that; if you have the money to buy insurance you can get good treatment.  But, from what I  read, millions of Americans cannot afford the insurance and do not get the treatment they need.  Which casts a poor reflection on a very rich country.
      Fortunately, in Britain health treatment is available for everyone, from the baby to the octagenarian, on the National Health: your income, or lack of income, makes no difference, it is financed out of general taxation.  The National Health was created by the first government after the war and is so good and popular that every political party here supports it.

    2. AlbertBrend profile image62
      AlbertBrendposted 6 years ago in reply to this

      Private health insurance rates take into account many factors including age, gender, medical conditions etc. Besides, if individuals maintain good health or improve on their health, they can also reduce on their private health insurance rates. It also differs depending on the difference in medical expense in different areas.

      Private Krankenversicherung Rechner

  2. Lynda Gary profile image60
    Lynda Garyposted 6 years ago

    The ONLY purpose of a health insurance company is to make money.  The ONLY way they make money is by rejecting claims.

    It's the most effed up system we have.

    1. 0
      Poppa Bluesposted 6 years ago in reply to this

      Well that isn't the only way they make money, and they don't make a lot of money either! The average profits of the HMOs is about 3.5% compared to say Microsoft which is about 24%!

      As far as denial of claims, well that is a problem, unfortunately it isn't just a problem with health insurance companies, Medicare denies about 6% of it's claims more than any of the HMOs!

      My personal experience was with the VA which denied me a prescription that nearly cost me my life, because of the cost.

      Now if you think Canada has great health care, and I'm sure the Canadians here will argue they do, then why did the Prime Minister of Newfoundland go to Florida for heart surgery?

      Are there problems with our system? Yes, but the plan that Obama is purposing won't fix them and for most it will make things worse. Please take some time to look at the senate bill, you will be shocked at the scope!

    2. Bill's Ideas profile image59
      Bill's Ideasposted 6 years ago in reply to this

      You may be right, but now the government will be rejecting claims. Now they will  have the power to get into every thing we do now. Which is better, the insurance companies or the government? I do not like either one but I do not like the government getting involved.

  3. mcrow profile image61
    mcrowposted 6 years ago

    First off, I'd like to say that there are way too many people that demonize insurance companies. 99% of claims are executed exactly as the patients policy state they will be. Of that 99% of that 1% that is left are errors that can be corrected. That very small amount of remaining claims are cases of fraud on either the patients or insurance company.

    As pointed out earlier, insurance make profits that are so small that most other types of businesses would simply refuse to do bisness and close the doors.

    If insurance companies were required to cover everyone, for everything and could never deny a claim we'd all have to either go without insurance or be on a governemnt program.

    Medicare pays only between 80% and 103% of the health care provider's cost for the services. That means that they are taking a a loss of 20% on some services. This means that that hospitals and clinics have no choice but to increase the charges for commercial insurances, which intern raises costs of insurance. With a profit margin of less than 4% the insurance companies can't absorb increases, they have to pass them on.

    Obama's plan is already calling for a cut in medicare pay rates. This alone will increase commercial insurance rates. Then, he wants to tell them that they have to cover high risk people and then tell them how much they can charge for a premium. It just not add up. You increase charges to insurance companies, decrease the amount they can charge for premiums,  and then force them to cover high risk people who cause the overall amount of money paid to claims to skyrocket.

    I don't work for an insurance company but the way things are going, the insurance companies will start dropping like flies over the next 10 years.