Health and Dental insurance

Health Insurance Contracts

Health insurance is coverage that pays for your medical expenses. It is sometimes used to provide long-term nursing care, or disability cover. It is a contract between you (or sponsor) and your insurance company. The contract can by renewed monthly or annually.

You can obtain health insurance from a private insurance company or a government sponsored social insurance program. You can buy it on a group basis which is what companies do to cover their employees or you can buy it individually. You then pay taxes or premium to help protect you from high or unforeseen medical expenses.

The type of procedures and amount of health care expenses will be specified in the insurance contract.

Some Employee benefit plans in the US offer additional benefits such as Prescription drug plans. With this form of insurance, part or the whole balance for drugs covered in the agreement of the plan will be paid directly by the insurer or by reimbursement of a proportion of the charge.
Most health care providers will have the patients sign an agreement stating that the patient will be responsible for the excess amount that is not covered by the insurance company. Sometimes the professional fees that the health insurer is willing to pay the network provider are less than the provider’s normal fee. The provider could agree to the discounted rate and he will have a separate contract for that.

Dental Insurance Contracts

The goal of having dental insurance is to help alleviate dental care expenses. Dental treatments could cost $300/year for regular dental hygiene visits to $25,000 for more advanced dental procedures or cosmetic surgery. Dental insurance plans offer specific benefits intheir field of coverage.

Dental insurance plans have a limit on the number of radiographs, dental visits and treatments. Some services and procedures may not be covered. Most plans reimburse patients if they choose the least costly alternative treatment. Some plans don’t cover treatments for pre-existing conditions.

There are several insurance plans available. Indemnity plans lets you choose your own dentist. With this plan you will pay a flat fee for a visit to the dentist but you’ll have a limit on the coverage annually. Some coverage limits are applicable to single dental procedures. Self-Insurance Plans are like indemnity plans without being able to choose your own dentist. Closed Panel Plans only allow you to use a specific group of facilities and the number of dentists available may be limited. Capitation Plans assign definite dentists for interval of treatment. With this plan the dentists will get their payment even if the dental treatment is not required. Preferred Provider Organization (PPO) plans are limited to a network of dentists that offer dental care and a reduced rate. Direct Reimbursement Plans lets employers repay their employees for the dental services they get. Dental Care Service Plans uses dentists in a non-profit organization that offers dental services at pre agreed fees.

With so many plans and levels of coverage, it is important to ask your dentist about the costs involved. The level of reimbursement offered will vary in each dental insurance plan.