When it comes to your health insurance, it might be tempting to ignore the “fine print”, but it really is important to be familiar with the detail in your policy. If not, you may find yourself with out-of-pocket expenses that you had not bargained for.
Scope of cover
The cover that you will get in your policy depends on what is detailed in your plan. Below are samples of what may be covered in your health insurance plan:
- Major Medical: coverage for major injury or illness.
- Surgical: coverage for surgery and the surgeon’s fees.
- Physician’s expenses: doctor’s fee coverage.
- Hospital: for fees incurred during a hospital stay.
- Prescriptions: known as the “formulary list” on your policy, this covers you for certain medication costs.
- Other coverage: providing coverage for vision, maternity, mental health and preventative care.
What you may need to pay:
Depending on your particular policy, you may need to contribute a certain amount towards the cost of your medical care, including:
- Deductibles: the amount you must pay before coverage kicks in. This is usually an annual figure.
- Co-payment: a fee for services which you must pay when accessing health care.
- Co-insurance: the percentage of insurance you agree to pay. Typically this is around 20%.
Other stipulations
It’s also important to know what other limits apply in your plan, such as a lifetime maximum. In any event, make sure to understand the finer detail in your prospective Group benefits in Dallas before you commit yourself to the final purchase.
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