UNDERSTANDING GLOBAL HEALTH INSURANCE COVERAGE TERMINOLOGY AND PLANS

DEDUCTIBLE IS NOT A DIRTY WORD
INSURANCE WAIVERS/RIDERS, RATE-UPS, & CAPPED COVERAGE
WHAT'S A “RIDER”? WHAT'S A “WAIVER”?
PRE-EXISTING CONDITIONS
WHAT'S A “PRE-EXISTING CONDITION”?
EXCLUSIONS
WEIGHT, WEIGHT CHARTS AND HEALTH INSURANCE
AGE AND INSURANCE PREMIUM
UNDERWRITING - WHAT IS IT?
TRIP OR HEALTH INSURANCE -- WHAT'S THE DIFFERENCE?
AMERICAN PPOs & HMOs - WHAT'S THE DIFFERENCE?
HIPAA / PORTABILITY INSURANCE
THE DIFFERENCE BETWEEN AN INSURANCE BROKERAGE & AGENCY
WHAT IS A “CERTIFICATE OF INSURANCE”
THE “PRE-EXISTING CONDITION” PROBLEM?
WHAT IS CO-INSURANCE?
UNDERWRITING AT THE POINT OF APPLICATION
HOW DOES AN INSURANCE COMPANY DETERMINE PREEXISTING CONDITIONS?
WHAT TO DO WHEN THE WEIGHT CHART SAYS YOU AREN’T TALL ENOUGH?
WHY USE A BROKER OR AN AGENT? HOW MUCH DOES IT COST?

DEDUCTIBLE IS NOT A DIRTY WORD

HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations), to say the least, are not the best of friends! One thing HMOs do in their marketing is to claim that they have "no deductibles." Of course this is a slam at PPOs that have deductibles. Yet HMOs don't mention that if a client goes into the hospital on many of their policies there is a co-pay of $250 or $500. This large co-pay in some ways is similar to and often larger than some deductibles.

Also, most people don't realize that even though you may have a $500 deductible with a PPO you still have small co-pays if you visit a doctor. Generally, the doctor's office visit, lab work, and x-rays are all covered with just the co-pay with no extra charge to the insured. This is very similar to how HMOs work.

So, when does the deductible kick in? Usually for outpatient surgery, emergency room, and in- hospital stays.

"Deductible" is not a dirty word. In many ways it is just a variation of a large co-pay.

Most international policies are "classical" PPOs, and, according to my knowledge, none have co-pays. They could all be classed as “traditional” insurance; that is insurance that works from a deductible, co-insurance, and then total coverage.

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