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Health Insurance: A Primer
As with any insurance, a health insurance policy is a
contract. You make set payments, and if you need
medical coverage, the insurance company will pay the
costs. Although this sounds simple enough, health
insurance has many versions and options. Richard
Cayne of Meyer International wants to make sure that
you understand the various options that you should
consider when selecting coverage.
What You Will Have to Pay for a
Health Insurance Policy:
The following are costs that you as the policyholder will
be responsible for. When selecting coverage, it is
important to consider all these and keep in mind that
the more you pay, the more coverage you may be able
to purchase.
Premium
Co-payment
Deductible
Premium
This is the amount you pay for the policy. It is usually
monthly and depends on the type of coverage.
Co-payment
If your policy has this option, you will be responsible
for paying this amount, normally for doctor visits and
sometimes for filling a prescription.
Deductible
A way to lower premium costs is to have a higher
deductible. This is the amount that you are willing to
pay yourself before the insurance company starts
paying your medical bills. Co-payments are often not
counted towards this amount.
Richard Cayne says:
Consider not only how much you can budget a month
for coverage, but also how you can or are willing to
spend if you need a doctor’s care. For example, you
may want to think about a higher deductible if you are
reasonably healthy. Your premiums will be lower, and
you can sometimes negotiate higher levels of care.” To
continue this discussion, contact Richard at Meyer
International.
What You can and cannot Get with
your Healthcare Policy
Out of pocket maximums
Exclusions
Pre-existing condition
Prior authorization
Coverage limits
Out of Pocket Maximums
This is when an upper limit is set for how much you
have to pay for certain services. Once it is reached, the
insurance company will start paying.
Exclusions
In many cases, the insurance company will not cover
certain treatments, and you will be responsible for
paying for them.
Pre-existing Condition
If you have a medical condition before you purchase
the policy, the insurance company often will either not
cover any expenses related to it or raise your premium.
Prior Authorization
For certain treatments or procedures, you will need to
get it approved first, but once obtained, the insurance
company is obligated to pay for them.
Coverage Limits:
Some policies will only pay up to a specific amount for
specific types of care. After this ceiling is reached, you
will have to pay for all subsequent bills.
Richard Cayne: “Insurance companies are
obviously going to try to get as much from you for as
little as possible. You need to be very careful and make
sure you understand all the exclusions and loopholes
so that you don’t end up paying for insurance that
won’t pay for most of your medical needs.” To
continue this discussion, please contact Richard at
Meyer International.
Meyer International Ltd
399, Interchange 21 Building, 23rd Fl., Unit 3,
Sukhumvit Road, Klongtoey-Nua,
Wattana, Bangkok 10110
Thailand
Tel: + 66-(0)2-611-2561-3 / +81-(0)50-5539-1501
Fax: + 66-(0)2-611-2564 http://meyerjapan.com
Contact us

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Health Insurance: A Primer

  • 1. Health Insurance: A Primer As with any insurance, a health insurance policy is a contract. You make set payments, and if you need medical coverage, the insurance company will pay the costs. Although this sounds simple enough, health insurance has many versions and options. Richard Cayne of Meyer International wants to make sure that you understand the various options that you should consider when selecting coverage.
  • 2. What You Will Have to Pay for a Health Insurance Policy: The following are costs that you as the policyholder will be responsible for. When selecting coverage, it is important to consider all these and keep in mind that the more you pay, the more coverage you may be able to purchase. Premium Co-payment Deductible
  • 3. Premium This is the amount you pay for the policy. It is usually monthly and depends on the type of coverage.
  • 4. Co-payment If your policy has this option, you will be responsible for paying this amount, normally for doctor visits and sometimes for filling a prescription.
  • 5. Deductible A way to lower premium costs is to have a higher deductible. This is the amount that you are willing to pay yourself before the insurance company starts paying your medical bills. Co-payments are often not counted towards this amount.
  • 6. Richard Cayne says: Consider not only how much you can budget a month for coverage, but also how you can or are willing to spend if you need a doctor’s care. For example, you may want to think about a higher deductible if you are reasonably healthy. Your premiums will be lower, and you can sometimes negotiate higher levels of care.” To continue this discussion, contact Richard at Meyer International.
  • 7. What You can and cannot Get with your Healthcare Policy Out of pocket maximums Exclusions Pre-existing condition Prior authorization Coverage limits
  • 8. Out of Pocket Maximums This is when an upper limit is set for how much you have to pay for certain services. Once it is reached, the insurance company will start paying.
  • 9. Exclusions In many cases, the insurance company will not cover certain treatments, and you will be responsible for paying for them.
  • 10. Pre-existing Condition If you have a medical condition before you purchase the policy, the insurance company often will either not cover any expenses related to it or raise your premium.
  • 11. Prior Authorization For certain treatments or procedures, you will need to get it approved first, but once obtained, the insurance company is obligated to pay for them.
  • 12. Coverage Limits: Some policies will only pay up to a specific amount for specific types of care. After this ceiling is reached, you will have to pay for all subsequent bills.
  • 13. Richard Cayne: “Insurance companies are obviously going to try to get as much from you for as little as possible. You need to be very careful and make sure you understand all the exclusions and loopholes so that you don’t end up paying for insurance that won’t pay for most of your medical needs.” To continue this discussion, please contact Richard at Meyer International.
  • 14. Meyer International Ltd 399, Interchange 21 Building, 23rd Fl., Unit 3, Sukhumvit Road, Klongtoey-Nua, Wattana, Bangkok 10110 Thailand Tel: + 66-(0)2-611-2561-3 / +81-(0)50-5539-1501 Fax: + 66-(0)2-611-2564 http://meyerjapan.com Contact us