It is very poor that only about 9% of Nigerians have health insurance cover. I do hope we all understand how important it is very every one of us to have a health insurance policy. Anyways there are different types of health insurance and today I will be writing on 2 categories of health insurance in terms of coverage.
1) The Fee-For-Service Insurance Coverage.
The health care service providers(hospitals, clinics, pharmacy, physicians, etc) are paid for sevices they render to a policyholder. You're hot bound to an insurance company to stick to any health care provider.
Limiting factors for Fee-For-Service.
a) Deductible: this is the mandatory amount in percentage imposed on the policyholder by the insurer to bear in the event of the medical bill or medical expenses. Deductibles deal with a specific period of time.
b) Coinsurance: it is a bit similar to deductibles. Here, the policy is implemented a specifically for the policyholder to bear a part of the medical cost.
c) Limited coverage: it is not all sickness that is insurable, everything is not provided for under this policy e.g pregnancy, childbirth.
Advantages for Fee-For-Service.
a) You can choose any doctor or hospital of your choice.
b) You can continue treatment with the same hospital even if there is a change in occupation or give or change of insurance companies.
c) There is no fear of insurance companies administering health care service providers to recommend substandard treatment.
2) Managed Plan.
They provide health insurance coverage for its members and o use health service providers that have a contract with the plan. The access to any medical health service providers will be made known to the policyholder by a body known as the HMO(health maintenance organization). They bring the contractual agreement between the insurer and the person who is to access a health service provide.
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