Health insurance is a contract between you and an insurance company, where you pay a premium (regular fee) in exchange for coverage of medical expenses.
When you need medical care, you visit a healthcare provider, such as a doctor, hospital, or clinic, and they bill your insurance company for the services provided.
The insurance company pays a portion of the medical expenses covered under your plan. The remaining portion is typically your responsibility, either as a copayment or coinsurance.
Health insurance plans often have a deductible, which is the amount you must pay out of pocket before your insurance coverage kicks in.
Once you meet your deductible, your insurance will start paying for covered services according to your plan's benefits.
Some health insurance plans have networks of healthcare providers. Visiting in-network providers usually results in lower out-of-pocket costs, while out-of-network providers may be more expensive.
Health insurance plans may cover various medical services, including doctor visits, hospital stays, prescription drugs, preventive care, and more, depending on the plan's benefits.
Some plans may require pre-authorization for certain services or medications, meaning you need approval from the insurance company before receiving the care.
Each health insurance plan has a maximum out-of-pocket limit, the most you'll have to pay in a year for covered services. Once you reach this limit, the Company covers 100% of the remaining expenses.
To use health insurance, review your plan's benefits, understand its limitations, and keep track your medical expenses and claims to ensure you receive the coverage you need while managing costs.