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Posts Tagged ‘deductible’
Friday, December 5th, 2008
Insurance benefits and terms can be tricky to understand at first even to seasoned insurance buyers. However, it’s important to understand fully what your policy covers and doesn’t cover. If you don’t, you may be caught in a situation where your policy doesn’t cover it and you may have a high medical bill to pay all yourself.
Let’s take for example, maternity benefits. These benefits will vary in most insurance policies you look at. Some policies may cover it after a 12 month waiting period, some may cover it right away and others might not cover it at all. You also want to make sure how much it covers and what the actual limit it is covered up to. For instance, the Citizen Secure policy offers maternity benefits after 12 month of continuous coverage. Covered maternity benefits include pre-natal, delivery and post-natal care. The insurance company will pay 50% of the next $100,000 worth of eligible expenses after the deductible, then 100% to a lifetime maximum of $250,000. On this policy the deductible is per certificate period and you must meet it before the insurance company will pay towards your eligible expenses. You will also have coinsurance if you choose not to go within the PPO. If you choose to go within the PPO, then you would have 0% coinsurance.
Maternity benefits for the Student Secure policy are quite different. If you are not pregnant before the policy is effective, then you receive full maternity benefits from the first day your policy starts. Covered maternity benefits include but are not limited to pre-natal, delivery and post-natal care as well as expenses for miscarriage and complications of pregnancy. Like all benefits on this policy, maternity benefits are first subject to the deductible and coinsurance. The deductible for this policy is $100 per injury or illness. Coinsurance is dependent upon which level you purchase. On the budget level, the insurance company will pay 80% of the next $10,000 worth of eligible expenses (after the deductible), then 100% to the overall limit ($250,000). On the select level, the insurance company will pay 100% of eligible expenses (after the deductible) up to the overall limit ($300,000) if you go within the PPO or to the student health center.
Finally, the Atlas Travel series policy does not offer maternity benefits. However, if you are already pregnant then this may be the only option we offer. The Atlas series does offer coverage for complications of pregnancy up to the 26th week. This is defined as illnesses whose diagnoses are distinct from pregnancy, but are adversely affected by pregnancy or cause by pregnancy, and not associated with a normal pregnancy. Like the other two plans, benefits are subject to the deductible and coinsurance. With this policy, you have the freedom to choose your deductible (ranging from $0 up to $2,500) and your policy limit (from $50,000 up to $1,000,000). Coinsurance is 100% of eligible expenses while outside the U.S. and inside the U.S. (if you go within the PPO).
Tags: atlas insurance, citizen secure, coinsurance, deductible, insurance terms, maternity, PPO, pregancy
Posted in Insurance Explained, Product Information, Student Insurance | No Comments »
Monday, November 26th, 2007
Almost all health insurance plans have a deductible or co-payments. A deductible is the amount the insured (you) must pay before the insurance company will pay towards your expenses. And a co-payment is the amount that you also must pay out of your own pocket; although a co-payment is typically a per service fee or per doctor office visit. For some plans, you will find that they have both a deductible and a co-payment. Usually with these plans, the deductible is for your larger expenses (i.e. emergency room visits, hospitalizations, diagnostic testing) and co-payments are for smaller expenses (i.e. doctor office visits, prescription drugs, etc.). Most domestic health insurance plans are typically set up in this manner. However, for international students some or most health insurance plans out there have a deductible that applies to the entire plan. In this case, it would apply to doctor visits, prescriptions, tests, hospitalizations, surgery, etc. The insurance company would not start paying towards your expenses until you’ve met the deductible.
So, how does this affect you? Well, let’s say you went to the doctor for a minor sickness (i.e. cold, flu, etc.). When you first purchased your health insurance plan you choose a higher deductible, $2,500, to offset the premium cost each month. If your plan only has a deductible and is not a co-pay type plan then you would pay the full amount of your visit out of your own pocket. You would need to pay the first $2,500 worth of eligible expenses in order for the insurance company to start paying towards it. On the other hand, let’s say you got injured and you needed to go to the emergency room. After all of your tests, MRI’s and doctor consultations your bill totaled $10,000 (assuming all are eligible expenses). This means that you will pay the first $2,500 of your $10,000 bill. After that, it depends on the way your health insurance plan is setup and whether or not it has coinsurance. Coinsurance is usually a percentage that you are required to pay after the deductible. Let’s say for example purposes your plan had 80/20 coinsurance up to $5,000 (all eligible expenses) then 100% coinsurance up to the overall limit. After the $2,500 deductible you would be required to pay 20% of the next $5,000 worth of eligible expenses or approximately $1,000. So, your total responsibility would be about $3,500. The insurance company would pay the rest or $6,500. This may or may not be a lot of money for you but for most international students it would be. So, when choosing your deductible it may make sense to choose a lower deductible with slightly higher premium costs each month.
For the plans we offer, the deductible and coinsurance will vary. For international students, the Student Secure Select plan offers 100% coinsurance for eligible expenses after the deductible if you go within the PPO or to the student health center. The Student Secure Budget plan offers 80/20 for eligible expenses after the deductible up to $5,000 then 100% up to the overall policy maximum. The deductible for this plan is $100 per injury or illness or it’s reduced to $50 if you go to the Student Health Center. This plan reduces a lot of your out-of-pocket expenses and provides coverage for doctor office visits, prescription drugs, maternity, diagnostic testing, x-rays, emergency medical evacuation, repatriation, etc. It will also meet most school’s health insurance requirements. You can check our school database for further information.
Tags: co-payment, deductible, international student health insurance, international student insurance, Student Insurance, Travel Insurance
Posted in Insurance Explained, International Student in the USA, Product Information, Student Insurance | 2 Comments »
Wednesday, October 17th, 2007
A PPO, also known as a Preferred Provider Organization, is defined as an organization of doctors, hospital and medical care facilities that have contracted with the insurance company to all provide services at a contracted rate. Usually the rate they receive is at a reduced rate. A PPO type arrangement can be beneficial for both the insurance company and the insured. The rates are usually significantly reduced so the insured does not have to pay as much out-of-pocket as they would if they went outside of the PPO. The insurance company also receives the lower rate so in effect they do not have to pay high claims amounts. This in turn, allows your renewal and premium rates to remain as low as possible.
With most of our plans, they do offer a PPO. However, you are not required to follow it. If you do choose to go within the network or PPO, then you will receive significant benefits. For example, the Student Secure plan, offers the coinsurance (coinsurance is the percentage that you would responsible to pay after the deductible) to be waived (select level only) if you go within the PPO or to the Student Health Center. The PPO for this plan is quite vast. To search the PPO go here: www.InternationalStudentInsurance.com/network. This can greatly reduce your out-of-pocket expenses. If you went to the emergency room let’s say for a broken arm and your total eligible expenses were $2,000 (the hospital you went to was in the PPO and all of your expenses were eligible expenses). The insurance company would pay 100% of your eligible expenses (select level only) after you paid the $100 deductible (the deductible is the amount that you are required to pay before the insurance company will pay towards your expenses).
Now let’s say for the same example you chose not to go to a hospital within the PPO. You would see much higher out-of-pocket expenses. Your deductible would remain the same however, the coinsurance would not be waived and you would be responsible for 20% of your eligible expenses (for this example it would cost approximately $500 total for you). On the select level of the Student Secure plan, the insurance company would pay 80% of your eligible expenses after the deductible up to $5,000 then they would pay 100% up to the overall policy maximum. So, as you can see, it’s much better for you to go within the PPO.
The Student Secure plan is available for full-time students studying outside of their home country. Outside of the U.S. there is not a PPO. You can go to any doctor or hospital and you will be provided 100% coverage for your eligible expenses after the deductible and up to the overall policy maximum (select level only). To find further information about all of our plans please visit our site: InternationalStudentInsurance.com
Tags: deductible, insurance terms, PPO, preferred provider organization
Posted in Insurance Explained | 2 Comments »
Wednesday, August 22nd, 2007
This is one of the most popular questions we receive. The Student Secure plan, which is particularly designed for F1 visa holders or full-time international and study abroad students, has two levels: budget and select. The budget level provides up to $250,000 worth of coverage and the select level provides up to $300,000 worth of coverage. The select level also provides coverage for accidental death & dismemberment and the budget level does not. However, these are not the only differences. The main difference is in the coinsurance.
Coinsurance is a percentage that you have to pay after you meet the deductible. The deductible is usually a fixed amount. For both levels, the deductible is $100 per injury or illness. For the budget level, your coinsurance portion would be 20% of the first $10,000 of eligible expenses. Then, the insurance company will pay 100% of your eligible expenses up to the certificate period maximum. So, for example, you incurred $5,000 worth of eligible expenses. You would be responsible for the deductible ($100) plus the 20% coinsurance. So, your total would be approximately $1,100. If you chose the select level, then your coinsurance is waived if you go to the Student Health Center or if you go to a doctor within the PPO (network of doctors). So, in the example above you would only be responsible for the deductible ($100). The select level may be more expensive when you choose to purchase the Student Secure plan, however, it greatly reduces your out-of-pocket expenses.
To further explain what a deductible is, the deductible is the amount that you are required to pay before the insurance company will pay toward your eligible expenses. For the Student Secure plan, the deductible is $100 per injury or illness. This means that you would pay the first $100 plus any coinsurance applicable (if you chose the select level and went within the PPO or to the Student Health Center you would not be responsible for the coinsurance) per injury or illness. This deductible is not per visit. If you became ill or injured and you went to the doctor you would pay the deductible plus any coinsurance applicable. If you needed to go back for a follow-up visit you would not need to pay the deductible again. You would simply pay the applicable coinsurance portion.
If you should have any further questions, please e-mail us at info@InternationalStudentInsurance.com or call us at 1-888-247-1387.
To view all the benefits, quote or apply online click here: http://www.internationalstudentinsurance.com/student_secure_international/
Tags: coinsurance, deductible, international student insurance, student secure plan
Posted in Insurance Explained, International Student in the USA, Product Information, Student Insurance | No Comments »
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