Catastrophic Health Insurance Coverage

A catastrophic or major medical insurance plan is a deductible and comparatively cheaper form of health insurance with an element of speculation to it.  A deductible is the amount you pay out of your pocket for medical expenses before the insurer pays the balance. For instance, if your deductible is £5,000 and the hospital bill is £12,000, the insurance company will pay only £7,000. The general rule is the higher the deductible, the lower the premium. When you opt for this plan, you're gambling that you will not face major medical problems in the near future.   

It is a calculated risk. According to one survey, the annual medical expenses of 90% of the U.S. population are less than £2000; for 73%of the population, it is below £500. 

Two groups that normally opt for catastrophic health insurance are young people in their twenties who are confident of their health condition, and older men between fifty and sixty-five who are still waiting for Medicare eligibility.

Catastrophic health insurance coverage is only meant to protect against major hospital charges and not routine medical expenses. It normally does not cover maternity care, doctor’s visits and prescription drugs. Certain pre-existing medical conditions and cases involving mental health and substance abuse are usually excluded from the coverage. A catastrophic health insurance policy can be purchased as an individual plan or as part of a group plan. In fact, there appears to be a trend among employers to encourage employees to opt for this type of medical cover. The maximum lifetime limit could be as high as £3 million.

Rates vary according to where you live and your age. In certain states, the saving on premiums could be two-thirds. For example, a 21 year old, non-smoking female may pay as little as £30 per month as a premium.

It is advisable to seek professional guidance from insurance companies andor agents and compare quotes before making a decision.
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Long-Term Care Insurance

Nursing home and long-term care insurance are available to cover custodial care in a nursing home. Some of these policies also cover care in the home, and others are available to pay for care in a skilled nursing facility (SNF) after your Medicare benefits run out (see page 3 for an explanation of the Medicare benefit for skilled nursing facility care).

If you are in the market for nursing home or longterm care insurance, be sure you know which types of nursing homes and services are covered by the different policies available. And if you buy a policy, make sure it does not duplicate skilled nursing facility (SNF) coverage provided by any Medigap policy, managed care plan, or other coverage you have.
It is important to remember that custodial care (the type of care most persons in nursing homes require) is not covered by Medicare or most Medigap policies. The only care of this nature that Medicare covers is skilled nursing care or skilled rehabilitation care that is provided in a Medicare-certified skilled nursing facility.

For more information about long-term care insurance, request a copy of A Shopper’s Guide to Long-Term Care Insurance from either your state insurance department or the National Association of Insurance Commissioners, 120 W. 12th Street, Suite 1100, Kansas City, MO 64 105-1925. You may also obtain a copy of the Guide to Choosing a Nursing Home by writing to Medicare Publications, Health Care Financing Administration, 6325 Security Boulevard, Baltimore, MD 21207.
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