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Essay / Health Insurance Definition - 897
DefinitionHealth insurance is insurance against the risk of incurring health care-related expenses. It compensates the insured for the related financial loss. It is important to note that health insurance is a short-term form of insurance. Disability, critical illness, and long-term care insurance are all subcategories of health insurance. When a person purchases health insurance, they enter into a contract (policy) with the insurance company so that, for a monthly premium, the insurance company will provide coverage for medical expenses incurred. The level of coverage and authorized healthcare providers will vary between different products. Coverage will include doctor or hospital visits, prescriptions, the cost of medical tests or vaccinations, and other medical expenses. Payment from the insurance company can be made directly to the policyholder or the respective healthcare provider. To limit moral hazard, most insurance companies will include features in contracts such as deductibles, co-payments, coinsurance, and other out-of-pocket payments. A deductible is the fixed amount that the insured must pay out of pocket each year before the health insurance company begins to pay for medical services. It is calculated annually and expressed as an annual amount. When the deductible is reached, the following costs are incurred: co-payment and/or co-insurance. A copayment is a set amount that the insured person must pay to the health care provider at each visit. Coinsurance is a percentage of the total medical bill that the insured must pay for a health service. To protect the insured against extreme costs, some policies include reimbursement..... . middle of paper ......t quickly to gain a competitive advantage. Additionally, these companies cannot employ full-time actuaries. For example, some companies may only use the assistance of an actuary on an advisory basis for certain large-scale projects. Alternatively, an actuary may be hired to fill a "multi-faceted" role in a business, which may include a combination of roles such as marketing, client management or financial tasks in addition to traditional analytical work. The best area for non-traditional work opportunities is with smaller organizations such as small/new biotech companies and healthcare IT companies. These companies are looking for agile professionals with little or no training. Additionally, actuaries with strong analytical skills and extensive experience in the healthcare industry are also commonly sought after by healthcare executives. (Society of Actuaries, 2010)