Health insurance varies between them just as the price of the policy is different between one package and another of coverage. However, there are 10 services that stand out among insurance due to their importance.
The health insurance offered by most companies is divided into basic and complementary insurance . The most normal thing is that the basic insurance includes a number of elementary services and that they have a copayment. That is, having to pay for each complementary service. Meanwhile, the most comprehensive insurances tend to have broader coverage with a higher price as well.
The most basic services usually include Preventive Medicine, certain specialties, diagnostic tests and simple therapeutic methods.
In addition, some companies also include dental services, emergencies and home services
A more complete coverage would be one that includes hospitalization, surgery, postoperative care or special therapies such as chemotherapy , among others.
The coverages that insurance usually includes:
Primary medicine , which includes the patient’s access to a family doctor, nursing services and some specialties, such as the pediatric service.
Medical specialties , such as Cardiology or Dermatology. Many insurances include these services in their basic packages.
Simple therapies , such as psychological treatments, rehabilitation programs or ventilation therapy among others. In addition, a large number of insurers offer these therapies at home.
Emergencies , both at home and at the nearest health center included in the company’s medical chart.
Family planning , which encompasses all services related to reproduction, such as IUD implantation, vasectomy, genetic studies or childbirth care.
Mental Health , such as psychiatric assistance or behavioral health treatments.
Preventive services , with which diseases are detected that have not yet manifested themselves. In addition, with this service you can also perceive other health problems such as poor vision or high blood pressure.
Dental coverage , included by many companies in their basic packages. Even so, most cases do not include the most serious interventions and only cover reviews. Therefore, if you want a more complete dental insurance, the best thing to do is usually look for it separately or pay for the complementary service.
Delivery coverage , which usually includes all services necessary for delivery before, during and after giving birth.
Hospitalization and surgery , usually belongs to the most complete coverage. Includes hospitalization before and after surgery. This coverage can also include the treatments or medications that the patient needs after the intervention.
What does health insurance not cover?
Health insurance alone does not guarantee full coverage in any situation. Insurance usually has its limitations , either imposed by the insurer as part of its company policy, or because the agreement reached by the insured and the insurer excludes some services
Exclusions are the cases in which the companies do not cover the insured. These are not general cases , but exceptions that the insurer has as a company policy. It could be that a company does not cover a certain disease or does not include a certain treatment.
Pre-existence is the name for a disease that the insured person suffers before taking out the insurance . It is recommended that the company know the preexisting disease. It is true that, given this, the insurer may reject the insured, increase the price of the policy or not cover the treatment of the disease. But if the client does not inform the company about the pre-existence before hiring, he can be accused of scam. The insurer could sue you, in addition to terminating the contract.
Unless a contract is made that specifies otherwise, insurers usually do not cover illnesses or accidents that occur during work activities or risk sports.