Since it is a system used to protect a company, association or individual against the economic and financial consequences of an uncertain event, health insurance is the financial is confronted with possible health expenses not covered by the health insurance of his social system. Thus before taking out insurance, it is necessary to establish the needs because all contracts are properly adapted. What is the role of health insurance? What is its principle of action? And what are the guarantees offered by health insurance?
Role of health insurance
The first of its roles is to bind the insurer to the insured through a contract chosen against the assumption of insurance.
When we talk about health insurance, we refer to a supplement of health insurance to cover the costs that social security does not cover or partially cover. In case of accident or illness, the need to follow a treatment or consult a doctor is necessary. Medical expenses are not fully covered by social security because of their high reimbursement rate or because their effectiveness is not recognized.
By subscribing to health insurance like Health Mutual, the patient arms himself to face the planned expenses entirely or not at his expense. She then takes charge, the difference between the total costs for the care of the patient and the amount paid by the social security. This means that health expenditure is best covered in full. But even if it is not, it allows patients with low purchasing power to benefit from the best care. Health insurance depends on the insurance code; so that it can be an insurance company or an insurance company that offers it for profit.
Principle of action of a health insurance
Like all others, health insurance is priced according to certain criteria. It may consist of a number of clauses that it is important to understand before signing to limit the risks of being wrong. The price of the insurance, the exclusions and the rate of contribution to the risk is established by the insurer according to the number of people who are designated to benefit from the guarantees. Logically, an individual health insurance will get back cheaper than a family health insurance. Only rarely does the insured person do it individually.
Age and sex are also criteria that insurers consider. From 18 to 70 years old, the tariffs operate in annual installments of 5 and older people as well as women are those who represent more risks due to old age, pregnancy and maternity. Young insureds do not pay premium because they represent less risk to insurers.
These criteria are supplemented by the medical questioning which allows the insurer to determine the level of risk you represent in terms of health. This document will inform your sporting and professional activities, the medical history and your current state of health in confidence. The results of this questioning as well as the analysis carried out towards you being directed by a doctor appointed by the insurance company will determine the position of your insurer to assure you or not. The other option is to increase your premium insurance depending on whether you have too much risk in his eyes.
The guarantees of a health insurance
They are numerous and vary from one contract to another. They are usually presented as a percentage in euros.
When the guarantee indicates repayment up to 350 €, it means that it will refund to maximum 250 € additional to the reimbursement of social security
When indicated at 160% of the reimbursement base, health insurance will reimburse 60% more than the social security reimbursement base.
They are as soon as a subscription is made by regrouping in more of your remainder dependent, the services like:
- . Medical consultation
- . Drug
- . Optics (glasses, lenses, frames)
- . Hospitalization (surgery)
- . Dental care
- . Spa treatments
- . Dental prosthesis etc.
In all, the financial protection of the risks that affect the person of the insured as well as the persons and would have designated the beneficiaries.
Health insurance was designed to allow people to take out a contract that will support the share of medical expenses that social security does not support. It is therefore important to subscribe but also to identify the particularities in order to make the right choice and benefit from optimal health coverage.