Health Care Insurance FAQs

What is the basic difference between individual and group health insurance coverages?

An individual policy is purchased by you directly with the insurance company. With a group health insurance policy, the group is the master insured and the insurance company contracts with the group.
What’s the difference between primary and secondary coverages?

Primary coverage is provided through the plan of which they are a member or the plan under which the member has been a participant for the longest time period. Secondary coverage, usually as a result of being covered as a dependent under someone else’s health insurance plan, provides reimbursement for medical expenses after exhaustion of coverage available through the primary plan.
What services and items might be paid for under my health insurance?

Typically doctor visits, surgeon and surgery expenses, costs of hospitalization, and follow-up therapy are covered by health insurance. Some plans provide for psychiatric care, drug and alcohol rehabilitation programs, and prescription medicines.
What variables will affect my insurance premium?

Some of these variables include (but are not limited to) deductible, co-payments and co-insurance, lifetime maximums, annual or “out-of-pocket” limits, and coordination of benefits