How Health Insurance Works
Health insurance can be tricky to navigate. Managed care insurance plans require policyholders to receive care from a network of designated healthcare providers for the highest level of coverage. If patients seek care outside the network, they must pay a higher percentage of the cost. In some cases, the insurance company may even refuse payment outright for services obtained out of network.
Many managed care plans—for example, health maintenance organizations (HMOs) and point-of-service plans (POS)—require patients to choose a primary care physician who oversees the patient's care, makes recommendations about treatment, and provides referrals for medical specialists. Preferred-provider organizations (PPOs), by contrast, don't require referrals but do have lower rates for using in-network practitioners and services.
Insurance companies may also deny coverage for certain services that were obtained without preauthorization. In addition, insurers may refuse payment for name-brand drugs if a generic version or comparable medication is available at a lower cost. All these rules should be stated in the material provided by the insurance company and should be carefully reviewed. It's worth checking with employers or the company directly before incurring a major expense.
Increasingly, health insurance plans also have copays, which are set fees that plan subscribers must pay for services such as doctor visits and prescription drugs; deductibles that must be met before health insurance will cover or pay for a claim; and coinsurance, a percentage of healthcare costs that the insured must pay even after they've met their deductible (and before they reach their out-of-pocket maximum for a given period).
Insurance plans with higher out-of-pocket costs generally have smaller monthly premiums than plans with low deductibles. When shopping for plans, individuals must weigh the benefits of lower monthly costs against the potential risk of large out-of-pocket expenses in the case of a major illness or accident.
Many managed care plans—for example, health maintenance organizations (HMOs) and point-of-service plans (POS)—require patients to choose a primary care physician who oversees the patient's care, makes recommendations about treatment, and provides referrals for medical specialists. Preferred-provider organizations (PPOs), by contrast, don't require referrals but do have lower rates for using in-network practitioners and services.
Insurance companies may also deny coverage for certain services that were obtained without preauthorization. In addition, insurers may refuse payment for name-brand drugs if a generic version or comparable medication is available at a lower cost. All these rules should be stated in the material provided by the insurance company and should be carefully reviewed. It's worth checking with employers or the company directly before incurring a major expense.
Increasingly, health insurance plans also have copays, which are set fees that plan subscribers must pay for services such as doctor visits and prescription drugs; deductibles that must be met before health insurance will cover or pay for a claim; and coinsurance, a percentage of healthcare costs that the insured must pay even after they've met their deductible (and before they reach their out-of-pocket maximum for a given period).
Insurance plans with higher out-of-pocket costs generally have smaller monthly premiums than plans with low deductibles. When shopping for plans, individuals must weigh the benefits of lower monthly costs against the potential risk of large out-of-pocket expenses in the case of a major illness or accident.
What Is Health Insurance?
Health insurance is a contract that requires an insurer to pay some or all of a person's healthcare costs in exchange for a premium. More specifically, health insurance typically pays for medical, surgical, prescription drug, and sometimes dental expenses incurred by the insured. Health insurance can reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly.
It is often included in employer benefit packages as a means of enticing quality employees, with premiums partially covered by the employer but often also deducted from employee paychecks. The cost of health insurance premiums is deductible to the payer, and the benefits received are tax-free, with certain exceptions for S corporation employees.
KEY TAKEAWAYS
- Health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured.
- Choosing a health insurance plan can be tricky because of plan rules regarding in- and out-of-network services, deductibles, copays, and more.
- Since 2010, the Affordable Care Act has prohibited insurance companies from denying coverage to patients with preexisting conditions and has allowed children to remain on their parents' insurance plan until they reach the age of 26.
- Medicare and the Children's Health Insurance Program (CHIP) are two public health insurance plans that target older individuals and children, respectively. Medicare also serves people with certain disabilities.
What's not covered under home insurance?
While coverage varies from policy to policy, it’s hard to determine the exact extent of what may not be covered. With TD Insurance, our home insurance offerings all follow comprehensive form/all risk coverage, meaning that all risks are covered, with the exception of specific properties and exclusions outlined in your policy. Regardless of who your insurer is, check your policy carefully to understand these exclusions. Should you find something you'd like/need coverage for that's listed as an exclusion on your policy, you can always check to see whether there is an option to buy additional coverage for it through an add-on. If in doubt, talk to your insurance provider to get the information you need.
Keep in mind that some exclusions are outright, meaning that there are no options to add on coverage to include them in your policy. In these cases, you would be responsible for covering these losses yourself. These exclusions are common to most insurance companies and typically include wear and tear, damage caused by pests (such as rodents or insects) and acts of terrorism, to name a few.
Your policy is also likely to contain specific dollar limits and possible coverage restrictions on certain categories of items, such as jewellery or wine collections. If you have belongings of particularly high-value, you should check these limits and restrictions to ensure you're properly covered. Should you need additional coverage, check out our Personal Valuables Coverage to learn more.
What does home insurance cover?
Home insurance covers expenses that occur when something unexpected or accidental happens to your home and/or your belongings. That means that you'll receive financial protection against losses due to theft, fire, wind damage and much more. Should anything happen to your home, your standard policy can include coverage for the structure of your home, coverage for your personal belongings, and coverage for additional living expenses (if you're unable to live in your home while it's being repaired due to a covered loss). Home insurance also covers more than just your home. It can also come to the rescue if someone injures themselves on your property, or if you damage someone else's property or accidentally injure someone. This is where your liability protection will kick in which is also typically included in a standard policy.
Let’s take a look at a couple of examples of what you’re generally covered for. Let's say you become a victim to theft and some of your big-ticket personal belongings are stolen. Depending on how your policy is set up, your home insurance will provide you with coverage based on either the Replacement Cost or the Actual Cash Value of your stolen items (subject to your deductible, of course). Or, let's say you experience a loss due to fire — your home insurance will cover the repair, the reconstruction or the replacement of your home, depending on the extent of the damages and your coverage limits.
What is Home Insurance?
Owning a home may be your biggest investment, so how can you protect it? Well, home insurance is a form of property insurance that you can purchase to protect your property and your belongings.
It may not be something we think about every day, but unexpected incidents can happen at any time to your home, which is why home insurance is important to have. But home insurance wasn’t always an option for people. Did you know that home insurance originated from something called "fire insurance?" As the name suggests, fire insurance was used to cover fires, but has since evolved to "home insurance" since it now covers more than just that. Like what, you may ask? Well, let's talk about it. We have answers to some questions you may be wondering about.Do I need home Insurance?
Before we get into the nitty gritty of all your home insurance questions, let's start off by saying we strongly recommend that you have home insurance, simply for all the value it offers — even if home insurance isn't mandated by law the same way that car insurance is. Keep in mind that if you're looking to purchase a home, or if you're a homeowner that has applied for a mortgage, your lender will likely require you to purchase home insurance first anyways. Having home insurance can protect you from having to pay a large lump sum to repair damages to your property and personal belongings if something happens to or in your home. So, although home insurance isn’t necessarily a requirement, it definitely plays a crucial role in protecting what may be your greatest asset.
Travel Insurance Defined
Travel insurance is a type of insurance that covers the costs and losses associated with traveling. It is useful protection for those traveling domestically or abroad.
According to a 2021 survey by insurance company Battleface, almost half of Americans have faced fees or had to absorb the cost of losses when traveling without travel insurance.Thirty-six percent of Americans say they're more likely to purchase travel insurance for trips abroad following the COVID-19 pandemic while 34% said they're more likely to do so for domestic trips.
According to a 2021 survey by insurance company Battleface, almost half of Americans have faced fees or had to absorb the cost of losses when traveling without travel insurance.Thirty-six percent of Americans say they're more likely to purchase travel insurance for trips abroad following the COVID-19 pandemic while 34% said they're more likely to do so for domestic trips.
KEY TAKEAWAYS
- Many companies selling travel packages also offer travel insurance.
- Some travel policies cover damage to personal property, rented equipment, such as rental cars, and even ransom requests.
- The main categories of travel insurance include trip cancellation or interruption coverage, baggage and personal effects coverage, medical coverage, and accidental death or flight accident coverage.
- Coverage often includes 24/7 emergency services, such as replacing lost passports, cash wire assistance, and re-booking canceled flights.