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| Health insurance is, basically, a promise by an insurance company or health plan to provide or pay for health care services in exchange for payment of premiums. Health care in the United States is delivered and insured in many different ways. Private indemnity or "fee for service" insurance can be obtained by individuals on their own, or through groups, such as employers or associations, and allows some level of choice of health care provider by the insured. When private indemnity insurance offers a more limited choice of providers, is it is typically referred to as Preferred Provider Plan, as your choice may be restricted to health care providers who are members of the sponsoring insurer's Preferred Provider Organization or PPO, or receive a reduced level of reimbursement when you see a provider who is not a member of the PPO. |
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| Health insurance coverage is usually obtained through an employer if a person is employed on a full-time basis. However, there are many exceptions. Employee benefits that include health insurance are often not available to part-time employees, and small employers, especially those with less than 5 employees, often do not provide health insurance coverage options.
Self-employed persons who do not have employees generally must obtain individual insurance. Self-employed persons and employees of small businesses sometimes can obtain health insurance through group endorsed insurance packages that include health insurance coverage. Some examples include teachers who obtain insurance through state teachers' associations instead of through their local school district employers, lawyers who obtain insurance through their bar associations, small business owners or self-employed who obtain insurance through chambers of commerce, etc. In the employment situation, there are many different kinds of employee benefit plans available and a variety of ways that that health care coverage is paid for in the group setting. For instance, there may be employee welfare benefit plans in which participation is mandatory and the employer pays the premiums as a fringe benefit. On the other hand, there may be plans in which employee participation is completely voluntary, or plans in which the employee may choose from different health care insurance offerings, or health care insurance offerings where the employer pays some but not all of the premiums or pays for the employee but not for coverage of dependents, or "cafeteria plans" where a certain amount of money is available through a plan and the choice of how to use it is left to the employee. Persons who have reached Social Security eligibility age can obtain insurance through Medicare, (including primary and supplemental coverage), military dependents can obtain insurance through CHAMPUS and the medically indigent or disadvantaged can obtain health care coverage through Medicaid or through local medically indigent adult programs. |
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| This isn't part of any policy issued by its affiliated insurers and is not a binding part of any insurance. Contract which may be applicable to you. It contains only general information and description of the coverages which may be provided and doesn't include all of the features, exclusions, and conditions of the policy. It describes certain coverages features and credits vary by the clients, and may not be available to all insureds. BAP suggests you that you read your policy very carefully or consult with us to determin your actual coverages with licensed BAP professionals. In the event of loss, the terms of your policy will determine your coverages. Any difference in coverages descriptions between this writing & your policy are inapplicable and should be disregarded. Home About Contact Claim Insurance |
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