6 Facts You should Know about South Carolina Health
Insurance
1. Are all Health Insurance companies the same? Before purchasing
your health insurance policy ask your agent to show you a current copy of A.M. Best Company. A.M. Best Company
reports on the financial condition of insurance companies and is the oldest and most reliable rating agency
available.
2. Do all health insurance companies pay claims according to the same
standard? Make sure you choose an insurance company that pays benefits based on studies from independent
third parties who determine the Usual and Customary Charges.
3. Do all health insurance plans cover all medically necessary hospital
care? Be cautious of those plans that only cover certain hospital procedures. Some plans are limited, and
cover only one doctor during an operation…there needs to be a provision that covers an assistant during surgery.
Look for the phrase “and all other medically necessary hospital expenses”. If this phrase is absent from your
policy, any procedure that is not outlined and is performed you will be financially responsible for. Make sure you
are covered for all other medically necessary hospital expenses. Ask your agent to fully reveal all the ‘small
print’ details
4. Do all insurance companies treat pre-existing conditions the
same? It is normal for plans to have a waiting period of at least 12-24 months before your pre-existing
condition is covered. During this waiting period, credit is sometimes given based on your previous policy and in
some states this is required.
5. Do all health insurance companies perform rate increases the same
way? Some companies perform rate increases that can single you out. Instances of this practice may include
higher rates each year on your birthday or because you have collected too much money from the plan. Although all
insurance companies are subject to periodic rate increases to offset claims loss and inflationary increases, a
policy holder should not be ‘singled out’ based on the above reasons.
6. Do all health insurance plans provide the same dollar limits?
Health insurance companies now provide $1,000,000 to $2,000,000 for each injury and sickness and a $3 million to
$10 million lifetime maximum for the entire family. It is very important to make sure you are sufficiently
covered.
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