How Does Health Insurance Work?

Health insurance is a vital tool for protecting your financial well-being and ensuring access to quality healthcare when you need it most. However, understanding how health insurance works can often feel like navigating a complex maze of premiums, deductibles, and coverage limits. In this blog post, Freedom will break down the basics of health insurance to help you grasp the fundamentals and make informed decisions about your coverage.

  1. Premiums: At the core of any health insurance plan is the premium – the amount you pay to your insurance provider in exchange for coverage. Premiums are typically paid on a monthly or annual basis, and they vary based on factors such as your age, location, and the level of coverage you choose. It’s essential to budget for your premium payments to ensure continuous coverage and avoid lapses in insurance.
  2. Excess: An excess is the amount you must pay out of pocket for covered healthcare services before your insurance kicks in. For example, if your plan has a $1,000 excess, you’ll need to pay $1,000 in healthcare expenses before your insurance starts covering eligible costs. Excesses can vary widely between plans, so it’s crucial to choose a deductible level that aligns with your budget and healthcare needs.
  3. Coverage Limits: Most health insurance plans have coverage limits or maximums, which cap the amount the insurance company will pay for covered services over a certain period. These limits may apply to specific services, such as hospital stays or prescription drugs, or they may apply to your overall healthcare expenses. Be sure to review your plan’s coverage limits to understand how much coverage you have and whether any services are subject to limitations.
  4. Network Providers: Many health insurance plans have networks of healthcare providers, including doctors, hospitals, and specialists, with whom they have negotiated discounted rates. When you visit an in-network provider, you typically pay less out of pocket for covered services compared to visiting an out-of-network provider. Before scheduling appointments or procedures, check to see if your preferred providers are in-network to maximise your insurance benefits.
  5. Preventive Care: One of the key benefits of health insurance is coverage for preventive care services, such as annual check-ups, vaccinations, and screenings. These services are designed to detect and prevent health problems before they become serious, helping you stay healthy and avoid costly medical expenses down the road. Many health insurance plans cover preventive care at little to no cost to the insured, so be sure to take advantage of these services to maintain your health and well-being.

Generally speaking, health insurance works by providing financial protection against unexpected medical expenses, such as hospitalisations, surgeries, and prescription drugs. By understanding the basics of health insurance, including premiums, excesses, coverage limits, network providers, and preventive care, you can make informed decisions about your coverage and ensure access to quality healthcare when you need it most.

For more information about various available options and what’s best for you, give us a call – 0800 667-257, or email us at ask@freedomfinancial.co.nz. We would love to hear from you.