Health insurance

economic-dictionary

Health insurance are those that cover the beneficiary in case of suffering health ailments. Thus, medical assistance and / or financial compensation is provided.

In other words, this type of policy is activated in the event that the contracting party becomes ill or has an accident that causes injury or temporary disability.

Health insurance falls within the category of personal insurance.

It should be noted that these types of policies have a grace period, that is, a period during which, although the contract has already been signed, the coverage is not active. In this way, the beneficiary is prevented from hiding, for example, an illness and taking out insurance to pay for their treatment. This is a clear information asymmetry problem.

Due to the conflict described above, the applicant for health insurance is also required to declare the pre-existing diseases that he may have. Likewise, it is consulted regarding risk factors that may affect the patient's health in the future, such as smoking or the presence of a hereditary disease in his family.

Types of coverage

Health insurance can provide three types of coverage:

  • Medical assistance: The insurer directly assumes the expenses for medical services so that the client can be cared for.
  • Reimbursement: The beneficiary is treated at the establishment of their preference and then presents the invoice and the respective medical report to their insurer, which will reimburse them for the money spent.
  • Compensation: The insured receives financial compensation for being forced to stop working. This, in case of temporary disability, hospitalization or surgical intervention necessary for the user's health.

Difference from health care insurance

An important point to clarify is the difference between health insurance and health care. The first, as can be deduced from the article, aims to provide financial compensation to the beneficiary for the damage that he may suffer to his health.

Instead, the purpose of health care insurance is to provide medical care to the insured. Likewise, it allows the reimbursement of health expenses that the patient has incurred.

In any case, health insurance is broader, because it not only covers medical consultations and / or treatments, but also compensation. For example, in case you cannot continue working due to a health problem that temporarily incapacitates you (as explained above).

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