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Everyone should have health insurance, but finding the right coverage can be a painstaking task. Paul Wolf of Innovative Benefits Consultants guides you through the policies and the pitfalls. Basic features of private insurance
Private health insurance policies generally offer one or two major levels of coverage: a comprehensive coverage, including in-hospital care and services as well as the services of doctors, lab tests, x-rays and other scans, etc. in a non-hospital setting; and a basic coverage which is limited to all care and services relating to an in-patient hospital stay only.
The common variables within these policies are various limits on reimbursement; a choice of deductibles; and any differences or limitations based on where the care is provided. But beyond this, there may be some traps waiting for you unless you look carefully at what is offered.
Applying for a policy
As the name suggests, it's easy to get coverage from guaranteed-issue policies - just answer a few easy questions and pay your premium. Beware though, when you submit a claim, you may be asked for proof that the problem you just treated wasn't a "pre-existing condition" at the time you applied for the policy.
A pre-existing condition generally means a medical condition, which is currently being (or was previously) treated and any condition associated with it.
Just for clarification, "treated" means:
- Doctor's visits, tests, taking medication, or even a special diet for that condition within the past one year, two years, five years, or anytime in the past (each policy has its own time frame).
- A condition which a "prudent person" would have had treated, even if you didn't, or, in some policies, even if you didn't know about it but they feel you should have.
- "Any condition associated with it" means a medical problem that they deem to be an outgrowth or result of the original pre-existing condition. For example, a broken leg could be deemed to be the result of brittle bones caused by cancer treatments.
If the insurer decides it is a pre-existing condition, they may deny the claim. Always remember, the larger the claim the more carefully they're going to examine it. Which is not what you want to go through when you have just incurred a claim for USD10,000.
Fully-underwritten policies ask very detailed health questions on the application form and may even ask for doctors' reports. Based on all the information they get, the insurance company may decide to:
- Accept you with no exclusions or conditions;
- Accept you with an increase the premium;
- Accept you with an exclusion for a specific medical condition; or
- Reject you.
It always makes good sense to disclose pre-existing conditions on your application form even if the application doesn't ask about them. Then, the insurance company will find it harder to deny a claim for a pre-existing condition if they didn't exclude it when they approved your application.


I accessed this comment via the Netherlands section of Expatica, but many things from this article don't apply to The Netherlands.
Likewise for France. I opened this article expecting to read something relating to top up insurance in France and found that it has nothing to do with it. Who exactly is this article aimed at?
Another interesting fact about Belgium---having been insured in another EU country-even with proof of care being paid for-does NOT count as being adequately insured previously. Hence - a reason for my BE hosp insurance company to not reimburse my hospital stay and surgery here. Or any that are needed in the future. Any advice on which EU parliamentarian to approach and make sure a new EU law will be made re insurance acceptance between EU countries?
Be aware when suffering from a pre-existing condition-that even if previously insured and having had adequate treatment and insurance, which is usually a reason to accept that-is not necessarily sufficient.
Do not fall ill in Belgium is my device
I had endless difficulties finding a dentist that had integrity and was honest and polite. I also had overwhelming complications to get insurance companies to honor their policies, most will screw around with you to discourage you from making claims. Eventually I figured the cost of premiums the dishonesty of insurance companies the collusion with the dentist = frustration costs dissatisfaction bad work. It actually works out cheaper and more rewarding to arrange a dentist abroad. I have an excellent dentist in Slovenia. Never had I had such good service and friendly and polite people. Twice a year I fly to Slovenia, with Ryanair, off season I find return flights for less then 50€. I stay in a pleasant inexpensive B
I accessed this comment via the Netherlands section of Expatica, but many things from this article don't apply to The Netherlands.
Likewise for France. I opened this article expecting to read something relating to top up insurance in France and found that it has nothing to do with it. Who exactly is this article aimed at?
Another interesting fact about Belgium---having been insured in another EU country-even with proof of care being paid for-does NOT count as being adequately insured previously. Hence - a reason for my BE hosp insurance company to not reimburse my hospital stay and surgery here. Or any that are needed in the future. Any advice on which EU parliamentarian to approach and make sure a new EU law will be made re insurance acceptance between EU countries?
Be aware when suffering from a pre-existing condition-that even if previously insured and having had adequate treatment and insurance, which is usually a reason to accept that-is not necessarily sufficient.
Do not fall ill in Belgium is my device
I had endless difficulties finding a dentist that had integrity and was honest and polite. I also had overwhelming complications to get insurance companies to honor their policies, most will screw around with you to discourage you from making claims. Eventually I figured the cost of premiums the dishonesty of insurance companies the collusion with the dentist = frustration costs dissatisfaction bad work. It actually works out cheaper and more rewarding to arrange a dentist abroad. I have an excellent dentist in Slovenia. Never had I had such good service and friendly and polite people. Twice a year I fly to Slovenia, with Ryanair, off season I find return flights for less then 50€. I stay in a pleasant inexpensive B
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