Health Insurance Guide - Kaiser Permanente Health Insurance Section

Mike Spencer

Copyright 2005 Mike Spencer

Health insurance is a kind of protection that provides payment of benefits for covered sickness or injury. Included in health insurance are various types of insurance such as accident insurance, disability income insurance, medical expense insurance, and accidental death and dismemberment insurance.

Before sign the health insurance policy make sure that you have read thoroughly the benefit’s section. Take note of any health care service that is not covered by your health insurance policy. Also, pay specific attention to how the health insurance policy is worded. Sometimes, health insurance companies hide the health insurance coverage exclusions within the definitions of words.

For instance, a health insurance company may define the term ‘emergency’ as anything that is life threatening condition that cannot be reasonably treated by a primary care physician. Whereas, your definition of ‘emergency’ may be anything that requires quick medical attention.

Clearly, there is conflict for the two definitions. If you find yourself in an emergency situation where you incur a broker arm, for instance, your insurance company may deny coverage for emergency room treatment of a broken arm for the reason that the broken arm does not fall under the life threatening category.

Therefore, you should read over carefully the health insurance policy definitions, paying close attention to the seven key words:

medical emergency
medically necessary
accidental injury
experimental or investigational
pre certification
pre-existing condition, and
reasonable and customary


These words and any words that are open to interpretation should be regarded with wariness. Find out how your health insurance company defines each of these.

Finally, find the section describing the procedures you must follow in order for your insurance company to reimburse you. These policy conditions or prerequisites are typically worded in a positive tone. Read through each condition carefully, make notes and call your health insurance company with any questions.

You should also compare health insurance contracts before you sign one. In order to compare exclusions, take two policy contracts and find the exclusions sections. If you want to compare a number of health insurance contracts then you could use an online service.

After you obtain your free quote for the health coverage you desire, apply for it online, and you'll obtain all the information that you'll need to compare exclusions of each health insurance policy (though sometimes this will require more research.)

About the author:

Mike Spencer recently became unemployed and moved into self employment. He was forced to find his own health insurance plan to protect his family. It wasn't as easy as he first thought. Here he shares the pitfalls of various plans and what you need to look out for when picking a good plan for you: