Insurance-Health Insurance

Another type of insurance coverage is health insurance. Health insurance contracts are frequently group insurance contracts wherein you, as a member of a group, pay a premium to the insurance company in return for the insurance company agreeing to cover medical and hospital expenses up to certain limits. The general limitation of the scope of coverage under these policies is that the treatment that you receive must be reasonable and necessary and the cost of the treatment must be consistent with the usual and customary charges for other practitioners in the area. For instance, if you decide to have plastic surgery that is purely elective, this type of treatment may not be covered unless you have a special endorsement or provision within your policy that provides coverage since the treatment is not necessary. Likewise, if you choose to go to the most expensive orthopaedic surgeon in the area because you think he or she is the best, all of the charges rendered by that surgeon may not be covered under your policy. The policy is governed by what is usual and customary for those types of services and not necessarily by what the best practitioner in that area may charge.

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