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What is the table of benefits in health insurance ?

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Question ajoutée par abdulrhman frikha , MEDICAL CLAIMS SPECILAIST AND PROVIDER RELATIONSHIP , GLOBEMED SAUDI
Date de publication: 2016/03/12
Shahul  Hameed Mohammad
par Shahul Hameed Mohammad , Human Resources Generalist (HR Generalist) , S A CO

Health benefits may vary from state to state but include at least the following items and services

1.      Outpatient care

2.      Emergency room asmission

3.      Treatment in the hospital for inpatient care

4.      Care before and after baby is born

5.      Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy

6.      Prescription drugs

7.      Services and devices to help to recover if injured, or a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.

8.      Lab tests

9.      Preventive services including counseling, screenings, and vaccines to keep one healthy and care for managing a chronic disease.

10.   Pediatric services: This includes dental care and vision care for kids

Please suggest your ideas as you are expert on this or waiting for the reply of experts

 

 

Khalid Jumani
par Khalid Jumani , Manager - Employee Benefits Practice , MARSH Pakistan - Unique Insurance Brokers Pvt Ltd

Table of benefit shows what benefits are covered under the policy. It shows the benefit limits. 

Mohamad Yehia
par Mohamad Yehia , Health Insurance - Manager , BRITISH MEDICAL CENTRE

The table of benefits for any Insurance company or TPA ( Thirt party Administrator ) are what the Insurance company will cover under its policy (Dental benefit - Maternity benefit - Optics benefit - Chronic benefit Physiotherapy benefit ) Doctor visit usually covered by any Insurance company with a copay ( a percentage should be paid by patient) if its not on Reimburse basis, actually its different from company to another depend on the company policy and terms.

Yehia 

abdulrhman frikha
par abdulrhman frikha , MEDICAL CLAIMS SPECILAIST AND PROVIDER RELATIONSHIP , GLOBEMED SAUDI

The medical insurance plan for AOPA members automatically includes in-patient and out-patient cover with no annual benefit limit. You can choose to add cover for Alternative Therapies, Psychiatric Care and Rehabilitation if you wish.

I apologized for the answer I do not know the answer Leave for professionals

Mai Sadeddin
par Mai Sadeddin , Medical Claims officer , MedNe

The benefits of health insurance can be summarized as the services you receive from your health insurance company.  Most companies are also willing to work with you to determine your needs. You can have certain areas of your health insurance plans cover certain types of injuries or illnesses more specifically, so that you pay less for recurring things like office visits and medicine, or you can spread out your coverage as a more general purpose plan.aslo you can add extra benefits that you can take an advantage as dental or optical benefits  .all the benefits you receive it according to your policy and contact with your insurance company. 

because covering your in-patient or out-patients treatment depends on you policy . aslo the chronic medications .

Ahmed Mohamed Ayesh Sarkhi
par Ahmed Mohamed Ayesh Sarkhi , Shared Services Supervisor , Saudi Musheera Co. Ltd.

sorry i'm not expert on this filed

 

Vinod Jetley
par Vinod Jetley , Assistant General Manager , State Bank of India

The benefits of health insurance through the Marketplace. No one plans to get sick or hurt, but most people need medical care – like a doctor visit, a prescription drug, a lab test, physical therapy, or counseling – at some point. These services can be expensive

Mohammed Amin Petiwala
par Mohammed Amin Petiwala , CFO , Osool Poultry SAOC

Normally Tables are set of coverage that the Personal Accident policy covers.

For example Table A, B, C, D refers to various positions that are covered. Table A is least coverage with temporary disablement, Table B covers all situations of Table A plus Partial Permanent Disablement, Table C is more than Table B and Table D ultimately covers Death.

Insured falls in either of these tables depending on its situation and the claim is fixed accordingly. Obviously, amount of claim that can be paid in Table D is more than that gets covered in Table A

Aidin Mc Grath
par Aidin Mc Grath , HR Generalist , Saudi Aramco

Not sure if I fully understand the question but normally the table of benefits outlines the cover that an individual is entitled to under the policy.

Rasha Maarabouni
par Rasha Maarabouni , Executive Registrar , Lebanese International University

I guess that differs from one country to another. 

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