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FRIDAY, JULY 2, 2021 | Roman

What the best private health insurance can do for you

What the best private health insurance can do for you

You have a non-acute but unpleasant back problem and receive a referral to an orthopedist from your family doctor. Now you call there to get an appointment. If you are an insured patient, your appointment may be within the next 30 days; if you are a private patient, your appointment could be as early as next week. Admittedly: It sounds like a cliché, but it corresponds to reality - private patients enjoy certain privileges, in addition to preferential appointment allocation, for example, shorter waiting times at the doctor’s office or the chief physician treatment in clinics.

Private health insurance is a comprehensive health insurance. Every citizen in the US must have health insurance, this is required by law. Above a certain annual gross income, you can choose yourself whether you want to be insured by statutory or private health insurance. If you choose the latter, the private health insurance will pay for your treatment costs in case of illness.

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The benefits of the best private health insurance

Private health insurance reimburses bills that a doctor or hospital issues to the patient. The range of benefits usually exceeds that of statutory health insurance. In addition to medically necessary measures and medications, depending on the tariff, particularly expensive or alternative treatments, over-the-counter medications and visual aids are also covered. If desired, the choice of single or double rooms in the hospital or treatment by a chief physician can also be included in the insurance coverage.

The costs of spa treatments, rehabilitation measures and patient transport are also covered. Special rates for stays abroad ensure smooth reimbursement for treatment abroad. Optionally, the private insurance covers up to 100 percent of all medical costs for life.

By the way: The treatment costs of psychotherapy are not automatically included in private health insurance. The benefits provided by private insurers vary. Some providers do not reimburse the treatment or only partially. The decisive factor here is the specific contractual agreement between you and the relevant insurance company.

The contributions of the best private health insurance

The contribution amount for private health insurance is determined individually. Among other things, the profession, age and state of health of the insured person at the beginning of the contract are decisive. The higher the risk of illness, the higher the premium. The individually agreed benefits also play an important role.

There are considerable differences between the various providers, but also within the tariffs. Premiums can also rise during the term of the contract. For example, a 30-year-old employee pays around $381 per month for the standard tariff without deductible and without entitlement to daily sickness benefits, depending on the provider. A 50-year-old has to pay about $600 under the same conditions.

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The plans of the private health insurance

In addition to the basic tariff, providers offer numerous other tariffs, some of which differ significantly in terms of benefits, deductibles and premiums. The advantage of this is that the tariffs can be flexibly adapted to personal needs, risks and requirements. A basic distinction is usually made between basic, standard and comfort tariffs. In addition, depending on the agreement, additional tariffs for higher reimbursement and special treatments can be concluded.

The requirements for private health insurance

Anyone who is not compulsorily insured by law can take out private health insurance. This includes all employees whose gross annual income is above the compulsory insurance limit of $64,350 for 2021. That is $5,362.50 in gross monthly income.

Civil servants, self-employed persons and persons with no or marginal ($450 per month) income also fall under this group. Students can switch from statutory health insurance to a private provider upon application. In the case of certain illnesses, the insurance company can demand a risk surcharge or an exclusion of benefits. This does not apply to the so-called basic tariff, which corresponds to the benefits of the statutory health insurance funds.

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