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Hospital expense is another type of potential group coverage. These policies can pay for hospital expenses whether inpatient or outpatient. Fees of an attending physician during hospital treatment may be covered. Some types of group policies may only cover surgical expenses.
Network model – This arrangement works like the Group model with the difference being that the HMO will contract with more than one group to provide the services. The primary purpose for this model is to provide convenience and increase accessibility for the members.
Further, there are a number of provisions that apply only or primarily to group policies. These provisions: Describe who is eligible for the group plan, Describe when individuals become eligible for the plan. Specify minimum number of participants and minimum participation by eligible people necessary to sustain the plan, Specify amount of insurance that individual group members are entitled, Describe the responsibilities of the master policy owner.
HMO (Health Maintenance Organization): Prepaid health plans. You pay a monthly premium and the HMO covers your doctors' visits, hospital stays, emergency care, surgery, checkups, lab tests, x-rays, and therapy. You must use the doctors and hospitals designated by the HMO.
If you are in that “no mans land” where you do not yet qualify for Medicare, Medicaid or any of the other social programs yet are too old for individual coverage you might take a look at AARP. It can provide a stop gap for that period of time while you are waiting to qualify for assistance.
The person who received the death benefit is called the beneficiary. The policy owner has the right and responsibility of naming beneficiaries. Usually there is a primary beneficiary however he/she can assign a second and even a third beneficiary.
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