Having a health insurance plan is a great way to protect your finances and your health. The cost of health care without health insurance coverage is very high. Enrolling in a health insurance plan helps you cushion the adverse effect of your health care needs on your personal finances. Health insurance coverage is the amount of risk or liability covered for the policyholder by the insurance provider. It is the amount of protection the insurance company agrees to pay upon the happening of an agreed event.
Health insurance coverage helps the policyholder regain financial stability from unexpected health issues or accidents. Your insurance provider pays for the cost of your health care based on the contract agreed between the both of you. Your insurance coverage is generally guided by the insurance policy between you and the insurance provider.
The 10 Factors
Health insurance providers provide coverage based on their estimation of future health issues that might occur. To make this assessment and determine the risk associated with a particular policyholder, there are certain factors that they have to put into consideration. There are different factors that determine how high or low your insurance coverage is. Some of the factors are not within your control like family health history. However, some others are within your control like lifestyle choices and the type of policy you enroll in.
We have highlighted a list of factors that can affect your health insurance policy.
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Type of Policy
There are different categories of health insurance policies offered by insurance providers. These categories are available to provide coverage based on your financial capacity. From the highest to the lowest, whichever one you decide to go with will affect the type of coverage you get. Some companies in a bid to make insurance accessible to a wide range of customers with different financial capacities have made it possible for you to customize your policy based on your budget and health condition. This makes your policy suitable for your specific health need and budget. Insurance companies offer different types of policies so it will also depend on your specific insurance services provider.
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Age
Age is a very important factor that affects your health insurance coverage. The premium payable increases with age. Age is an important factor because your health condition will get worse with age. This is a natural principle. Health insurance is a calculated risk. Thus, the insurance providers put this into consideration when determining the coverage to give you.
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Gender
On average, men are high-risk policyholders compared to women. This is because men have riskier jobs than women and are more likely to drink than women. Women also live five years longer than men statistically. Gender also affects your coverage as a woman because there is the likelihood of pregnancy and the cost of maternity care.
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Pre-existing conditions
The better your health condition, the better the insurance coverage you get from your insurance provider. Pre-existing health conditions are to be disclosed during the process of enrolment. Do not leave out any pre-existing conditions when enrolling. Any omission could invalidate your policy because it would amount to insurance fraud. These pre-existing health conditions if any will affect the health insurance coverage you get.
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Family Health History
There are a lot of diseases that passed on genetically. For example cancer or diabetes. If you have any family member that has or died of any of such diseases, it puts you at risk of having them. Thus, the need for full disclosure as it is considered when determining your coverage.
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Habits
Bad habits such as smoking and drinking affect coverage. Generally, insurance providers charge smokers more than they charge non-smokers. The consumption of tobacco and not just smoking also put the policyholder at high-risk for tobacco inflicted diseases. Certain bad habits already put the policyholder at risk for diseases. For this reason, these habits affect your insurance coverage. When enrolling policyholders, insurance providers ask candidates to disclose information regarding these habits. It is an important determining factor in your coverage. Failure to disclose any or providing false information amounts to insurance fraud.
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Occupation
There are high-risk jobs and low-risk jobs. If your job is classified as a high-risk job, it will definitely affect the premium you pay and your coverage. You will need to give full disclosure of your occupation when enrolling. It helps the insurance provider access the kind of accidents you are at risk of having.
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Hobbies
In close relation to the occupation are hobbies. There are certain hobbies that are risky hobbies. They are hobbies such as scuba diving, rock climbing, mountain climbing, base jumping to mention a few. These hobbies are classified as high-risk because they put you at risk for accidents. If you have any high-risk hobbies, then it will definitely affect your health insurance coverage. If you do not disclose this hobby and get adequate coverage for it, then you will not be able to get financial compensation in the event of an accident that happens in the course of any of such activity. You will have to bear the burden of any financial obligation that arises from the accident. The point of health insurance is to get coverage in situations such as this. Thus, it is important for you to get full coverage.
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Driving Record
It’s not motor vehicle insurance you are getting but driving records affect your health insurance coverage. Insurance providers want to find out if you have had any DUI or spotty driving record. This information helps your health insurance provider to access your risk of having a car accident and whether or not you should get coverage for any car accident that might occur.
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Location
Location affects coverage. State and local laws and policies on insurance vary. Additionally, the cost of living and competition in different states will affect the coverage made available by insurance providers.
If you’re exploring health insurance or looking for alternative healthcare plans, Life Insurance, or supplemental insurance plans feel free to reach out to our professional agents and see what program or programs might be right for you, that can help you through this time. Call Vivna, Inc. today to learn more here: 866.793.2301