Вибір страхової компанії для іноземного студента (англійською)
To select a health insurance policy, begin by asking what is the insurance company’s A.M. Best rating.
A.M. Best is a company that rates insurance companies based on the insurance company’s ability to pay claims. Do not accept an insurance company with an A.M. Best rating lower than “A.” They have a rating system for insurance companies that ranges from A++ (the highest) down to F5 (theТ lowest).
Companies that are in the range between B and F5 are considered “vulnerable.” This means that there is a possibility that if they received a large number of claims all at once, they may not be able to pay them. The companies that are rated between A++ down to A- are considered “secure.” This means that they can always pay all of their claims. I will not work for an insurance company with a rating lower than “A,” and no one should accept an insurance company with an A.M. Best rating lower than “A”.
The deductible is the amount you pay before the insurance company pays anything. There are two types of deductibles. The first type is an annual deductible. Over a period of a year you have incurred a few small medical claims. Once the amount of those accumulated claims reaches the deductible amount (usually $100), the insurance company begins to pay. The second type is a per occurrence deductible. This means that you pay the deductible amount with each claim. If you had five claims in one year (each over $100), and the deductible amount was $100, then you would have paid $100 five times, or $500. Look for an insurance policy with an annual deductible or no deductible at all.
The co-insurance clause requires you to pay a percentage of the medical claim up to a certain dollar figure. It is usually expressed as 80/20 co-insurance. This means that after you have paid the deductible, the insurance company will pay 80% of the claim, and you will pay 20%. This continues until the claim amount has reached some pre-determined dollar amount, and then the insurance company will pay 100%. The dollar figure will vary among insurance companies; I have seen this figure vary from $2000 to $50,000 dollars.
Example: The total medical claim is $12,000. The deductible is $100. The co-insurance clause is 80/20 up to $5000. You pay the first $100 which satisfies the deductible. You are required to pay 20% of $5000, or $1000.
The insurance company pays 80%, $4000. The insurance company pays for 100% of the remaining costs, $6900, but you have already paid $1100 (the co-insurance plus the deductible).
It is very important to understand your policy before you have a claim.
This includes any medical condition that existed prior to the policy effective date. If your were to arrive in the US on August 28, and your policy was effective on that date, any medical condition that was in existence prior to August 28, might not be covered at all. Some companies cover pre-existing conditions after a certain amount of time has passed, and you have had the insurance coverage the whole time.
The biggest problem with the medical claims is that students often do not fill out the claim forms properly or completely. If the claim form is not completely filled out, the insurance company will not pay the claim. Some insurance companies also require that you provide the original bill along with the claim form. Be sure you make and keep photocopies of everything you send to the insurance company.
What is not covered? In all policies you will see an extremely long list of exclusions. Pre-existing conditions will not be covered for a period of time. Self inflicted injuries will not be covered at all, and any injury incurred while you were involved in a criminal act, will not be covered. Basically, that is all that long list says.
Some things you do want to look for. If you intend to drive a car in the US, will your medical insurance cover you if you are in an accident? If you are going to play sports here, does your medical insurance cover sports? If you are female, the maternity coverage may be very important to you. Be sure to learn what the dental coverage is. Do not assume that these things will be covered. In many policies for international students, those things are specifically excluded.
As an international exchange student, the insurance policy you select should cover medical evacuation and repatriation. Some plans also provide emergency visitation. This coverage provides a plane ticket for a family member to come to the United States if you are hospitalized in a serious condition. Health insurance policies for international students can be very different. I have one program for high school students that does not have a deductible or a co-insurance. This plan is not available to anyone that is above high school age. I have a plan for university students that is not available to high school students. Both plans are very different from each other.
While you may be required to have health insurance in the United States, you have the right to select which insurance plan is best for you. Make your decision carefully and be sure that you know what is or is not covered. Do not be afraid to ask questions and make sure that you understand the answer.
Submitted by Kent Corrick of BGI, Inc. insurance company. 1995. If you have any further questions, I would be happy to try to answer them for you. My coordinates are:
2033 6th Ave., Suite 236
Seattle, WashingtonТ 98121
1-800-322-9998 (from the United States)