TN Health Insurance Latest Update Already Passed

TN Health Insurance Latest Update Already Passed Conditional Receipt If initial premium is paid at time of application, the producer with issue a continual receipt. Provides that coverage will become effective as of either the date of application or the date of completion of any required medical exam - which ever is later. Underwriting The process of selection, classification, and rating, The process of determining if someone is insurable, classifying risk, and determining rate or premium. Sources of Insurability Application, Medical exam, an attending physicians statement, the MIB, an inspection report, and the agent's report. Pre-existing condition a prior medical condition that applicant received, or should have received medical advice, diagnosis or treatment within a specified period before policy effective date Traditional Health Insurance aka indemnity or free-for-service plan -reimbursement for medical expenses -patient makes the choice of where to receive care Managed Care Plans Care plans that provide participants aka subscribers with a list of health care providers (in network) they may visit and then either cover the entire cost or collect co-pays from members, Payment Structure Comparisons (Managed Care Plans) 1) Fee-for-Service - provides separate payment to doc for med service 2) Prepaid - benefits to subscriber for monthly premiums 3) Usual, Customary, Reasonable (UCR) - benefits based on avg fee charged by all docs in area, insurers pay that & insured pay left overs. 4) Lifetime Limit - the max a policy will pay for losses during life 5) Annual Limit- max per year 6) Per cause - max per claim