Uses of the summary of benefits and coverage?
Health insurance comes with a huge collection of paperwork that one needs to complete. Unfortunately, most of the paperwork contains insurance vocabulary that most people are not familiar with. Thus, it is very easy to complete insurance forms and other documents in error because you don’t know what is contained on them. In this article, I will be looking at a concept called summary of benefits and coverage.
What is the summary of benefits and coverage?
A summary of benefits and coverage refer to a list of benefits that are contained in a certain insurance policy as provided by the insurer. The law requires insurance companies to provide the public with a list of benefits that are contained in the health insurance plans they provide. The list should provide details of all details that people might find to be useful to them.
Importance of the summary of benefits and coverage
Besides providing information on all the benefits that the insured is entitled to when they purchase a certain MSH health insurance in China policy, the summary must also contain details of the rights that the insured has if they have a grievance or appeal against the insurance company. It should also contain details on procedures to follow. It is important that a policyholder keeps a copy of their summary of benefits and coverage so that they can refer to it in case there is need for that.
What information is on the summary of benefits and coverage?
The summary of benefits and coverage that you receive from the insurance company will contain a lot of information, which will contain:
deductibles
cost-sharing amounts
out-of-pocket limit
network of providers to be used by the policyholder if there are any
Whether one needs a referral to see a specialist
Any services or treatments not covered under the plan