Most people are not familiar with the terms used in health or major medical insurance contracts or policies. One of our objectives as an insurer is to provide you with information so that you master the subject and can make better use of the services you have contracted.
Surely at some point, you have heard insurance agents mention the word deductible, but… do you know what their role is in terms of health insurance? Beyond memorizing a concept or repeating phrases, what we are looking for as specialists in the sector is that you appropriate the term and know the advantages you have as an insured.
What is the deductible of your health insurance?
The health insurance deductible must be understood as a percentage that has been agreed to share responsibilities for the insured property, in this case, personal or family health. This is done so that the contracted services are fulfilled and there is no irresponsible accident rate.
Here are other ways to understand the function of the deductible in health insurance and other types of insurance:
The Mexican Association of Insurance Institutions (AMIS) defines the deductible as the amount or percentage established in a policy whose amount must be exceeded for a claim to be paid.
In Insurance Plan denominated deductible to the maximum fixed amount that is borne by the insured, which corresponds to the first expenses. The deductible is established on the title page of each policy and is applied once per condition. If the expense to be covered exceeds the agreed amount, it will be the insurer’s obligation to pay the rest.
In summary, we can say that when health or other insurance is contracted, the deductible fulfills the function of sharing the risk between the insured and the insurer. So, when a disease or specific expense related to it occurs, the insured has to pay an amount (previously stipulated) out of pocket, that is the deductible.
Depending on the insurance you have purchased, the deductible can be a specific amount or a percentage of the total amount of insurance. Generally, if the deductible amount is high, the cost of the premium is lower.
According to data shared by the National Commission for the Protection and Defense of Users of Financial Services (Condusef). In Mexico, the percentage of the deductible is set about the number of claims that are recorded and the amount of money that, in a certain period, is paid by insurers per event.
As we already mentioned, offering you this information is intended for you to know the contracted services and make the most of your insurance.
What is Major Medical Expenses insurance?
It is an instrument that allows you and your loved ones to be protected from the economic impact that an expense in Health can represent. Insurance protection will help you pay for health care costs, so you can focus on getting well.
How does it work?
You will contract the product that best suits your style and stage of life, so that you decide your participation per event, the hospital level to which you would like to have access and, if you wish, additional benefits that can improve your coverage.
In case of requiring care due to an Accident or Illness, the medical expenses derived from the care will be covered, such as: hospitalization, medical fees, medications, laboratory studies, etc.