The principle of health insurance is based on the medical coverage available to any subscriber. Whether it is a person registered in the public sector workers’ directory or a private professional, this guarantee is available to everyone. Here is what to know when it comes to health insurance.
Focus on health insurance
In the developed countries of the West, the financial costs of workers’ health insurance are borne by the state. Why is that? This is because health insurance is an essential component of social assistance.
Remember that social assistance supports individuals facing economic, social, family, and especially health difficulties. It is this last category of deficiencies that is subject to health insurance. Thus, thanks to this device, the financial risks of care in the event of illness or work accident are covered. Better still, in the event that the insured is the victim of an illness depriving him of his mobility, he benefits from a support premium.
It should be noted that in some economies the management of the health insurance system is entrusted to private structures. In the event that this management is ensured by both the government and private entities, we speak of a mixed system of organization.
Be aware that in the public health insurance system, the deposit paid by the insured is not always based on pure insurance. Indeed, the state bodies in charge of regulating this system establish a pure insurance function and a distributed one so that the insurance of the most disadvantaged is paid for by the middle class and the rich.
The main forms of health insurance
In general, the operation of insurance focuses on the pooling of risk. Each insured is therefore subject to a deposit fixed according to the clauses of the contract and its conditions. In case of need or difficulty in the medical field, the insurance covers the expenses according to the lease contract. To this end, here are the two popular health insurance models are financial insurance and networks of care.
With financial insurance, you are insured against illness and accident. The costs of care administered to you are reimbursed according to the scale established in advance. Whether it is the areas of medicine that require the greatest expense or otherwise, you will get substantial health coverage. Your drug costs and practitioner benefits will also be paid at a certain rate.
Insurance established in a healthcare network
In this case, practitioners, pharmacists, and other health officials are contacted. It is then up to the insurer to take out a medical subscription on behalf of the insured. Here, the subscriber cannot choose his own hospital. He is assigned a well-stocked list of specialists if of course, he intends to take advantage of free care. In the private sector, there is complementary health insurance (mutuals and insurance companies) that provides access to multiple healthcare networks, in addition to public insurance.
Health insurance is a system governed by state law to provide relief to the working population. This can be financial coverage in the event of an accident or illness and access to healthcare networks.