About Health Insurance
Health Insurance policies, in most cases, have three levels or tiers of paying for claims. They are as follows:
I. 1st Tier Deductable - This is always the responsibility of the insured. Usually, each family member has their own deductible to be satisfied.
II. 2nd tier co-Insurance: The word "co" means to share with the insurance company. The co-insurance comes into play for each individual after they meet their deductible dollar amount responsibility. For example, on the American Republic Plan, "Ultra Care Medical Expense Plan," the co-insurance is split on a 80%-20% (ratio) basis. That means that the 1st $10,000 in medical expenses that an insured may have, let's say for a hospital admission, will be paid 80% by the Insurance Company and 20% by the insured. In other words the expenses are shared 80% by the insurance company and only 20% by the insured. In this way, the insured's losses are limited to only 20% of the first $10,000 in medical expenses beyond or above the deductible. This sharing of Co-Insurance guarantees that the insured and their family will never be impoverised by a catastrophic illness.
III. 3rd Tier - The insurance companies responsibilities up to the maximum benefit of the insurance company. This means that any medical expenses beyond the co-insurance of $10,000 will be paid 100% by the insurance company, up to the limit of the (company's) policy maximum as specified in the company's brochure and insurance contract.