Advantages and Limits Of The Health Insurance Policy

All The Information To Understand What Are The Advantages and Limits Of The Health Insurance Policy

All The Information To Understand What Are The Advantages and Limits Of The Health Insurance Policy
What guarantees does a health policy provide? What, on the other hand, are the limits and restrictive clauses of a health insurance contract? All the information and points to pay attention to to better understand the health insurance contract, evaluating the pros and cons, based on your needs.

Although the national health service is perfectly able to cover all the necessary treatments provided for by medical assistance, many times it is advisable to resort to a health policy , in order to better protect one’s person.
The health policy, in fact, can guarantee coverage of the expenses necessary for the treatment of serious diseases that require specialized assistance in private clinics, such as in the case of delicate operations or hospitalizations. The policies are able to cover all those pre and post-operative expenses, even if rehabilitation periods are required.
Health policies , therefore,they are a good ally, to be integrated into the national health system, in order to receive more immediate and effective assistance in case of need .
Health policies allow you to enjoy a series of benefits for policyholders , but, like other types of insurance, they also include restrictive clauses . Sometimes, the customer is so sure that he has certain coverages provided for in his policy, that he does not take into account a whole series of clauses that limit the guarantees.
The advice is always to carefully evaluate the contract to be signed, in order to choose the one that best suits your requests .


Is it really worth taking out a health insurance policy? The answer is simple: it depends on the guarantees granted by the insurance companies, that is, based on what is stipulated in the contract.
Usually, the benefits that are found in most of the health insurance policy contracts are the following, namely:

health benefits;

the possibility of choosing the health facility in which to receive assistance;

adding extra medical care;

check-ups and optional visits;

cancellation of waiting lists;

insurance coverage for the whole family.

The national health system does not cover the total costs for the purchase of health benefits , such as, for example, wheelchairs, crutches or prostheses, therefore, resorting to a health policy, allows you to protect the insured from any costly expenses. .
Each health policy allows the insured to be able to choose the private hospital where he wishes to receive the necessary medical assistance. In this case, in fact, the insurance company will provide for the reimbursement of a part of the medical expenses incurred by the insured: it is necessary to present the invoice for the service received.
Another alternative, however, is to choose among the affiliated clinics with the insurance company, so that the insured can receive all the necessary care, without spending anything.
Furthermore, by signing the health policy, it is possible to perform a whole series of treatments and analyzes which, although not provided for by the national health service, can reassure the sick and prevent any other ailment.
Sometimes, extra checks and examinations are not considered by the national health system, especially those concerning the prevention of the sick, as they are very expensive. With health policies , however, it is also possible to add the guarantee on prevention, so as to help the insured in the fight against the occurrence of any type of future disease.
Furthermore, with the stipulation of a health insurance policy, it is possible to receive immediate and specialized assistance, without having to wait for the booking lists. In this way, the insured is able to know in real time what their health conditions are.
Some insurance companies also allow you to extend health insurance to the whole family , while maintaining the payment of the single premium.
Furthermore, with the health insurance policy, the insured person is able to face his illness more peacefully, as all hospitalization and analysis costs will be covered by the company, as well as those of everyday life, so as to face even the cases in which it is impossible to go to work.
The guarantees included in the health policy include the following services:

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optional periodic check-up;



physiotherapy costs;

expenses for medical, surgical and nursing services;

diagnostic tests;

specialistic examinations;

dental expenses (on teeth) if necessary following an accident;

expenses for the purchase of prostheses / medical surgical aids.

Many insurance policies allow you to get health care even in the event of childbirth , although in these cases it is advisable to carefully evaluate any clauses.


The real limit of insurance policies is constituted by the clauses : they, equivocal and limiting , are not always clear and understandable for those who subscribe to a policy. Their true meaning is revealed only when, after the facts, the insurance does not cover a specific event, since in the contract, a limitation is indicated in clause X.
The same limitations also apply to health policies, precisely for this reason, it is always advisable to check and carefully study the entire contract, in order to evaluate all the cases and the application of the insurance guarantees .
Among the most common and annoying limits of a health policy, surely, the following should be considered:

the clauses;

penalties and compensation.


The clauses are not secondary elements of a contract, as they represent unpleasant surprises, which impose restrictions and limitations on the validity of the guarantee.
As regards health policies, in fact, it is not uncommon to come across vexatious clauses that restrict the scope of the contract, almost always for the following reasons, namely:

exclusion of certain illnesses or injuries from the policy

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limit from the policy .

Therefore, it is of fundamental importance to always make sure of all the pathologies that are included among those covered by the policy, as well as to check the age limits, within which it is possible to consider the insurance contract valid .
However, the policy limits may also concern other aspects, including the territory. Some insurance companies do not extend the validity of the policy to other countries , therefore, it is necessary to understand if the health coverage can be valid even if the accident or illness occurs during a stay abroad.
Another limitation of the health policy concerns injuries that are related to sports practices, which may not be covered by the insurance coverage. Furthermore, in the health insurance contract, the so-called waiting period
must also be assessed , ie the one including the date of signing the policy and the one in which the insurance becomes valid. Usually, in fact, the policy does not have an immediate effect, in the sense that it is not possible to include accidents and illnesses that occur immediately within the health coverage. This is the trick experienced by the companies, in order not to pay for any necessary care and assistance for all those unhappy events, which occurred previously or during the signing of the contract.


Although the insurance companies grant the freedom of choice regarding the hospital structure in which to receive assistance, it is very common that they foresee penalties to be paid when the insured prefers the treatment of a non-affiliated structure . In the event that one relies on non-affiliated structures, in fact, the possibility of taking advantage of direct compensation is lost , therefore, the insured must necessarily anticipate the sum foreseen for medical expenses, which will then be reimbursed with a percentage lower from the same insurance company. In the most extreme case, as mentioned above, it is also possible that the same requires the insured to pay a penalty to be paid for the application of the indemnity limits.

Ultimately, it is strongly discouraged to turn to non-affiliated facilities to receive the necessary treatments, unless the contract does not include the guarantee of full reimbursement of expenses even in the event that you decide to rely on other hospitals or private clinics.
Below, a series of points to be noted are provided in order to avoid incurring unpleasant penalties; the advice in this regard are as follows:

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assess the limits of compensation

do not make false statements about your health

choose to take out an annual policy and not opt ​​for a multi-year one

not to take out a policy which provides for the company’s recession after a complaint or liquidation

avoid entering into a health insurance contract that includes a bilateral withdrawal clause or an arbitration clause .

Low compensation limits are offset by heavy costs, which invalidate any health policy benefits.
Furthermore, making false statements about one’s health risks relieving the insurance company of any obligation to pay, or at best, it can claim the right to halve the coverage.
The freedom of withdrawal after each complaint or liquidation, in reality, is not a fair clause, but an abusive one, devised by the insurance companies to free themselves from any contractual constraint, at the time of the payment of the requested service.

All The Information To Understand What Are The Advantages and Limits Of The Health Insurance Policy.

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