Article by: Ing. Hugo Piña | Last update: April 10, 2022
It is the set of coverages and conditions of the policy such as group of hospitals, Sum Insured, deductible, coinsurance, tabulator of medical fees, additional benefits, among others, including its endorsements, which indicate to the Contracting Party the benefits to which the community is entitled. insured.
- 1 What is Medicallife?
- 2 What does Medicalife cover more?
- 3 What does the MetLife Executive major medical insurance cover?
- 4 How does coinsurance for medical expenses work?
- 4.1 When does it apply to pay coinsurance?
- 4.2 What is coinsurance and how does it work?
- 4.3 What are the 21 surgeries that MetLife covers?
- 4.4 How to use GMM MetLife?
- 4.5 What happens if I have two major medical insurance plans?
- 4.6 How to buy family insurance?
- 4.7 What does Metlife Mexico guarantee mean?
- 4.8 How is major medical insurance paid?
- 4.9 What is a major medical expense policy?
- 4.10 How long does it take for MetLife to authorize a surgery?
- 4.11 What are the critical illnesses that MetLife covers?
- 4.12 What critical illnesses does MetLife cover?
- 4.13 How much does MetLife pay on death?
- 4.14 What is Bolivia coinsurance?
- 4.15 What is the purpose of coinsurance?
- 4.16 What is the importance of coinsurance?
- 4.17 When do I not pay coinsurance?
- 4.18 What is the coinsurance limit?
- 4.19 When is coinsurance paid on AXA medical expenses?
What is Medicallife?
MédicaLife Familiar is a Medical Expenses Insurance with which you can feel totally safe having access to the hospitals you decide. MédicaLife Executive: Enjoy complete medical coverage that gives you access to the most prestigious hospitals throughout the national territory.
What does Medicalife cover more?
Medicalife Más: It allows you complete medical coverage with access to mid-cost hospitals throughout the country. Basic Medicalife: With the vision of empathy and understanding, this is a plan that adjusts to your possibilities and you will have access to affordable hospitals.
What does the MetLife Executive major medical insurance cover?
Your Major Medical Expenses policy covers diagnostic expenses, medical fees, medical supplies, medicines and hospital expenses, as long as you have been diagnosed by a doctor legally authorized to practice the profession.
How does coinsurance for medical expenses work?
Some common examples of coinsurance include: 100%, 80/20, 90/10, and 50/50, so if you have 80/20 coinsurance in your insurance plan, this means the insurance company will cover 80% of your costs. medical expenses and you are responsible for paying the other 20% yourself. A deductible is commonly used with coinsurance.
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When does it apply to pay coinsurance?
The coinsurance fee is established by the insurers before signing the contract. The more we pay monthly, the lower this cost will be. The percentages regularly range between 5 and 20%.
What is coinsurance and how does it work?
Coinsurance, by this definition, is an insurance contract subscribed, on the one hand, by the insured and, on the other, by several insurers who assume, with complete independence, one from the other, the obligation to respond separately for the part of the risk that they receive. correspond.
What are the 21 surgeries that MetLife covers?
3. Covers 21 surgeries, including: gallbladder removal, appendix, prostate, uterine fibroids, testicle(s), mammary glands, tonsils, adenoids, hemorrhoids, urinary stones, cataract surgery, colon surgery and hernia correction.
How to use GMM MetLife?
How does Metlife’s GMM policy work?
Confirm the compensation forms of your medical expenses policy. … Use the services of the network of doctors and hospitals that you contracted in your policy. … Be clear about the sum insured that you contracted. … Consider that you will have to pay the deductible and coinsurance.
What happens if I have two major medical insurance plans?
When in doubt about what will happen if you have two health insurances, the answer is that nothing would happen as long as the coverages of both insurances do not contradict each other in their competence. So that this does not happen, you must know the different modalities in which health policies are applied: Recognition of medical expenses.
How to buy family insurance?
Requirements to join
Go to the subdelegation that corresponds to the address of the insured, from Monday to Friday from 08:00 a.m. to 3:30 p.m. Submit official identification, birth certificate, CURP and proof of address, if applicable, marriage certificate, of the owner and family members to incorporate.
What does Metlife Mexico guarantee mean?
Guaranteed Protection gives you the option of expanding the Medical Expense Insurance that your company gives you, protecting you if you lose the benefit, due to: resignation, dismissal, retirement, disability or loss of economic dependent.
How is major medical insurance paid?
This is paid only once per condition and is a fixed amount. The amount of the deductible is chosen when contracting the insurance policy for major medical expenses. Tip: The higher the deductible, the lower the cost of the policy. For example, you can choose between a deductible of 9, 25 or 55 thousand pesos.
What is a major medical expense policy?
The Major Medical Expenses Insurance is a financial protection plan to cover the expenses generated by medical attention originating from an accident or illness, since unfortunately, no one is safe from such events and the expenses of hospitalization and follow-up They can be very…
You will receive the response to your Surgery Scheduling procedure, within 3 business days.
What are the critical illnesses that MetLife covers?
It protects you in case of diagnosis of any of these diseases:
- Cancer. Myocardial infarction. Cerebrovascular incident. Kidney failure. Coronary artery surgery. Organ transplant. Multiple sclerosis. Paralysis.
What critical illnesses does MetLife cover?
Coverage of 7 diseases: Cancer, Myocardial Infarction, Cerebrovascular Accident (Heart Attack, Thrombosis or cerebral hemorrhage) Aortocoronary Bridge (bypass), Coronary Artery Surgery, Heart Valve Surgery, Aortic Surgery and Coronary Angioplasty.
How much does MetLife pay on death?
If the owner dies before the policy is issued, their beneficiaries may receive up to $500,000.00 pesos. If you are diagnosed with a terminal illness, you can receive an advance payment of 30% of the Sum Insured of your basic coverage for death.
What is Bolivia coinsurance?
Coinsurance is the way that insurers have to distribute a risk and that is contemplated in article 33 of the Insurance Contract Law. It consists of one or more insurance contracts through which 2 or more companies offer coverage for the same risk and for a matching period of time.
What is the purpose of coinsurance?
The objective of coinsurance is to distribute the risks so that the insurance companies protect their assets in the event that they have to cover the expenses of the insured event. Coinsurance is used for important risks, where the insured resources have a high value.
What is the importance of coinsurance?
It is mainly intended to reduce high-impact risks, such as airplane accidents, coverage of museums of national importance, coverage of specialized plants, etc. In fact, most of the time some co-insured contracts are themselves reinsured.
When do I not pay coinsurance?
In the event of an accident covered by the policy, where the first expense has been made within 10 days of its occurrence, the deductible and coinsurance charge will be eliminated; In addition, the total expenses are not required to exceed the deductible.
What is the coinsurance limit?
What is the Coinsurance Cap? A concept as important as coinsurance is the COINSURANCE CAP. Most large companies cap the maximum amount of coinsurance payable at $35,000 pesos, $40,000 pesos, or similar amounts. This limits the expense of the insured in the event of a catastrophic illness.
When is coinsurance paid on AXA medical expenses?
The Coinsurance will be applied to every claim presented to the Company, related to the Loss that gave rise to it and with respect to each covered expense. Said percentage, as well as the maximum amount payable by the Insured for this concept (maximum Coinsurance), are indicated on the face of the Policy.
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