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Healthcare Information Technology Exam Guide for CompTIA Healthcare IT Technician and HIT Pro Certifications by Brian Gugerty, Kathleen McCormick

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The Nature of Health Insurance

In theory, the objective of health insurance is to pool risk. Illness—particularly catastrophic illness that could bankrupt a family—is (fortunately) rare. Insurance is a vehicle that allows individuals to pay (for example, annually) a relatively small amount to an insurance pool, which covers the costs (of necessary services) for those individuals who are unfortunate enough to need care. It is important to note that insurance works only when there is broad participation and, in particular, only when individuals who are at low risk for illness participate (as well as those who are at high risk for illness). The cost of insurance—the insurance premium—is set based on predicted expenses (the so-called actuarially ...

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