What is the relationship between covered condtions and covered services in health insurance plans?

Expert Solution

In a health insurance plans, covered conditions are those medical conditions for which the insurance company agrees to pay. It can be anything from acute to chronic disease, injury or surgery only when both are in agreement to this. For example, if some one has a pre-existing condition of any chronic disease, then most of the insurance company will not include that condition in the covered section. In the same way, covered services are those medical services for which the insurance company agrees to pay like yearly or quarterly physical or dental check-up. If a patient requires a particular healthcare service for covered condition, then the insurance plan would provide that particular service under covered services.section. In simple word, in both the situations, the healthcare insurance company pays.

Nightingale answered 2 years ago

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