They are also entitled to impose a 12-month waiting period for advantages for therapy referring to an obstetric situation, and a 2-month waiting period for all different benefits when an individual first takes out personal insurance. Funds have the discretion to cut back or remove such ready periods in particular person instances. It would additionally appeal to people with existing medical conditions, who might not otherwise have taken out insurance at all because of the denial of advantages for 12 months due to the PEA Rule. The insurance company pays out of community suppliers based on “cheap and customary” expenses, which can be less than the provider’s traditional charge. The provider may have a separate contract with the insurer to simply accept what amounts to a reduced price or capitation to the provider’s normal costs.
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