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In health insurance, it is crucial to consider limits on what a company will pay for medical or dental services, impacting coverage and out-of-pocket expenses. Various mechanisms can control healthcare spending, from direct patient payments to government regulations.
False. Concern should be present about limits on what a company will pay for medical or dental services, as insurance coverage usually comes with annual caps or limits. These limits can affect the extent of coverage and out-of-pocket costs for the insured individual, impacting their healthcare decisions.
For example, if a dental contract has an annual limit, a treatment plan may be spread out over years to maximize insurance coverage. This illustrates how both the insured individual and the healthcare provider respond to the incentives set by the insurance contract.
The mechanisms to control healthcare spending may involve requiring patients to pay more directly, using insurance companies to limit spending, or implementing government regulations like states, such as Oregon, refusing to cover certain services.
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