Archive for April, 2009

Life is full of unexpected situations which can affect our existence. Health is one of them, although it is often overlooked until we find it failing. ‘Health is wealth‘ is a proverb, which has lost its significance in the modern times. The fast-paced life of the contemporary world where everyone is trying meet deadlines and work in a jam-packed scheduled, health is often relegated to being one of the least important considerations. It is only when, we suffer from a sudden difficult health situation that we realize that our well-being is more important than we had previously thought? Serious health issues like cancer, stroke and many more can corner you without a prior indication. What do you do then? If you have a Health Insurance you need not worry about anything other than trying to get better. A health insurance can assist you to take care of this precious possession even in times of distress.

You should note that health insurance differs significantly, but in essence it denotes a type of insurance plan that pays a pre-arranged percentage of an insurance possessor’s enclosed medical treatments. Whether or not your require health insurance depends entirely on your circumstances. However, it is always advisable to obtain insurance for health, keeping in mind the uncertainties that encompass modern way of life and also its associated health implications.

Health insurance comes in various forms like dental insurance, vision insurance, student health insurance, business health insurance, international health insurance amongst others. These different forms of health insurance is to cater to your specific requirement. Health insurance usually covers medical expenses such as:

  • Hospitalization;
  • Doctors visit;
  • Prescription drug;
  • Annual check up;
  • Emergency room visits; etc.

You must have heard a lot about various health insurance companies offering insurance products with lucrative tags of even returning certain % in fixed yearly dividends. But it is up to you which one to go for. If you are thinking of obtaining a health insurance policy, internet can provide you with an easy route. Are you confused about what kind of health insurance to go for? A simple way to strike upon the desired insurance is to chalk out the expectation you may have from it, how well it suits to your situation amid other factors. Most online health insurance companies can give you a chance to compare and evaluate health insurance that befits your pocket. Online application procedure for health insurance can expedite your path to ensure the most significant part of your existence that is your health.

Before you choose a health insurance plan, it is advisable to be thorough with the terms and conditions of the health insurance providers. This approach would not only keep you at pace with procedures of procurement and functioning of insurance but also save you from confusion later on down the line.

You must realize the importance of you and your loved ones’s well-being with health insurance. It can be the single ray of home in a sea of dark health issues.

Group Health Insurance

To discuss the terminology Group Health Insurance, we must first familiarize ourselves with the concepts Insurance and Health Insurance.

Insurance is a kind of protection, a safety net against unforeseeable losses. No one knows what the future holds, and insurance is a good way of preparing for what may come. Health insurance is a protection against medical costs. The insurer pays the cost of the insured person if the latter falls ill – due to accident maybe, or any of the covered causes. Magnify the health insurance more than ten times over and you get the Group Health Insurance.

Group Health Insurance is a health coverage based on a group of people under a company or an organization. The cost of the insurance is allotted among the members of this group. The group enjoys a wide range of benefits of Group Health Insurance. A master contract or policy is issued to their employer or to any of the group’s affiliations.

Health insurance is one of the most important benefits offered to an employee through their employers. Not only does an employee feel secure with this insurance, he also feels assured of the care of his employers. Companies spend billions annually for health insurance, and group health insurance make up the bulk of the revenues earned by health insurance companies.

Group health insurance can be availed by any company with two or more employees. Requirements vary around the world, though one constant requirement is the proof of legitimacy of the company’s operation. The number of employees to be insured under the group plan determines the type of coverage available to the employer. A company with more than a thousand employees will have customized health plans, and these may include additional benefits.

With the rising costs of prescription drugs and health care in recent years, companies have experienced a drastic increase in the cost of providing health care benefits to their employees. Many companies are forced to cut back on the benefits of the health plan, and some even require their employees to pay a higher share of the monthly premium of the insurance, even to the point of requiring them to pay the 100% of the dependent premium! Decreases in the health insurance benefits cause some employees to pay medical expenses themselves when they require medical treatment or prescription drugs. Businesses offering full premium payment for employees and their dependents are fast decreasing.

The rising unemployment rate is causing not just job loss but also the loss of valuable health insurance coverage for many people. In response, the federal government has enacted new legislation to help with COBRA coverage as well as state aid to families with children.

Changes to COBRA

COBRA stands for the Consolidated Omnibus Reconciliation Act of 1986. Under COBRA, if you worked for a company that had more than 20 employees, then you are able to continue on the group health insurance plan for as much as 18 months. The downside of COBRA is that it can be quite expensive. In most states, recipients report that COBRA payments account for more than 75% of their unemployment benefit. However, under the recently passed Economic Stimulus Package, you could be eligible for assistance with 65% of your COBRA premium.

To qualify for the program you must have lost your job between September 1, 2008 and December 31, 2009. Your income must be less than $125,000 for an individual and less than $250,000 a year for a family. If you did not take advantage of COBRA initially, you can still sign up for it. If you did sign up for COBRA coverage, you won’t get any money back for the premiums you have already paid, but you will be eligible for assistance from the point after the law has taken effect. Under the new law you will pay 35% of the premium, and the government pays the other 65%. Your assistance could continue for as much as nine months.

State Children’s Health Insurance Program

Another measure the federal government has taken recently to help people with health insurance coverage is to expand the State Children’s Health Insurance Program or SCHIP. The law will provide $32 billion to the program over the next five years and expand coverage to from 7 to 11 million children. SCHIP is designed to provide health care coverage for children up to age 19 and pregnant women, in families whose income is low, but not low enough to qualify for Medicaid. A portion of the funding will come from an increase in the tax on cigarettes.

Under SCHIP, the federal government provides the states with matching funds to provide health care for families with children. To qualify, families could earn only up to 200% of the poverty level. Under the new law, families can earn up to 300% of the poverty level and still qualify for SCHIP. Each state has set up their program differently, so programs can vary from state to state.

If you find yourself out of a job and out of health insurance, two recent measures by the federal government may provide some assistance. The first are changes to the COBRA program in which the government could pick up to 65% of the cost of your health insurance premium. The other is the expansion of the State Children’s Health Insurance Program. Either of these options could provide short-term assistance with health insurance coverage.

Lap band surgery can be the last resort for achieving weight loss for someone who is suffering from morbid obesity. It is indeed a tough decision to make due to the expensive surgery cost - $25000 for a successful surgery. Despite its cost, additional overheads associated with the post surgery treatment may increase the cost further.

In fact, there are some insurance companies that cover this particular weight loss surgery and thus, it has proven to be an advantage for those seeking such a surgery without having to bear this expensive cost of this surgery.

For individuals who neither have the means to finance their lap band surgery nor have a health insurance - are the ones often seek for various options from health insurance companies. There are portfolios for such individuals. As long as they meet the various criterion that are set by health insurance companies, they would be entitled to getting their surgery sponsored (or co sponsored).

There are many people who meet the eligibility criteria for Medicaid insurance schemes being operated by different health insurance companies. Such schemes usually cover most of the expenses related to their medical care. Sometimes, you would need to share the expenses, while at other times, the company might finance for all your expenses (with terms and conditions applied).

Applicant’s age (you need to be over 65 years in age), disabilities, income (needs to be below a certain limit) and citizenship are the parameters which are considered by health insurance companies during the evaluation of the claims of the applicants.

One of the most expensive things we have in this life is health care insurance. If you happen to work for an employer that has a good group insurance plan then you are set. But many people do not have this type of plan and going out in the open market to find health insurance can be very expensive. It can be even worse if you have a pre-existing condition because your rates can be higher than you can afford to pay each month. When searching online it is important to compare not only price but also the policy itself. You need to have enough coverage in case you go to the hospital and need extensive care.

When searching online make sure you find a friendly website that allows you to search several companies with online quotes. This will allow you to shop and compare the price and the policy of any insurance plan. Even if you feel healthy it is most important that you have some kind of insurance in case something goes wrong. In most cases the younger you are the more likely it is that you have no insurance coverage at all. Do not wait until something medically goes wrong with you and you need to go to the hospital, it is important for you to find affordable health insurance today.

Remember the finding low-cost cheap health insurance can be easier than you think. You need to search online and find a website you feel comfortable with getting quotes from. Make sure that you always compare the policy and the price before making a final decision on which health insurance you are going with.

You want to buy the best health insurance plan, which will not only give you excellent policy benefits but also render you maximum tax savings. Choosing the right health insurance company should be the first step of applying for health insurance policies and plans. You need to know about the rate and quote of the health insurance company, in order to choose the best insurance plan.

India has witnessed major growth and development in the area of insurance, since 2001. National players have tied up with global insurance companies to earn more recognition. ICICI Lmobard, Tata AIG, BajajAllianz and others are some of the major players in the insurance sector. Some of best health insurance plan are offered by these major private health insurance companies.

ICICI Lombard GIC Ltd is a globally recognized company that provides General Insurance. The company is rewarded for the kind of service it provides to the customers and it offers a range of plans for people in various categories. Health Advantage Plus launched by ICICI Lombard is tax saving plan while Family Floater Health Insurance covers health needs of your entire family. Personal Accident policy protects you against accidental hospitalization. The chief benefits offered by these plans include coverage against terrorism and convenient online buying process without any paperwork.

A private health insurance company, Tata AIG Life Insurance Company Limited or Tata AIG Life is a tie up between the Tata group and the American International Group (AIG). It offers a variety of health plans and policies. Some of the major products of this private health insurance company include Tata AIG Life Health First, Tata AIG Life InvestAssure Care, Tata AIG Life Health Protector - 5 Year Guaranteed Renewal Accident and Health Plan, Tata AIG Life Health Investor and Tata AIG Life InvestAssure Health. The Tata AIG Health Insurance policy offers you benefits under Section 80D of the Income Tax Policy.

You can insure the future of you and your family with a health insurance policy from Bajaj Allianz. Bajaj Allianz Life Insurance Company Limited is another big name amongst the private health insurance companies. The company is a tie-up between Allianz SE, a life insurance company and the Bajaj Auto, a leading name producing two and three-wheelers. This private player offers some of the best health care plans and policies. Family Care First, Care First and Health Care are some of the major health care products offered by this company.

Get a quote and rate on health insurance to compare health care products. You can then take your decision accordingly. Browse online for the same, make a smart choice and save money!

  • Coinsurance

The amount you are required to pay for medical care in a fee-for-service plan after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the health insurance company pays 80 percent of the claim, you pay 20 percent.

  • Coordination of Benefits

A system to eliminate duplication of benefits when you are covered under more than one group plan. Benefits under the two plans usually are limited to no more than 100 percent of the claim.

  • Co-payment

Another way of sharing medical costs. You pay a flat fee every time you receive a medical service (for example, $5 for every visit to the doctor). The health insurance company pays the rest.

  • Covered Expenses

Most health insurance plans, whether they are fee-for-service, HMOs, or PPOs, do not pay for all services. Some may not pay for prescription drugs. Others may not pay for mental health care. Covered services are those medical procedures the insurer agrees to pay for. They are listed in the health insurance policy.

  • Customary Fee

Most health insurance plans will pay only what they call a reasonable and customary fee for a particular service. If your doctor charges $1,000 for a hernia repair while most doctors in your area charge only $600, you will be billed for the $400 difference. This is in addition to the deductible and coinsurance you would be expected to pay. To avoid this additional cost, ask your doctor to accept your health insurance company’s payment as full payment. Or shop around to find a doctor who will. Otherwise you will have to pay the rest yourself.

  • Deductible

The amount of money you must pay each year to cover your medical care expenses before your health insurance policy starts paying.

  • Exclusions

Specific conditions or circumstances for which the policy will not provide benefits.

  • HMO (Health Maintenance Organization)

Prepaid health plans. You pay a monthly premium and the HMO covers your doctors’ visits, hospital stays, emergency care, surgery, checkups, lab tests, x-rays, and therapy. You must use the doctors and hospitals designated by the HMO.

  • Managed Care

Ways to manage costs, use, and quality of the health care system. All HMOs and PPOs, and many fee-for-service plans, have managed care.

  • Maximum Out-of-Pocket Expenses

The most money you will be required pay a year for deductibles and coinsurance. It is a stated dollar amount set by the health insurance company, in addition to regular premiums.

  • Non-cancellable Policy

A policy that guarantees you can receive health insurance, as long as you pay the premium. It is also called a guaranteed renewable policy.

  • PPO (Preferred Provider Organization)

A combination of traditional fee-for-service and an HMO. When you use the doctors and hospitals that are part of the PPO, you can have a larger part of your medical bills covered. You can use other doctors, but at a higher cost.

  • Pre-existing Condition

A health problem that existed before the date your health insurance became effective.

  • Premium

The amount you or your employer pays in exchange for health insurance coverage. Primary Care Doctor
Usually your first contact for health care. This is often a family physician or internist, but some women use their gynecologist. A primary care doctor monitors your health and diagnoses and treats minor health problems, and refers you to specialists if another level of care is needed. In many health insurance plans, care by specialists is only paid for if your are referred by your primary care doctor. An HMO or a POS plan will provide you with a list of doctors from which you will choose your primary care doctor (usually a family physician, internists, obstetrician-gynecologist, or pedicatrician). This could mean you might have to choose a new primary care doctor if your current one does not belong to the plan. PPOs allow members to use primary care doctors outside the PPO network (at a higher cost). Indemnity plans allow any doctor to be used.

  • Provider

Any person (doctor, nurse, dentist) or institution (hospital or clinic) that provides medical care.

  • Third-Party Payer

Any payer for health care services other than you. This can be an insurance company, an HMO, a PPO, or the Federal Government

Why You Need Health Insurance

The United States does not have socialized medical care. If you have no health insurance coverage, you have to pay for health care out of your own finances at the time of service. This can run into many thousands of dollars for serious illnesses.

You buy health insurance for the same reason you buy other kinds of insurance: to protect yourself financially. With health insurance, you protect yourself and your family in case you need medical care that could be very expensive.

You cannot predict what your medical bills will be. In a good year, your costs may be low. But if you become ill, your bills could be very high. If you have health insurance, many of your costs are covered by a third-party payer, not by you. A third-party payer can be an insurance company or, in some cases, it can be your employer.

Many people in the United States are enrolled in some sort of managed care health insurance plan. This is an organized way of both providing services and paying for them. Different types of managed care plans work differently and include preferred provider organizations (PPOs), health maintenance organizations (HMOs), point-of-service (POS) plans and fee-for-service plans.

Individuals enrolled in health care plans pay a monthly or quarterly fee as insurance for the time when they will need medical attention. At the time when a service is provided, the health insurance organization pays part or all of the fee, minimizing the amount you have to pay at the time you receive the service.

The information presented here will help you choose a health insurance plan that is right for you. If you are married or single, have children or no children, this information will help you to find out how to choose a health insurance plan that best meets your needs and your financial circumstances. Definitions of the health insurance terms used are included in the section called Understanding Health Insurance Terms.