A health insurance policy will provide a cover to you and your family against sudden medical contingency or bodily injury.

Why health insurance?

Every human being is exposed to various health hazards. Medical emergency can strike anyone without pre-warning. Inadequate facilities in government hospitals, Private hospitals are too expensive, Medicines have become quiet expensive, Diagnostic charges are beyond common man’s reach, Specialists come at a price, Tax benefit under section 80 D of the Income Tax Act, Health risk is a personal risk, which could arise from various factors viz.

• Physical condition
• Psychological condition
• Accident related
• Occupational related
• Environment related
• Life style related
• Travel related

What is the kind of medical emergency that can strike?

A medical emergency can be:

1. Medical illness
2. Injury / Accident
3. Major illness
4. Critical illness
5. Chronic illness
6. Untreatable
7. Terminal

What impact will a medical emergency have on you and your family?

1. A medical emergency can
2. Burn a hole in your pocket
3. mmediate need for medical aid
4. Loss of quality life
5. Loss of career options / Income
6. Disruption in home life
7. Mental trauma and incapacitation

What does a standard insurance policy cover?

A standard health insurance covers :

1. Room and boarding expenses provided by the hospital
2. Nursing expenses
3. Diagnostic and medicine expenses
4. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist fees
5. Anesthesia, blood, oxygen, operation theatre expenses, cost of surgical appliances, medicines and drugs and similar expenses
6. Pre-hospitalisation and post hospitalization expenses subject to conditions and limits .

What are the benefits of buying health insurance at a young age?

Health insurance premium tends to increase with age — more the age, higher the premium. You can be covered for medical conditions that may be diagnosed over the years provided there is no break in the policy. In addition, each `no claim’ year would fetch you a discount on your premium or an increase in your sum insured amount at no extra cost. The treatment in case of ‘no-claim’ bonus varies from company to company. Lastly, income tax benefit under Section 80 D of the Income Tax Act.

How is premium determined?

1. Premium depends on several factors viz.
2. Your age
3. Amount of coverage required
4. Number of family members covered
5. Other additional benefits
6. Your health condition
7. Your income earning

How does a health policy differ vis-à-vis a life insurance policy?

The health insurance plan is more comprehensive in its coverage. All expenses involved in hospitalization fall under its purview. Life insurers usually cover critical illness and hospital cash extensions (only room rent charges) on life policies, which do not include doctor’s fees, expenses incurred on buying medicine and surgery costs etc.

Why is it important to disclose health details when I buy a policy?

Mention of details is critical since insurance companies assess the policyholder’s risk profile on the basis of his/her health. An insurance contract works on the principal of “utmost good faith”, which implies that information furnished by a policyholder is true and correct. Moreover, non-disclosure can also lead to rejection of a claim.

State Senator Arthenia Joyner (D-Tampa) on Tuesday welcomed reassurances from the governor’s office that a move to transfer the innovative Office of Minority Health into a sprawling division within the Florida Department of Health would be rejected.

The decision came less than 24-hours after the Tampa Democrat sent a letter to Governor Charlie Crist, urging him to rethink his agency’s pending action.

“The Office of Minority Health is currently on the cutting edge with regard to research, cultural competency and health equity policy,” Joyner wrote. “This momentum must be continued. Moving this office into a large department division will most certainly diminish the capability of the office to continue developing and implementing direly needed policies and strategies essential to eliminating health disparities among racial and ethnic populations.”

“It is my deepest fear that the focus and progress of the program will be lost by swallowing this mission within an immense bureaucracy.”

At issue was an abrupt decision by DOH to transfer the highly effective Office of Minority Health into the agency’s sprawling Division of Family Health Services.

Established by the Legislature five years ago, the Office of Minority Health was launched by the former governor as a way to close the widening gap in health care for minority and ethnic residents by providing community medical outreach services, among other programs.

Since then, the group has made significant headway in rolling back not only the disparity in health services available to such groups, but the high costs taxpayers shoulder due to over-reliance on indigent emergency room care.

This has been accomplished at little cost to the state. Staffed by five including the director, only three full time members of the unit are paid by the state; the other two are funded through federal grant money.

“Since its inception, the Office of Minority Health has been extremely effective, already touching 50,000 lives throughout Florida and saving taxpayers potentially millions of dollars,” said Sen. Joyner. “The medical treatment this office spearheads costs on average about $100. Compare that to the typical emergency room visit costing taxpayers roughly $1600. That’s a huge savings.”

Cut this last legislative session by $1 million, the office has been struggling to complete a series of innovative initiatives, among them an agency-wide strategic and operational plan, along with a county-by-county database so that private health care organizations and residents can track community needs and progress.

The sudden decision to absorb into a larger, more cumbersome bureaucracy such a dynamic office noted as much for saving lives as for saving money made little sense, particularly in light of the economic conditions the state currently confronts, according to Joyner.

“Nationwide, our state comes in 45th in health care rankings, much of it due to the lack of health insurance and health care options for a large group of our diverse population. The worsening economy is only compounding matters.”

The Senator said she was heartened to hear that the governor pledged to protect the group’s independence, while continuing to report to the agency’s deputy surgeon general.

After being refused health insurance coverage:

• What can you do?
• What options are available to you?
• What are the common reasons for denial?

Should you be refused health insurance coverage for individuals as a result of pre-existing health conditions, contact other service providers for their offerings and rates. Not all companies use the same guidelines in their health insurance options nor do they all offer the same packages.

Do not assume that being refused cover by one company all other companies will follow suit. You can also contact an independent health insurance agent.

Look for health insurance companies that do not bother with questionnaires. You may even consider receiving minimal coverage for a small fee. Take this option only as the very last resort as almost any plan that has no medical underwriting can be considered disguised discount plans and will not provide adequate coverage.

There are some 29 states that have options named high risk pools. These plans were created for those individuals who were considered by insurance companies as too risky or the ones that can be classed as medical uninsurable.

These pools provide some form of health insurance cover to this class of individuals. With this type of cover, you will not be refused cover and you will also be with very large medical bills.

There are many disadvantages with this type of risk cover that should be considered before an individual decides to join.

Some states can terminate your cover should legislation be passed against the cover, the premiums are much higher than for other plans and when you move or start using Medicare or Medicaid, may become ineligible.

To find out more about the high risk pools or whether your state is among the 29 that offer this service, contact a health insurance broker in your state.

The 1996 Health Insurance Portability and Accountability Act (HIPAA) opened new doors for those individuals who were unable for whatever reason get health insurance. This act includes a statute that states that no individual who wishes to join a group health plan can be refused health insurance for any reason whatsoever. As such, should you join an organization that offers a group health insurance cover, you may not be refused health cover, except the eligibility requirements of the employer.

Some eligibility requirements which can affect you are the number of hours worked every week or the type of contract, salaried or hourly paid. Of special note is that you could still be refused health insurance cover for pre-existing conditions.

You can however still get cover with a pre-existing condition if you would have had continuous health cover for a period covering at least 12 months.

This does not guarantee your cover, though. If there was a lapse (break) in your cover, the group coverage you are applying to may impose an exclusion period, during which. You will not be covered for medical expenses related to the condition. The insurer will not however pay any medical expense, including visiting the doctor, related to the pre-existing condition during the period the exclusion is in force.

The laws of HIPAA also state that health coverage for individuals’ health insurance cover, must have guaranteed issuance, i.e. everyone is approved and any pre-existing condition will be covered for anyone meeting 6 criteria.

These 6 requirements are a critical component of the laws of HIPAA that must be understood by all individuals who have preexisting conditions and have been refused standard cover.

The American health care system offers an enormous range of health insurance choices starting from low-cost minimum coverage plans to highly-expensive comprehensive plans. Health insurance plans are broadly classified as Indemnity Plans, Managed Care Plans and Health Savings Accounts (HSA). These different health plans differ in the approach they use to cover medical costs which includes factors like the your control over the care you receive, the cost of the care, the network of doctors and hospitals, and insurance coverage. Indemnity and consumer directed plans offer a wider choice of doctors whereas managed care plans offer broader coverage. Check out the details of various health care plans below:

Indemnity Plans: These plans are also commonly known as traditional or fee-for-service plans. These health insurance plans give insureds the full freedom to choose any doctor or hospital and they then indemnify him for the cost of the care. This means that the insurance company does not directly pay the provider unless the benefits under the policy have been assigned to the health care provider. These plans generally have a deductible before any benefits are available and will pay a percentage of the cost after the deductible has been met up to a specified limit. Indemnity Plans are usually very expensive option and are suitable for people who are willing to pay more for the freedom of choice they get to select medical providers.

Managed Care Plans: Managed care plans provide 1st dollar benefits like office and prescription copays and they control the cost of health care by managing health care services. The insurance company has an agreement with network of doctors, hospitals, and other health care providers that provide health care services to the insured at a reduced cost. These plans are less expensive, provide benefits for preventive care and offer less out of pocket expenses. There are three primary types of Managed Care Plans:

• HMO or Health Maintenance Organization
• PPO or Point of Provider Organization, and
• POS or Point of Service.

HMO or Health Maintenance Organization

HMOs benefits are usually a copayment which varies on the type of services you are receiving and they generally have no deductibles or co-insurance expenses. Benefits are limited to services delivered by a medical provider from the HMO network except in the case of a life threatening emergency, and a referral is generally required to visit a specialty care physician like a cardiologist. HMO networks include physicians, physical therapists, psychologists, surgical centers, hospitals and other health care providers. Some include holistic and alternative medicine providers as well. HMOs include the convenience of minimal paper work when you see a network provider and a simple copayment when you get care. These insurance plans protect you against all types of health challenges and also provide health benefits like preventive care. The downside of an HMO is that you have to use their providers, which is fine when you are healthy. The challenge is when you or one of your dependents becomes catastrophically ill, and you need to see an expert who is not in the HMO.

PPO or Point of Provider Organization

PPO includes benefits of both indemnity plans and managed care plans. You can visit the doctor of your choice but your benefits are much better if the doctor belongs to the PPO network. The cost of a PPO plan is also lower than an indemnity plan, and can be comparable to an HMO plan. Benefits typically include a copay for office visits and prescription drugs and you will need to pay your deductibles and coinsurance for other services and a higher deductible for out of network care.

POS or Point of Service

POS plans are a hybrid between an HMO and a PPO plan. POS plans provide the highest benefits when you work within the rules of the plan but you also can receive care from medical providers outside the network, but you will have more out of pocket expenses. These plans generally require referrals for specialty care although you can visit specialists without a referral by paying the higher cost in the benefits.

Health Savings Account (HSA): HSA’s require that you buy a qualified high deductible health plan with minimum deductibles and out of pocket maximums. These plans are generally offered with an Indemnity or PPO plan design, with the PPO plans providing you with the negotiated discount for health expenses before you meet the deductible. You then can save money into the account on a tax deductible basis, and take the money out with no taxes to cover any qualified medical expenses. These plans are the most affordable plan and the best value for most consumers.

It is a common fact that more and more people today don’t have any health insurance coverage. The reason behind this is that it is very expensive whereas some people think that they don’t require it because they are not suffering from any major illness. However, you are required to keep in mind that a health care plan is something that you can’t afford not to have. Health insurance will prepare you for the future in case of emergency or in any other major illness. With the aid of health insurance you will get all your expenses that you have spent in medicines and treatment.

The first thing that you need to consider is whether you are going to take group plans or individual plans. Although some people think that it is cheaper to buy a health insurance plan through an employer or via a group health care plan, there are some plan where buying individual health insurance is quite cheaper. Price of health insurance is always depends on various factors. If your company is paying high premium then you must get the health insurance at low price and it is possibly best to select this option. If you are healthy and your company is offering a health insurance policy where you are alone responsible to pay the premium then it is advisable to select individual health insurance plan.

You should not forget that group health insurance plans must cover everyone in it that includes preexisting conditions. It is given in state laws and it meant that healthy people included in health insurance plan will balance out the costs that the insurance company needs to pay for individuals with preexisting health conditions that are covered by the similar policy.

Finding cost effective health insurance plans is very simple to do. You just need to do little research for finding a perfect health insurance plan for you. There are thousands of health insurance plans available on the Internet. Internet is the perfect resource for finding a health insurance plan. Whether you are in India, UAE, US, or Australia, you ca easily find health insurance plan.

Once you’re done comparing health insurance quotes and plans and you’ve settled on employer-based health insurance, it’s good to keep in mind the Department of Labor’s Employee Benefits Security Administration (EBSA) administers a number of laws that cover these health insurance plans.

Here is a list of some of the laws affecting health insurance :

• The Employee Retirement Income Security Act - This law protects people in retirement, health and other benefit plans through private employers by providing rights to information and a grievance and appeals process for private employer health insurance participants.
• The Consolidated Omnibus Budget Reconciliation Act - This law only applies to special instances, but if you qualify as a former employee, retiree, spouse or dependent child you can purchase a temporary continuation of health insurance at group rates.
• The Health Insurance Portability and Accountability Act - This law applies to working Americans and families with preexisting medical conditions. Through this act there is a guarantee of individual health insurance policies for eligible people and it prohibits discrimination in health care coverage.
• The Newborns’ and Mothers’ Health Protection Act - Just as it sounds, this law offers rules on minimum health insurance coverage on how long the mother and child can stay in the hospital after childbirth.
• Mental Health Parity Act - This law ensures mental health is given as much emphasis as physical health by requiring annual, or lifetime, limits on mental health benefits to be no lower than limits for medical and surgical benefits provided by a group health insurance plan.
• Women’s Health and Cancer Rights Act - Breast cancer is a frightening diagnosis and treatment runs a wide range of intensity and invasiveness. This law protects breast cancer patients who want to have a breast reconstruction after a mastectomy.

When you are part of an employer - based health insurance plan the Department of Labor’s Employee Benefits Security Administration is a great source of information on subjects such as your rights to information on how your plan works, how to quality benefits available in your plan and how to make claims on your health insurance plan.

Remember EBSA administers these laws that help protect your health insurance when you lose coverage, change jobs or if you suffer from certain special medical conditions. Also remember when choosing employer-based plans to carefully compare your health insurance options to make sure your plan works best for you and your family’s medical needs.

Three percent of children do not have health insurance. Kids need this insurance, possibly more than anybody else. Their small bodies are constantly growing and adapting to the world around them, which leaves them open to disease and injury. A sick or injured child who is uninsured can quickly create a financial burden that is much higher than any insurance premiums.

If you have kids, you know that they can be clumsy on the playground. Playground injuries are extremely common and often go beyond just a skinned knee. Broken bones can happen quickly on a playground, where children are not as careful as they should be while they are going about their fun activities. Young children are not the only ones susceptible to injuries. Teenagers often get into car accidents as they are learning to drive, and while many of them are lucky, some of them get hurt badly and need insurance.

Having health insurance is something that is important for everybody to have. Whether you are young or old, requiring medical assistance is unpredictable and you never know when you will have to use it. By insuring your kids, you are ensuring that if they got sick or injured, it would all be taken care of and you wouldn’t have to worry about a major debt that you would be paying off, possibly for the rest of your life. Health insurance is a great idea for any child.

When it comes to health insurance, kids are often overlooked because they are “young and healthy“. As you can see, no matter how careful you are, children can get injured or sick. They need health coverage, and all it takes is a little time and money to make that happen.

Health insurance has become one of the largest monthly expenses for the vast majority of Americans. Not only has it become quite expensive, but for many, health insurance isn’t even available because they simply don’t make enough money to fit health insurance into the budget. This has left hundreds of thousands of Americans without adequate health coverage, including many children. For these reasons, health insurance has also become one of the biggest concerns for most people in the coming elections. So, why has health insurance become so expensive?

The first thing you need to understand about health insurance companies is that they are businesses whose sole interest is to make money by providing a service. In order to make money, these companies must turn a profit by bringing in more money than they spend. In today’s regulatory environment, along with the increased number of lawsuits related to health care, the cost of doing business in the health insurance industry has skyrocketed. These companies, in turn, have had to raise rates to accommodate those additional costs in order to keep making a profit.

That’s not to say that health insurance companies are completely honest with you about just how much health insurance is going to cost you. Most health insurance companies quote premiums based on age. You’ve seen the television ads that offer health insurance for a mere $129 per month for a 29 year old non-smoker. While that sounds like a very reasonable rate, there is more to this than meets the eye.

In order to get the rest of the story, so to speak, you’d need to look at the actual policy and the so-called “fine print.” In order to qualify for that low $129 rate, you’d have to be a perfectly healthy person whose never gotten sick in the past and have absolutely no reason to need health insurance in the first place. In short, they can offer this rate because there is little to no risk that the company will have to pay out any kind of benefit to this person.

Another thing you might not notice from just watching the advertisement is the size of the deductible. For the rate mentioned above, the deductible is likely to be somewhere around $1000. For other policies, the deductible can be as high as $5000.

So, what is a deductible, you might ask? The deductible in an insurance policy is the amount of money you must pay out of pocket before the insurance company will start paying out benefits. Usually, the deductible does not apply to all health care expenses, so you have to pay careful attention as to whether the policy is worthwhile in your particular situation. In some cases, you would spend less money just paying for health care services out-of-pocket than actually purchasing health insurance because of the deductible.

Another thing that might raise the price of insurance coverage is a pre-existing condition. This is any condition that existed before you purchase coverage with any specific health insurance company. In many cases, you may not be able to get coverage for that condition at all, unless you can prove that you have had continuous care for that condition during the time in which you had no insurance. Even if it is covered, you can be assured that it will cost you more money for it.

Because of all of these variables, most people wind up with far higher premiums than those low rates advertised on TV. In some cases, people may not even be able to get insurance at any price, due to the perceived risk to the insurance company. In many cases, the resultant premium is just simply too high to fit into an individual’s budget, and so they continue on without health coverage.

High insurance premiums are a fact of life in these times, and are likely to remain so for a long time to come. The only way to change this is to fundamentally change the approach to providing health care in this country, by socializing the health care system. This, however, comes with its own set of problems that can be worse than the current system in many respect. The bottom line is that there are no easy answers to solving the health care problems in this country. The only thing you can do is to be aware of all the issues surrounding the problem and make your decision based on facts, and not what the talking heads on television are trying to tell you.