Should we avail Health Insurance Facility?

• If you have a lot of resources then it is a good for you to get a comprehensive individual health insurance plan that includes everything from a small deductible for hospital visits to full dental and vision coverage.

• But If you are on a very tight budget, then you should consider getting a smaller plan. If you don’t have any dependents and don’t need to make regular hospital visits for any reason, consider whether you really need a full health insurance plan that gives you complete coverage. Paying more than you need for health insurance can be a heavy financial burden, so it is worth thinking creatively and realistically about what you really need and if it is possible to get the care you require without shelling out a large monthly payment to a health insurance provider.

• Many people find that through a combination of free clinics and minimal health insurance coverage, they are able to get by spending much less money than they would pay for comprehensive health insurance. It is still a smart idea to have coverage that will help alleviate the financial burden if you suddenly develop a condition or meet with an injury that requires emergency care. However, it is a good idea to look into what kinds of plans are available, as one of the many plans designed specifically to give you emergency coverage may be a much better choice than a plan that will leave you generally well insured.

• It is never a good idea to gamble with your health care, so make sure that you if don’t opt for the maximum amount of insurance that you can afford, that you have a plan for how to meet any medical expenses that may arise. Think about other ways that you can designate money for your health care needs, such as starting a savings account where you store away the money you would be paying for insurance every month. This will help you make sure that you are prepared for anything. Don’t forgo coverage entirely though. At the very least purchase a high deductible plan that will cover you in the case of a serious illness or injury. Otherwise one serious illness or injury could wipe you out financially. Many people think the best way to get health insurance coverage is simply to get the most complete coverage one can afford. This is, to some extent true, and if you have a lot of liquid resources it is a good idea to get a comprehensive individual health insurance plan that includes everything from a small deductible for hospital visits to full dental and vision coverage. However, if you are on a very tight budget, you may want to consider getting a smaller plan than you can afford and paying for some of your medical expenses out of pocket.

• Many people find that through a combination of free clinics and minimal health insurance coverage, they are able to get by spending much less money than they would pay for comprehensive health insurance. It is still a smart idea to have coverage that will help alleviate the financial burden if you suddenly develop a condition or meet with an injury that requires emergency care. However, it is a good idea to look into what kinds of plans are available, as one of the many plans designed specifically to give you emergency coverage may be a much better choice than a plan that will leave you generally well insured

Individual Health and Group Insurance

In Case Of Group Plans:

If you’re going to buy health insurance, you will see a lot of health plans and insurance companies are available in the market. As part of a group plan, you can enjoy a significant discount on premiums as well as comprehensive policies.

In Case Of Individual Plans:

You can also buy individual policy that will also cover your whole family.
There is no guarantee that an insurer will take you on. Individual plans are medically underwritten and the insurer may reject your application or attach exclusions to your policy if you have health problems. However, some states don't allow this practice and require that any insurer selling individual health plans must offer you a policy, no matter what medical problems you have.
However, your premiums are still likely to be substantially higher. People enrolled in individual plans pay premiums more in line with their expected health costs, so the premiums will be higher for those who are older or less healthy. To find out what your rights are, contact your state insurance department. You can find the contact information by selecting the state in which you live from the pull-down menu at the top of this page.
Crunching the numbers
Pricing is probably the most bewildering aspect of individual health policies, so it's worth your while to shop around. For instance, the premiums for similar products from different insurers can vary by as much as 50 percent for the same person. What's more, the rules and regulations about individual health insurance vary from state to state, making comparison-shopping difficult for the consumer.
If you're faced with finding individual insurance, don't let the confusion tempt you to go without. Even if you're healthy, you could fall off a ladder or have a serious car accident and be financially ruined. Plus, you'll lose your pre-existing-conditions coverage in most states if you go without insurance for more than 63 days.
Finding the right balance of coverage and cost can be challenging, but it's a necessity. So take your search one step at a time. The first step is to evaluate your needs and understand your health insurance options. For some, that may mean buying COBRA coverage from their former employer

History About Health&Group Insurance

Health insurance:

It Started in 1930 in America provided by employer first.This was was originated by Blue Cross Hospital.Then H.J. Kaiser offered prepaid group health insurance plan to employees of his construction company.


Group insurance:

Term used as the combination of the pool of people who are healthy and adds few who require costly medical aid. Thus pool of large number accounts for balancing the expenditure of few people, who actually need them. This phenomenon makes group insurance viable and beneficial for both employer as well as employees. Health insurance through employer also provides significant tax benefits to both.In health insurance plans provided by employer where total premium is borne by him is generally cheaper, compared to plans if purchased by employee himself.
This plan has many disadvantages workers are unable to pay their portion of premium for policies provided by their employers. In case of lay-off or relinquishing service means loosing health coverage for self and family. Circumstances like change in type of job retirement or divorce can lead to cut in the group health insurance sponsored by employer.

Group Insurance

Health insurance is purchased for self & family members, termed as individual health insurance policies or group health insurance policies, mostly provided by employer to their employees.
health insurance is as below (based on US Census Bureau).
Group insurance In millions

Group Insurance In Million
Through employer 175
Individual/ Direct Purchase 27
Uninsured 44

Role of Health Insurance In OPD area

We all of us have gotten the awareness regarding the importance of health insurance it is very important and now it becomes our necessity to protect against huge medical expenditure.Medical technology become more advance now a days and quality of health care has been improved, but it has also resulted in increase in cost of medical care.Health insurance premium has increased much rapidly compared to increase in salary of workers.
There are about 1500 health maintenance organization and health care providers in America who fund all political parties heavily, which in turn keeps them much mum on health insurance reforms.









In OPD:
Charges / fees paid to Registered General Medical Practitioner,also may be included
Homeopath or Hakeem and specialist consultation.

Treatment,Medicine and surgical dressings
physiotherapy and acupuncture.
Laboratory and X-ray examinations, ECG, EEG, EMG,ULTRASOUND
and other diagnostic tests.
Dental Treatment.

What can be Covered

In Health Insurance: It depends upon the policy of the Insurance Company; these may also vary company by company. But Standers are the following.


HOSPITALIZATION EXPENSE BENEFIT
O.T. Charges, Consultation Fee, Nursing Charges etc.): It includes
Investigation and Medicines
Miscellaneous expenses

MATERNITY BENEFIT
Following benefits are payable under this cover: It covers many areas but these may be varying company to company policy.

DREAD DISEASE

Management of Acute Myocardial Infarction (Heart Attack)
Coronary Artery By-pass grafting and Coronary Angioplasties.
Management of all type of Malignancies (Cancer)
Cerebro Vascular Accidents (CVA- Stroke)
Management of Renal Failure (Kidney Failure)
Renal and other major organ transplants.
Major Burns.
Multiple Sclerosis.
Aids Complex.
Chronic Hepatitis “B” & “C”.

Who is Covered

Medical Insurance also called Group Hospitalization Policy which covers the following.


• Out patients (OPD),
• Hospitalization,
• Surgical treatment,
• Maternity,
• Dread Diseases & Specialized Investigations.


WHO IS "COVERED"?

Health Insurance is mainly provided at corporate sector and well renowned in the business sectors like Financial Institutions, NGO’s and Multinational Firms
.
Mainly All Categories of employees are covered up to the age of 60 years may be (Extendable under special circumstances).



It covers all the employees their Spouses and children.
Special modules are designed to cover dependent parents.
In case of female children, age relaxation is till the time they get married or employed.