Top 5 Medical Aid Mistakes to Avoid

The type of healthcare we need varies from one person to the next. It depends on our individual healthcare needs and not in the least, our available budgets. In order to avoid costly medical aid disasters, make sure you are aware of these mistakes:
1. Failure to shop around
Yes, it is quite a thing, looking for the best medical aid scheme and a package that best suits your individual needs. But taking out some time to do some shopping around can save you thousands of rands. Your personal circumstances as well as medical scheme pricing structures change all the time, so loyalty may not necessarily be the wisest thing to go on. Get a range of quotations and determine which option best suits your budget or contact a medical aid broker. You can also use online price comparison tools.
2. Not asking questions
Another huge mistake that can cost you dearly is not asking questions. And these questions can vary from information regarding waiting periods, rules around pre-authorisation for special procedures etc. To get clarity on things that you are not sure about, you should talk with your medical aid broker or with someone at the medical scheme's call centre. They are there to help you.
3. Assuming that there's a one-size-fits-all option
Since each person's medical needs and conditions are different, the medical aid option that's right for one person may not necessarily be right for you. It's understandable that you get confused when comparing the large variety of options because their descriptions can be pretty daunting, tempting you into making a decision without thinking things through. Make sure, however, you read all the fine print and ask as many questions you need in order to get the medical aid cover that suits your particular needs and budget.
4. Not getting cover because you're healthy
You may be on top of the world and super healthy and fit now, but what if you fall ill and need cover to avoid exorbitant medical costs? You may be faced with long waiting periods before you are eligible to claim. Make sure you get yourself on a medical scheme while you're young and healthy so that you are prepared for any unforeseen medical circumstances.
5. Getting an unnecessarily high package
When chatting to a medical aid broker, you may be tempted to choose an option that far exceeds your requirements. If you don't go to the doctor very often and you are generally pretty healthy, get adequate cover but take one that makes medical as well as financial sense.
Before you take out any medical aid cover, determine what you need and what you can afford. There are plans ranging from hospital plans and basic cover to fully comprehensive cover, with a lot of variations in between. Compare packages and premiums, speak to your medical aid broker and ask questions so that you get the cover that is right for you.

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Healthcare Reform Teaches Financial Responsibility

As I listen to people grumble and complain about their health insurance plans due to the recent changes of healthcare reform; the percentage of individuals complaining the most are middle wage income earners whose incomes exceed $40,000.00 a year or higher. Many of these individuals who are fall between these income guidelines are not eligible for a tax credit or what is also known as a subsidy. The value people place on their material wealth rather than their own health and well-being is astonishing.
These new guidelines have made all of us realize the importance of managing our finances more wisely. Why do people place a higher value on things, rather than on themselves? In the sight of God; we are more valuable than anything in our possession; yet, we value little when it comes to insuring our own lives with the right mix of financial products to protect our material wealth and overall health and well-being.
The challenge many people face today is the fact that overall, they may be healthy individuals and do not see the need for coverage or understand the reasoning behind why he or she has to pay higher monthly premiums. Though I agree premiums are high for the individual market; the total protection insurance provides does not compare if someone had a catastrophic event happen their lives. People focus on four main parts of their health insurance plan; the four parts are: the deductible, co-insurance, co-payment, and their monthly premium.
Although these four elements are important in general; a person should tailor their plan based on their individual needs rather than being focused on these elements. For example; for someone whose on prescription medicines on a regular basis, he or she needs to have a co-pay prescription drug benefit with their plan so their prescription medicines can be paid for with a minimum dollar amount for their medications; rather than having a plan based solely on their deductible, where first they would have to meet the deductible before the percentage of their co-insurance kicks in. In my previous articles on healthcare reform, I stated how we must educate ourselves to better understand these new laws and guidelines. The prescription drug benefit is one of the ten essential benefits that is included with every plan sold today under healthcare reform.
One specific benefit most consumer do not understand is what is known as the out-of-pocket-maximum. (OOPM) This simply limits how much money a person would pay out in any calendar year if he or she had medical expenses exceeding $6,350 as of 2014. These limits will change accordingly. In 2015, the out of pocket maximum on cost sharing is: $6,600 for an individual (up from $6,350 in 2014) and $13,200 will be the amount of coverage for a family (up from $12,700 in 2014).
These limitations helps protects your household income and limit your financial losses in the event you had a major illness, or if you found yourself or family member being hospitalized over an extended period of time. We all need to understand that insurance is to protect us all from financial losses and as individuals we are more valuable than the materialism we have in our possession. Your material wealth including but not limited to: your home, car, boat, or any other material thing that cost you money to maintain, does not compare to your overall health and well-being. Keep yourself healthy in order to keep your medical expenses low and remember that insurance is in place to protect your wealth in the event of financial loss.

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Healthcare Reform Teaches Financial Responsibility Part II

As consumers it is not about the doctors in the networks as much as it is about ways of lowering medical expenses. As people complain about the network of providers due to the recent changes in Healthcare Reform; the question you should be asking your provider is; are you part of xyz network? Healthcare reform has changed drastically for the better to help many people who once were never able to receive any type of coverage due to either unaffordable premium rates or because of a person's pre-existing conditions.
The changes with Healthcare Reform has made it possible for even with people who has multiple health conditions; even they are now able to get the medical services they need from healthcare professionals. Many people today place too much value on their providers; either they are part of the insurers network or they are not.
Most consumers do not understand the purpose for in network and the out-of-network benefit of providers. These two features are important in the sense they can and will save you a certain amount of money by using providers within the network. An example; for someone whose goes to their in-network provider their co-insurance will be lower than compared to someone who goes to an out-of-network doctor. If you choose to go to an out-of-network provider your co-insurance could be as high as 40% to 50% more depending on certain plans. Insurers cannot make health care professionals stay in their network.
The purpose for using in network providers is to help control the cost of insurance and this helps control what insurers pay healthcare professionals. Though you may have built a relationship your current provider; if he or she is not willing to accept lower negotiated rates, then they will not be part of the network, and as a consumer you would have to find another doctor in the network if you want to save money on the services rendered by a physician. If insurers are going to lower insurance premiums, healthcare professionals have to come on board and accept lower rates to help reduce the cost of healthcare. This is what it is going to take to help lower cost and to help consumers realize we all have to live within a certain budget to control and reduce medical cost.
Is your current healthcare practitioner worthy of your loyalty to him or her? It's not about being loyal to your physician as much as it is about your physician being loyal to you. Keep in mind as a consumer you are the one having services rendered to you, though your provider has an expertise in a particular area of medicine; does that mean he or she are the only ones practicing medicine in that specialty? Most likely not; although every physician has the right to choose which plan he or she will accept to their practice, one of the best ways to get your practitioner into a network is to ask them to join and negotiate a reasonable rate with your insurer. We all need to understand that insurance is in place to protect us from financial losses. As consumers, in order to keep medical expenses down, we have to work within the network of providers insurers offer us; this will help lower the overall cost of healthcare services.

Article Source: http://EzineArticles.com/8627122

Can Health Insurance Premiums Be Claimed On Taxes

One of the most controversial issues of Earl Warren years as governor was his effort to achieve passage of state administered health insurance from 1995 through 1999. It was an issue in which he strongly believed, having for years witnessed the hardship imposed by medical bills on families in modest circumstances, the ill-fed for whom sickness was more frequent. Many observers believe this is also the issue on which Warren chose to make a stand for his Independent leadership of the people of California against control by powerful interest groups.
The concept of health insurance legislation can be traced back to Germany under Bismark In the 1880s and to a limited law enacted In England in 1911. The California Social Insurance Commission recommended compulsory health Insurance in a 1917-1919 study. During the 1920s, the French and German communities in San Francisco operated health services for members of their own nationalities at their own hospitals, similar to the church-based medical care societies which were common in Europe. A scattering of companies provided partial coverage insurance plans for employees, and a few physicians were experimenting with prepayment for care of clients of Joint medical practices.
It was during this decade that, as a young attorney in Oakland, Warren frequently met for dinner with a group of young physicians and lawyers, providing an opportunity for casual exchange of professional concerns and opinions. As the post war years gave way to the Depression, growing worries were expressed about the increasing numbers of people unable to pay their medical bills. Another lively topic would have been the five-year study of costs of medical care, headed by Secretary of the Interior (and later Stanford president) Dr. Ray Lyman Wilbur, which? In 1932 suggested tax-supported health insurance as a solution. Simultaneously, extensive research was underway at the University of California and other universities, codifying the actual human facts of employment, health and living conditions and developing general principles for universal health insurance.
The details of possible legislation to provide relief for the burden of medical care appealed to the public spirited. Warren, who by now had become district attorney of Alameda County occasionally offered advice to his medical friends. State wide, the House of Delegates of the California Medical Association approved the principle of compulsory health insurance and directed a committee to draft legislation, which was introduced in 1935 by the chairmen of the senate committees of Public Health, Insurance, and Banking.
This comprehensive medical health Insurance bill (SB 454) covered employed workers and their families plus voluntary enrolments, allowed employers the alternative of contracting with private insurance companies for coverage, established a system of regulations covering the services of all health professions, required their licensing, and established a fund for payment of benefits. The fund required a 5# employer payroll contribution including l/2# to J-1/2% deducted from employee salaries plus a contribution from the State General Fund varying to maintain a cash reserve.

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Obamacare Might Take A Turn For The Worse?

Last week, two court rulings about the wording of the health care law may change the face of "Obamacare". The case revolves around four words of the Affordable Care Act, which says the tax credits are available to people who enroll through an exchange "established by the state". Millions of people may see premium increase if the court ruling stands. They would lose their premium tax credit that are making their premiums more affordable.
Since majority of those who enrolled with tax credit, used federal exchanges, it can be devastating to the life of "Obamacare".
The court ruling in Halbig v. Burwell, in which a panel of U.S. Courts of Appeal for the District of Columbia found that premium tax subsidies could only be awarded in states that have their own health insurance exchanges. Only 14 states elected and implemented a health insurance exchange. In the 36 states that used the federal Insurance Exchange this year, about 87 percent of those enrolled in a private plan qualified for a premium subsidy.
Within hours of the ruling, unanimous three-judge panel of the U.S. Court of Appeals for the Fourth Circuit, in Richmond VA, issued a ruling that came to the opposite conclusion.
The Fourth Circuit panel upheld the subsidies and said the IRS ruling was "A permissible exercise of the agency's discretion".
The language of the Affordable Care Act on this point is "Ambiguous and subject to multiple interpretations," the Fourth Circuit panel said. It gave deference to the tax agency.
Subsidies in the form of a tax credit are a major element of the health care law. Without them, many of them would be faced with unaffordable premiums, purchasing a new "Qualified Health Plan", mandated by the new health care law.
The employer mandate would become meaningless in states where subsidies were unavailable. This leaves employers with one less incentive to drop the employer sponsored health plan and let their employees go to the exchanges to receive a tax credit.
The Obama administration filed an appeal to the court ruling not to long after they have been briefed on the news. At the moment, there is no change to the premium tax credit on the state or the federal level. Those who purchased a plan through the federal exchange will see no premium change as a result of the court ruling. Stay tuned for more updates as the court system evaluates the health care law wording.

Article Source: http://EzineArticles.com/8641543

Health Insurance Plans for Parents or Senior Citizens in India

Health insurance for senior citizens or parents is a must, considering the rate at which the medical expenses are rising every year. On an average, the medical costs are rising around 15% every year. Interesting fact is, Indians pay around 75% of their medical expenses from their own pocket.
In last few years, I have seen many companies (employers) stopped offering health insurance coverage for employee's parents. So, irrespective of whether your employer offers or not it is advisable to buy health insurance for your Senior Citizen parents.
Why health insurance for Parents?

• The medical costs are increasing more than the average inflation rate.
• Parents may have limited income or unstable income after their retirement
• Parents may be financially dependent on their heirs
• They are easily prone to illnesses or accidents. There might be sudden requirement of financial help.
• Their employer's health insurance policy might be ceased to exist after retirement.

If you are living with dependent parents who are aged above 60 years then buy individual health insurance plans instead of family floater plan. In family floater plans, the age of the oldest family member is considered in determining the premium rates.
Terms to watch out for in a Senior Citizen's Health Insurance Plans:

• Co-payment clause: Co-payment means the policyholder will bear a specified percentage of the claim amount. For example, in an 80%-20% clause, the policyholder will bear 20% of the cost and the remaining amount (80%) can be claimed.
• Sub-limit: Health insurance companies may specify limits for certain illnesses or treatments. For ex: the policyholder can claim only Rs 20,000 for a cataract operation but the policy sum assured might be Rs3 Lakhs.The policies without sub-limits are better but charge high premiums.
• Pre-existing diseases: You need to check if the existing diseases are covered by the policy. In some policies all the existing diseases may be covered and in some the policy holder has to wait for few years before making a claim.
• Waiting Period: The policy holder has to wait for certain period of time (in most of the cases it is 30 days) before claiming any expenses.
• Alternative Treatments: Some policies also cover alternative treatments such as homeopathic, ayurvedic etc.,

Below are the salient features of different health insurance Plans:
Star health's Red Carpet plan:

• All pre-existing diseases are covered except for diseases for which treatment was recommended by or received during the immediately preceding 12 months.
• Co-payment clause - 30% for other than claims for pre-existing diseases and 50% for pre-existing diseases.
• Discount of 10% on the premium is available if lab tests documents are submitted.
• Enhancement of SA is permitted during renewal time.

Apollo Munich's Optima Senior:

• Husband and wife can be covered under the policy on individual sum insured basis and get 5% discount on the premium
• Pre-screening medical tests are mandatory. The company would reimburse 50% of these expenses.
• 140 day-care procedures, which do not require 24hours hospitalization, are covered.
• Enhancement of SA is permitted during renewal
• Cumulative Bonus (CB) of 5% for every claim free policy year
• Pre-existing diseases are covered after 3 years
• 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries etc.,
• Co-payment of 30% applicable on specified illness/surgeries like Cataract (each eye), Hysterectomy, Arthroscopy etc.Co-payment of 15% shall be applicable to all Day Care Procedures;

Max Bupa's Heartbeat:

• Reducing co-payment clause. This is a very good feature. After 4 years of continuous renewals the co-payment percentage will become nil for senior citizens.
• Free health check up every year
• Plan will not cover treatment during the first 90 days of the policy, unless the treatment needed is a result of an accident or emergency.
• All day care treatments are covered.
• 10% additional sum assured at each renewal.

ICICI Lombard's iHealth plan:

• No mandatory sub-limits. However the customer can get the hospitalization cover with a reduced premium by limiting the medical expenses pertaining to specified medical and surgical procedures.
• Co-payment clause is voluntary
• Free health check up every year
• Certain list of diseases or ailments are not covered for first 2 years.
• Cumulative bonus of 10% on Sum assured can be accumulated for every claim free policy year.

National Insurance's Varishtha Mediclaim:

• Policyholder can either opt for a premium discount of 5% for each claim free year till it reaches 50% or can select the cumulative bonus option.
• Mandatory co-payment of 10% and additional 10% for pre-existing diseases.
• Sum Assured amounts are fixed at Rs 1Lakh for mediclaim and Rs 2 Lakhs for Critical Illness.

New India's Senior Citizen Mediclaim:

• Premiums will increase by 10% for renewals between age of 81-85 years and 20% for renewals between the age group 86-90 years
• Reimbursement of Medical Check-up costs once in block of 4 claim free years.

United India's Senior Citizen Plan:

• Free Medical check-up once at the end of every three policy years provided no claims are reported.
• Family discount of 5% on the total premium if policy is taken for self and any one or more family members viz. spouse or dependent children.

Bajaj Allianz's Silver Health:

• Reimbursement of pre-medical tests' costs.
• Cumulative bonus of 10% for every claim free policy year.
• 20% co-payment is applicable if the policyholder is hospitalized in a non-network hospital.
• 1 year waiting period for pre-existing diseases. After one year, the company will pay only 50% of the claim amount on these diseases.
• 130 day-care procedures are covered.

Article Source: http://EzineArticles.com/8614989