Health Insurance Pros

Health Insurance Pros
Have you ever thought for a moment if you got an accident and you are not health insured? What this mean? It means help of medical expenses and
hospitalization charges. Health insurance is simply the risk of incurring any sort of medical expenses. Unfortunately, only 6 out of 10 people think that
health insurance is important (Blakely). There are two contrasting viewpoints regarding compulsion of health insurance at government level. The debate
of health insurance to be required by law opens up many debates. Several people perceives it a trouble: many think it is beyond access of low income
group and other think that health insurance provides security to them. I believe health insurance is an essential part of living and is a precautionary ...
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The opposition might be convinced with benefits of health insurance, however, they have objection over health insurance price being costly. It is not
easy to buy health insurance policies due to mountain high premiums. A person who hardly makes both ends meet cannot afford to purchase health
insurance. Health Insurance is an extra burden to the public. Dashiell Bennett in an article pointed out towards words of former president Barak
Obama who said, "People want to have health insurance but they aren't able to pay high insurance premiums". (Bennett, 1). The opponents believe that
instead of paying high premiums people can make compulsory savings at regular period that they can use rainy days. People can save a lot by not
having health insurance. If they have health insurance the low income group suffers they might just keep giving half of the income they are earning
just to wait till they get sick and need the medical payment. It can keep them in continuous strain of saving money for insurance premiums by
squeezing other necessary
... Get more on HelpWriting.net ...

Medical Insurance And Health Insurance
Medical Insurance is a highly debated topic throughout the United States. The cost of health care in the United States is on the raise and individuals
are having harder times paying for their medical insurance. Companies who provide medical or health insurance as a benefit for their employees are
becoming more and more popular. Employees need to know what is the benefit of having employment based medical insurance, when and if they are
eligible, and they need to understand their plans in order to know what medical insurance provides them.
What is the Benefit? Medical or health insurance can help cover the high costs of several different services that are associated with a person health and
wellness. There are also several different types ... Show more content on Helpwriting.net ...
As of 2011, the average amount paid by an employee for a single coverage plan is 921 dollars and the average amount paid by the employer is 4,508
dollars. The average amount paid by and employee for a family plan would be 4,129 dollars and the average amount paid by the employer would be
10,944 dollars (Milkovich).
Medical insurance premiums could increase, based on different trends in the prices and costs of different health services. Health care costs have
risen by about 430 percent since 1984 for a number of reasons. Some of the reasons that lead to higher costs of health care includes: longer life
expectancies, aging of the baby boom era individuals, and the prolong lives of the terminally ill (Martocchio). There are also a number of other
reasons that have caused higher costs for health care and one of the biggest in my opinion would be the abuse of health care. Sometimes some people
will go to the hospital when they only have a cold, this causes longer waits and higher costs due to a high demand.
There are a few things that employees should know about their medical insurance plan. Employees should know how much the employer is paying
on their premiums and if there is a copay for certain visits. They also should know whether or not their plan covers prescriptions drugs, if so how
much. A lot of employees would like to have their families added to their plans, but the employee should know who is eligible and the

Plan For Purchase Health Insurance
. If you were going to purchase health insurance today, which of your "Top
Two" plans would you choose and why? Include the rationale for your choice and information about the deductible, premium, co–pay, and specialist
information.
When purchasing insurance it is extremely imperative that one assesses all of the benefits, specifications, and details offered in order to choose the
best plan in regards to deductibles, co–pays, and coinsurance–just to name a few. Among the "Top Two" plans that I chose, if I were to purchasehealth
insurance today I would choose the United Healthcare Silver Compass H.S.A. 3600 plan, as it fulfills my healthcare needs the most. This specific
plan has a $500 deductible, full premium, and $0 copay after the $500 ... Show more content on Helpwriting.net ...
However, in the event that I need emergency and urgent care services, outpatient or inpatient services, prescription drug coverage, preventative care
services or to have imaging done, I am covered at no charge after the $500 deductible. Overall, anything could happen in the course of a year that
costs more than $500 dollars and if it does happen, any other services after will be covered, as the out of pocket limit is $500.
b. Is your selected plan classified as an HMO or PPO? Explain.
The United Healthcare Silver Compass H.S.A. 3600 plan is classified as a HMO plan, meaning such plans offer a wide range of health care services
through a network of providers that contract exclusively with the HMO, or who agree to provide services to members at a pre–negotiated rate. Since
this is a HMO plan I will need to choose a primary care physician who will provide most of my health care. In addition, this plan is best for me
because I value preventive care services such as coverage for checkups, immunizations, and similar services.
c. How simple or difficult was the process of requesting a quote? Why was this process simple or difficult?
The process of requesting a health insurance quote was quite simple because the primary applicant information only asked for simple information such
as gender, tobacco use, household income, and

Problems With The Health Insurance
In America we have many problems that society may view as harmful or problems that need a remedy to fix, there problems are called a social
problem. Social problems can range from school problems to drug problems. Each person in America can have their own opinion of what a social
problem is to them. Just like with time, social problems will change, some will come and some will go. So, for right now in time one of the biggest
social problems I can see in America is the healthcare. There are many problems with the health insurance in America. According to our books in
America some of the biggest problems are: Medicare, Medicaid, Military Healthcare, Workers' Compensation, Complemtary, and AlternativeMedicine.
The book states that there are a few strategies for action people can take to make these problems go away, such as: Selective primary healthcare,
Comprehensive primary healthcare, fighting obesity, work wellness programs, public education, and the Affordable Care Act. (Linda A. Mooney,
2015) In this paper I am going to discuss the biggest problems in America that involve healthcare insurance, how to fix these problems, and the
possible outcomes. As was previously stated, there are many social problems in healthcare, but the biggest problems are: Medicare, Medicaid, Military
Healthcare, Workers' Compensation, Complentary, and Alternative Medicine. Now I will break each one of these down and explain why they are the
biggest problems. Medicare is a type of insurance that

Impact Of Insurance On The Health Insurance Market
Impact of employer–provided health insurance on the health insurance market
Introduction
Health insurance has been a topic of discussion lately due to its impact on the nation 's health status. Recently, President Obama passed the health
insurance reform so as to facilitate the accessibility of health to the majority of the US citizens including the uninsured. In the US most of the
organizations both private and public have provided a medical cover for their employees and this paper will discuss the impact of this provision on the
economy based on the population health, the impact on both private and public healthcare spending and finally the paper will focus on the impact of
employer–health insurance on the future generation.
Economic impact on population health
Employer–provided health insurance is an important tool for the economic growth of the country as well as the promotion of the general public well
being. First this form of insurance provides psychological and physical well–being of the employees' health (Kim 19). When an employee is provided
with a health care cover they reduce the worries of what will happen if they fall sick and this facilitate to being at peace which in turn increases the
productivity of the workers. When the employer provides a medical cover the employee is sure that he will receive quality treatment whenever he is
sick, also in case the employee falls sick he will receive health care services as provided in his cover which will, in turn, lead

Health Insurance Exchanges ( Hix )
HEALTH INSURANCE EXCHANGES
Health insurance exchanges (HIX) are the marketplaces which are established based on the Affordable Care Act provides customers at an individual
level or to small businesses, health insurance which they can compare and purchase from private insurance companies. Individuals can make use of the
state level exchange depending on one's state residence or can purchase insurance from a federally facilitated exchange which is accessible at
Healthcare.gov website. (1)
Affordable Care Act requires every state to either operate their state exchange or use federally facilitated exchange to provide affordable healthcare
coverage to individuals and small businesses as a means to increase the access to health ... Show more content on Helpwriting.net ...
ACA also proposed federal subsidies to individuals with household income lying between 100% and 400% of federal poverty level without the
employer sponsored coverage or individual health insurance is made eligible for federal subsidy grants by helping those individuals to pay for
coverage through the health insurance exchanges(2). For state based exchanges, it should efficiently operate in assessing the eligibility for programs
like Medicaid and Children 's Health Insurance Program (CHIP) by providing and determining the premium tax credits and cost sharing subsidies for
the individuals who are going to purchase insurance from the exchanges. (3) For individuals to qualify for subsidies these Health insurance exchanges
are the only place to enroll and obtain the subsidies.
Based on the Patient Protection and Affordable Care Act (PPACA), by 2014 it is mandated that every individual is obliged to have health coverage
which may be provided by the employer or can purchase the coverage plan through private insurance companies off the exchanges or can buy through
public health insurance exchanges and apply for subsidies if unaffordable and if the individual opts for not purchasing health insurance except
qualified for individual financial exemption is obliged to pay tax penalties.(6) Similarly, for small businesses with 50 or lesser employees, employer
should provide fully insured plan or offer a self– funded plan if accepted by the

Health Insurance History
History of Health Insurance in the United States Health insurance has a long and extensive history in the United States. The history or beginning of
health insurance can be traced back to the Great Depression in the 1930s. The Depression affected several indigenous hospitals in the United States. In
order to ensure adequate payment for medical services during the Great Depression, hospitals and physicians had to establish and implement different
types of insurance. The health insurance was also meant to cover different types of injuries and sicknesses at work environments. In the same period
(Great Depression), managed care and conventional insurance were also brought into existence. Managed care was later developed in the 1980s. ...
Also in the 1980s, the private health insurance sector witnessed drastic changes while the Prepaid group practice plans (now generally known as
HMOs) started enrolling more members on the plan. In addition, the period also witnessed the development of point–of–service (POS) and the
preferred provider organizations (PPOs). One of the major events in the 1980s as regards to the history of health insurance in the United States was
the enlargement of Medicaid and Medicare for the benefit of pregnant women and children. The major highlight of this event was when Congress
made the decision to expand (also known as SOBRA expansions) the Medicaid coverage to pregnant women and children with total income classified
below 133% of the federal poverty level. The expansion also meant that Medicare now includes prescription drug

Rationale Of Health Insurance Expansion
Health Insurance Expansion
Rationale of Health Insurance Expansion.
In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (HHS, 2014). This law placed health insurance reforms put
consumers in charge of their health care choices (HHS, 2014). The Affordable Care Act has been working to make health care more affordable,
accessible with high quality for families, seniors, businesses and more (HHS, 2014). This law also was intended to change the Medicaid programs by
providing federal funding for states to adopt a national Medicaid income–based eligibility standard, improve Medicaid reimbursement for primary care
services, maintain the existing Medicaid and CHIP eligibility requirements, and improve the Medicaid enrollment process (ACP, 2013).
There are many benefits of the ACA such as, free preventive care, prescription discounts for seniors, small business tax credit, healthinsurance
marketplace, coverage available for children up to the age 26, yearly wellness visits, and more (HHS, 2013). The Medicaid expansion is one of the
biggest milestones in health care reform (Obamacare facts, 2015). The Obamacare Medicaid expansion expands Medicaid eligibility to all
individuals and families earning below 138% of the Federal Poverty Level (Obamacare facts, 2015). This included individuals who were not
previously eligible.
However, in 2013, the Supreme Court ruling made the Medicaid expansion to states voluntary; this overturned the ACA's authority to

Family Health Insurance
Third, I am going to discuss the family's health insurance plans. Alex's employer provides health insurance through a comprehensive major medical
plan with a $1,200 deductible and an 80–20 cost sharing provision and a $5,000 out of pocket maximum. Alex uses a preferred provider organization
(PPO) managed care plan. The plan is noncontributory so the employer pays the entire premium to cover Alex. Since Marty's father died at age 46 of
cancer, the chance of Marty having cancer is higher. They bought an AFLAC cancer policy for $50 per month on Marty and an accident–only health
insurance policy for $45 per month on the children. I think that Alex has a very good health insurance plan because the deductible amount is $1,200 and
also Alex's employer pays the entire premium to cover Alex. A PPO contracts... Show more content on Helpwriting.net ...
Family savings will be based on that estimate. When Marty's income changes, Marty can update his application to adjust his coverage and
savings. I would also suggest Marty have a Point of Service (POS) health insurance plan. POS coverage will allow my client to maximize his
freedom of choice. Like a PPO, Marty can mix the types of care he receives. Also, Marty would pay only a nominal amount for network care. When
Marty choose to use network providers, there is generally no deductible. If Marty chooses to go outside the POS network for treatment, he is free to
see any doctor or specialist he chooses without first consulting his primary care physician (PCP). Of course, Marty will have to pay substantially more
out–of–pocket charges for non–network care. Healthcare costs paid out of his own pocket (deductibles and co–payments) are typically limited. The
average yearly limit for individuals is around $2,400. I think having to pay $2,400 a year for a health insurance plan is cheaper than paying $5,000 for
uninsured medical

Health Insurance Subnetwork
RESULTS
1.General analysis results
The basis of general analysis (Figure 1) was a shrunken version of the network additionally adjusted by the proportion of variables in each subnetwork
of social resources. Into the general shrunken network, health insurance subnetwork connected with 15 (83.3%) subnetworks of other social resources
by 29 shrunken links accounting for 15.67% of all connections, which was the higher value and equal for demographics subnetwork. Relationships with
13 subnetworks (72.2%) of social resources were cyclic (including incoming and outgoing links).
According to centrality indexes calculated for each shrunken subnetwork, health insurance ranked 6th by degree (general, in and out–degree) and
betweenness, and 7th by closeness ... Show more content on Helpwriting.net ...
The middle left community shows single adults as a profile significantly linked to 'no any health insurance'. The bottom left community signals the
coexistence of direct purchase of insurance with public insurance through Medicare, Medicaid, Tricare and no insurance through employer, as well as it
shows the overlap between Tricare and

The Legacy Of Health Insurance
As an individual becomes a part of something it is almost always necessary to comprehend the history and reasoning behind the way things are being
completed in today's world. With this being said, the history of health insurance has flourished throughout the centuries. With health insurance being
one of the most needed household items, in the 1920s, the situation was somewhat a different story. In 1919, there was a study directed in Illinois to
show that the wages that were lost from the individuals being out sick were actually four times larger than the incidentals linked with curing the
illness. As the world was moving forward so was the need for health insurance. In the 1929, a group of Dallas school teachers made an agreement with
the Baylor hospital to arrange for 21 days of hospitalization for $6 per year. Then in 1930, blue shield came into the insurance world with plans for
people using physician services. With blue shield becoming an available insurance company, the businessmen soon realized that those who worked a
job were healthier and better for business. Further marketable carriers began to raise the value of the business sense and they soon began to
outperform blue cross/blue shield. As the insurance companies were becoming a booming business, in 1954, section 105 was added to the internal
revenue code. This allows an employer to offer a plan to reimburse employees, medical expenses which include insurance premiums. Developments in
medical equipment alongside

Mandatory Health Insurance
Mandatory Insurance Coverage for Women's Reproductive Health
Critique of Health Policy Position Statements
All people in America should have a right to health–care benefits and services considering health care is at the center of the national agenda.
Mandatory health care insurance is a system that pays the cost of health care for those who are enrolled and in which enrollment is required for all
members of a population. Insurance works by people pooling together their risks of incurring expenses, not knowing whether they will file claims but
choosing to insure for the emotional and financial security coverage provides. In health insurance, the norm in America has been that guaranteed issue
leads people to wait to purchase a policy until they ... Show more content on Helpwriting.net ...
Recommendations on women's preventive health care, including contraception, have been developed by a panel of the Institute of Medicine (IOM)
after the reforms were enacted and became binding for many plans. There is need to prioritize the aspect of guidance from the government to the
insurers concerning the plans owing to the complexity of reproductive health matters including on preventive matters. Preventive services requirements
include a wide array of services beyond contraceptive care that are central to the sexual and reproductive health of women but the biggest challenge is
how much the public will learn about other preventive care services that these same plans must also cover without patient cost–sharing. Reproductive
health isn't all about treatment. Prevention, counseling, and checkups matter as well, and they should be covered comprehensively by sealing all the
loopholes that insurance plans

Health Insurance And Social Insurance
Neupane 1
Sujata Neupane
Professor Hinds
April 05, 2016 Health Insurance
One of the important insurance that a person should do is health insurance. Medical expenses are so much higher that every person cannot afford when
they were suffering from major illness or an accident. Health insurance is a method or a way to pay medical expense in exchange for premiums. Simply
health insurance is a contract between the insurance company and an individual or their sponsor. These insurances can be monthly, annually, or lifelong
depends on the people demand. If a ... Show more content on Helpwriting.net ...
Similarly the hospitals and medical coverage policies were developed during the first half of the 20th Neupane 2century. Even private health
insurance is unaffordable or imply unavailable to many, including the poor, the unemployed, and elderly. Before 1965, only half of seniors had the
health care coverage and they paid three times as much as younger adults pay in spite of having a low income source. Having health insurance is
important for several reasons. Uninsured people get less medical care and timely care, have worse health outcomes, and lack of medical insurance is
burden for people and for their families. The benefits of health coverage outweigh the cost of additional services. In case of the United States,
insurance has become the method for people to pay for their health care costs. Insured people pay the insurance bill every month which helps them to
deduce the cost of major unexpected medical incidents. Well, it's not like that all the people in US are insured. There are lots of people who are
uninsured. People not having health insurance have a profound negative effect on personal finances. Lack of insurance direct effect on person life by
bankruptcy, reduction of income, and penalties. If a person has suffered from major illness or an accident occurs when they were uninsured, then it
might

Advantages And Disadvantages Of Group Health Insurance
GROUP HEALTH INSURANCE
Are you running an organization with an employee–centric nature and planning to have a Group Health Insurance?
Then you are making a right decision since Group Health Insurance will be a better choice. The best gift you can give to your employees to make
their lives more secure and happier and this can be made possible through Group Health Insurance.
Still in dilemma to have Group Health Insurance? No worry! By the end of this blog, you will get a clarity regarding the advantages and disadvantages
of Group Health Insurance.
Firstly let us know, What is Group Health Insurance?
Group health insurance is the Medical policy which is beneficial to every individual in the organization provided by the insurance companies. In order
to stop the drain of ... Show more content on Helpwriting.net ...
Drawbacks of Group Health Insurance:
пЃ¬Employee is eligible to claim the policy as far as he is a part of the organization or in relation to it.Once he is out of the organization, he does not
have any access to the Group policy of the organization(but still employee can opt for the option of portability depending on the Insurance providers)
пЃ¬The Group Health Insurance is not customized according to the individual in the group
пЃ¬Renewal premium depends on claims availed in the expiring policy. Increase in value of claims also results in the increase of premium
For every context, there will be pros and cons. On evaluating the pros and cons of Group Health Insurance it is advisable to have a Group Health
Insurance for a better and happy life.
To know more about group health insurance stay tuned. Also, please don't forget to give your feedback in the comment section below.Do please let us
know what you are looking for. Our experts will be more happy to understand your requirements and suggest you the best

The Health Of Health Care Insurance
The eating habits of people in the modern days have led to the increased health complications. Most people are therefore turning to medical care
through specialists such as nutritionists in order to learn how to keep their bodies healthy. In addition due to the uncertainty of disease attack and its
severity, people have turned to health care insurance. Health care insurance is a medical plan that is aimed at benefiting an insured person by covering
the medical and surgical expenses (Enthoven, 2003).
The insured is the person who is covered by the policy and can be said to be the owner of the health insurance policy. The provider on the other hand is
the specific insurance service provider and can fall in various categories such as: doctor, clinic, laboratory or pharmacy. Therefore, health insurance
policy in this modern days translates to any payment plans that is meant to cover emergency procedures and which are mostly of a high cost. Health
care insurance in some countries is included in the employment benefit package as an employment incentive. This is mostly the case in countries
without universal healthcare covers, an example of such is the USA.
Consumers in a way deceive themselves by believing that this medical covers protect their own health (Enthoven, 2003). The payment plan develops a
mindset of total reliance on the medical industry and medical services instead of focusing on their quality of life. In this view, a need arises to change
the existing philosophies

America's Health Insurance Plan
America's Health Insurance Plan
Today's options for medical healthcare is a wide stream business that has took off when healthcare became a hot topic on Capitol Hill. Thru the joining
of American Association of Health Plans and Health Insurance Association of America a new trade association was created. That medicalhealth
insurance is called The America's Health Insurance Plans (AHIP) it's currently representing the health insurance industry. Like such a large number of
other focused medicinal medical coverage AHIP is one numerous spots that a person will realize that they have an organization that pays special mind
to their wellbeing. AHIP has exceptionally solid perspectives on why individual ought to end up becoming a member. They... Show more content on
Helpwriting.net ...
A huge number of industry experts depend on AHIP to give top notch promotion, instruction, and data. The AHIP Center for Policy and Research is the
exchange affiliation 's examination arm. The middle distributes research on an assortment of types of private medical coverage, regularly in light of
review information accumulated from AHIP part organizations. The types of protection contemplated incorporate inability to pay and long haul care
protection and also distinctive sorts of therapeutic cost protection. Wellbeing arranges assume an exceptional part in uniting those included in human
services. This coordination of consideration is key to wellbeing arrangements ' worth in the framework. Patients get better care when it is composed
consistently over numerous specialists, offices, and remedies or medications. Medical facility arranges likewise have entry to clinical information from
a huge number of associations with social insurance experts
In December 2008, AHIP distributed its recommendations for human services change like taking off social insurance costs because of extortion and
waste. It conceded that lower spending ordinarily did mean lower quality. It encouraged that an open private Advisory Group ought to be tasked with
the occupation of controlling and lessening inefficient and pointless spending, changing the prizes structure to support quality and results as opposed to
volume of work, and streamline authoritative

Indemnity Health Insurance Essay
Indemnity Health Insurance Coverage is one that gives the policy holders a unique chance to use the services of a medical service provider (it may be
a hospital or just the doctor) and share the bill with the insurance firm. The very characteristic of the Indemnity Health Care Insurance is that the policy
holder and the insurance company both pay a part of the medical bill as an part of the contract.
This article discusses the various features of the Indemnity Health Insurance. For the last few decades the indemnity health insurance had been one of
the most common health care policies that almost every American had owned. But with the latest developments in the field of health care policy,
advanced strides have been taken to formulate more affordable health care policies. Nowadays, any average American prefers to buy a policy that in
a systematic and handy way provides the various medical services and at the same time pays for them as well. That is why the new age custom ... Show
more content on Helpwriting.net ...
Anyone who has an Indemnity Health cover can use the services of any medical practitioner or any other kinds of medical service, only the bill
needs to be forwarded to the insurer and the medical costs are instantly reimbursed. Either the policy holder or the medical service provider can
forward the bill and the rest of it is taken care of by the insurer. However, for this smooth processing the policy holder is required to have paid the
deductible amount before hand.
The Indemnity Health Care policies also pay a part of the customary charge that is usually kept reserved for all the covered medical services. The
insurance firm pays for as much as 80% of these costs. The policy holder is such circumstances is supposed to coinsure just the 20% of the rest of the
cost. In case the medical services used cost more than the allotted customary charges, the policy holder will have to pay both the coinsurance expenses
as well as the excess amount, if

Health Insurance
INSURANCE LAW PROJECT| HEALTH INSURANCE AND REGULATORY ISSUES UNDER IRDA ACT 1999| Rudresh Pratap Singh Roll No. 49
Semester V RMLNLU |
Contents INTRODUCTION4 The Insurance Regulatory and Development Authority5 Regulatory issues in the health insurance business5 It should be
the duty of the regulator (IRDA) to ensure that the new entrant in the health insurance sector:5 II. Regulations Pertaining To Consumer Protection8
Relationship Between Insurers And Providers9 Is A Health Insurance Policyholder A Consumer?10 III. Regulations Pertaining To The Functioning Of
Third Party Administrators10 Operational Requirements11 Other Requirements... Show more content on Helpwriting.net ...
I. Regulations pertaining to financial requirements
In an era of "cut–throat" competition where strict financial requirements may lead to financial instability and bankruptcies, the key should be an
achievement of a harmonized approach between the extremes.
The regulator's obligations as regards maintenance of financial requirements can be analysed from three perspectives:
1. Entry Requirements
2. Operation requirements and
3. Exit Requirements
1. Entry Requirements
It should be the duty of the regulator (IRDA) to ensure that the new entrant in the health insurance sector:
Fulfils the Capital Requirement, i.e., has a minimum capital of Rs. 100 crores;
According to the Statement of Objects and Reasons of the Insurance Development and Regulatory Authority Act, 1999, the duties, powers and
functions of Authority, inter alia, include regulation and maintenance of margin of solvency.
Section 6 of the IRDA Act, 1999 deals with the requirements as to capital.

This section sways that no insurer carrying on the business of life insurance, general insurance or re–insurance in India on or after the commencement
of the 1999 Act shall be registered unless he has:
(1) A paid–up equity capital of Rs. 100 crores,

An Introduction To Private Health Insurance
INTRO
Private health Insurance is a $1.42 billion (before tax) industry in Australia (Seah, 2012) and has played a prominent role in the country's health
system for over 60 years. As of 2009, 51per cent of the Australian population was covered by some form of private health insurance. Privatehealth
insurance is a regulated industry; this means it is controlled by government legislation under the Private Health Insurance Act (2007). Private health
insurers are required to register under this Act, and the policies they sell must adhere to these regulations (Shamsullah, 2011). Due to the size and
regulation of the industry managers in the sector may face many complex challenges.
Complex management has been around for thousands of years. Basic management tools that were used in the past have formed the foundations of the
theories that have shaped today's management practices. One of the major challenges in today's organisational environments is the interconnectedness
of all management aspects. It can be difficult for leaders to identify the exact problem, the cause of the problem and what relevant information (within
the available abundance) is relevant and could be used to address problems (Maznevski, 2007). This study aims to analyse the issues and problems
faced by HealthCo and provide potential solutions and recommendations to enhance management and business success.
BACKGROUND:
HealthCO is a longstanding, leading company in the Australian health insurance industry.

Health Insurance Benefits
Choosing a health insurance plan is not as difficult as what it used to be. It is much easier to understand and research. When choosing a plan,
consider which plans would be beneficial more. Make sure that the provider that is used is in the network. Also, figure on how often go to a provider
or prescriptions. Are these plans flexible enough to fit in with the medical issues and needs of the family or individual? Find out which essential
benefits are included in the network. This way there is no out–of–network costs that should not be. The following plans are simply share costs. The
Bronze covers approximately 60 percent and have lower monthly payments, silver covers 70 covers percent, gold covers 80 percent, platinum covers
90 percent, and higher monthly costs and lower out–of–pocket, then the Catastrophic for 30... Show more content on Helpwriting.net ...
This is how it works: Deductible is paid before the insurance pays. The copay is a fixed amount after the deductible is paid; this may be different
depending on the type of service too. Coinsurance is the cost a person has to pay. The premium is the cost of what either the employer or someone
has to pay monthly. The following market plans to research are Exclusive Provider Organization (EPO): This is also flexible, and do not need a
referral for special services. The exception is hospital emergencies. Health Maintenance Organization (HMO): Providers that work through a HMO,
the exception is emergencies. Point of Service (POS): One would pay less if using providers within the network. Preferred Provider Organization
(PPO): More flexibility and use the physicians outside of the plan. There are also dental and vision in various plans. In addition, there are separate and
stand–alone plans too. When choosing a plan considers the following information: Several doctors and special visits, the regular medical services, or
use prescriptions, qualifying for out–of–pocket expenses, or any hard

The Health Care And Insurance Industries
Climate Change. Insurers are central to how we deal, or don't deal, with climate change. They price the risk facing property owners, and others, from
weather events. These companies could become financially vulnerable if they fail to properly account for the risks they face from climate change since
it is about a $23 million global investment. Damage claims could rise significantly when the atmosphere warms up due to the retention of moisture,
which can cause more extreme weather, such as more powerful hurricanes and increased flooding. Damages to this extent could create massive
liabilities.
Employee Protections.
пѓ Laws against unfair discrimination at work and when applying for jobs.
пѓ No unfair discrimination on the basis of race, religion, sex, age, or color.
пѓ Business can not dismiss the workers because they have joined a trade union or for being pregnant. There needs be proper warning before
dismissing a worker otherwise it will be treated as unfair dismissal.
Obamacare. The health care and insurance industries continue to be significantly affected by the enactment of the health care reform law under
President Barack Obama. Insurance companies were forced by law to accept high–risk customers, resulting in an increased number of claims and
payments due to "free" insurance. Insurance companies posted significant losses and have petitioned the DOI to raise rates in an attempt to counter the
losses.
Economic Forces
Employment. The economy tends to

Health Insurance
INSURANCE LAW PROJECT| HEALTH INSURANCE AND REGULATORY ISSUES UNDER IRDA ACT 1999| Rudresh Pratap Singh Roll No. 49
Semester V RMLNLU |
Contents INTRODUCTION4 The Insurance Regulatory and Development Authority5 Regulatory issues in the health insurance business5 It should be
the duty of the regulator (IRDA) to ensure that the new entrant in the health insurance sector:5 II. Regulations Pertaining To Consumer Protection8
Relationship Between Insurers And Providers9 Is A Health Insurance Policyholder A Consumer?10 III. Regulations Pertaining To The Functioning Of
Third Party Administrators10 Operational Requirements11 Other Requirements... Show more content on Helpwriting.net ...
2. Section 27–D of the IRDA Act, 1999 specifies that the regulator (IRDA), may in the interests of the policy–holders specify the time, manner and
other conditions of investments of assets to be held by an insurer by regulations.
3. Section 32–B of the IRDA Act, 1999 lays down that every player in the insurance market must undertake such percentage of life insurance and
general insurance in rural or social sector as may be specified by the Authority in Official Gazette in this behalf after coming into force of the 1999 Act.
4. Section 32–C of the IRDA Act, 1999 deals with the obligations of insurers in respect of rural or unorganised sector and backward classes. The
section specifies that it shall be compulsory for every insurer in the health insurance to provide life or general insurance policies to persons residing
in the rural sector, workers in the unorganised or informal sector or for economically vulnerable or backward classes of the people and other
categories of persons as may be specified by regulations made by the Authority after the commencement of the 1999 Act. In the event of insurers
failing to fulfill the social sector obligations, a fine of Rs. 25 lakhs would be imposed the first time. Subsequent failures would result in cancellation of
licenses.
It shall also be the duty of the regulator concerned to ensure that all health insurers participate and contribute into the

The Health Insurance Industry
Health insurance is a critical component that strives to offer quality healthcare. Uninsured individuals often receive a less intensive medical attention,
drag heavy financial burden to their caretakers and are often victims of undesirable health outcomes (Bovbjerg, & Hadley, 2017). Also, an increased
healthcare cost highly affects the US economy and individual family budgets along with the State and Federal budgets. On the contrary, possessing
health insurance leads to healthier children and adults who can focus on school, be more productive and excel in their fields. Therefore, it is the
responsibility of the health insurance market to provide high quality health insurance with a possibly lowest payment while making sure that they have a
... Show more content on Helpwriting.net ...
The modern–day healthcare is evolving to the extent that can hold an enormous amount of patient's records while ensuring that a patient's health is
monitored more individually. However, the health insurance companies adhere to the traditional insurance practices which revolve around pricing the
health risks based on the generalized information regarding ailments. Hence, new healthcare structure indicates that each potential health insurance
consumer will present the insurance firms with varying insurance requirements. As a result, the insurance firms will require to go beyond their current
responsibilities to not only offer insurance coverage but come to agreeable terms with their consumers and establish preventative measures to reduce
their risks. It is evident that with an increased competition and more individualized health records, the insurance firms will need to offer more
individualized insurance services to survive in the thriving market. Thereby, it can be affirmed that the future market will be characterized by savvy
technologies, consumer centered insurance services and flexible and cost–effective insurance

Affordable Health Insurance
Finding affordable health insurance can be difficult. Paying private health insurance rates can be high and unrealistic for those without a stable source
of income. However, there is hope for those looking for affordable health insurance without breaking the bank. Health insurance company will offer
different products and policyholders can opt for guarantees or offers that fully meet their expectations. To better guide subscribers in their choice,health
insurance facilitate the search for the best formula corresponding to their expectations and this also help in the comparison of offers and prices existing
in the market. According to your chosen company, healthinsurance can cover almost all medical expenses, ranging from generalist or specialist
consultations, from simple tablet pads to lenses, or even hospitalization. This area is currently a very important investment. Health insurance is mainly
designed to supplement medical expenses that are not covered by the Social Security. Each individual corresponds to his own mutual health. According
to the needs of each, health insurance is very wide and includes, among others, the dental insurance, the optical insurance, the family insurance,
insurance maternity, etc. ... Show more content on Helpwriting.net ...
In order to obtain better offers, it would be best to provide useful and important information such as surname, first name, date of birth, age, contact
details, occupation and information about relatives, Insurance to provide a solution adapted to each search for health insurance.
Knowing where to look for good coverage is both a matter of patience and ingenuity. There are a few basic steps you can follow to make sure that you
will find the coverage you need to promote your health continues at a price that fits your

Health Insurance Matrix
University of Phoenix Material
Health Insurance Matrix
As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working
knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding
how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future
health care worker. Fill in the following matrix. Each box must contain responses between 50 and 100 words using complete sentences.
Include APA citations for the content you provide.
Origin: When was the model first used?
What kind of ... Show more content on Helpwriting.net ...
Indemnity health plans run on a retrospective payment system. A member has a monthly premium. Co–pays and a deductible. Upon visits the provider
submits claims for services rendered to the insurance company, upon which the insurance company pays their part and the member is billed for the
remaining balance to be paid out–of–pocket.
With indemnity plans employers deduct the monthly premium from payroll of each employee on the plan. Both the member and the insurance
company pay for services rendered. Upon receipt of the services the insurer pays the provider their portion if the deductible has been met. The member
is then responsible for the remaining balance and the co–pay at the time of service.
The structure of an indemnity plan is completely "open access". The member may choose any provider or specialist they would like. In an indemnity
plan there are no restrictions on providers or provider type. It is the member's responsibility to seek and sign on with their preferred provider or
specialist.
Positive aspects of indemnity plans include the liberty of the member to choose their preferred provider or specialist and their preference of type of
care they wish to receive. A negative aspect of indemnity plans from a members stand point is the cost of these plans. Premiums and deductibles then to
be higher with indemnity plans over other insurance plans due to the freedom

Health Insurance Claims
In order to process health insurance claims there are two standard forms. The CMS–1500 Claim Form, this billing method is used for physician and
supplier services (ex: specialists, dentists, ophthalmologists, durable medical equipment) and the CMS–1450 Claim Form (UB–04), used by hospitals,
rehabilitation centers, clinics, and ambulatory surgery centers to process both inpatient and outpatient services (ex: medical expenses [bed pans/pads],
x–rays). Over many years updates were made for each form with numerous changes being made, so any old forms should be discarded to prevent
denial of a claim. Both forms are used for Medicare, Medicaid, and many commercial third–party payer claims. Paper claim forms are still in use today
on the brink of

A Brief Note On Health Insurance And Insurance Essay
While on the topic of insurance, I will also need to start putting diverting some of my income to cover health insurance, possibly disability insurance
and even life insurance. I currently have an HMO plan through Blue Cross Blue Shield of TX and the rates are astronomical. Health insurance is one
of the key factors I am using as I am looking for long–term employment. Since I am a student, there are not many individual insurance policies
available so I am forced to pay extremely steep monthly rates, but am hopeful that the health insurance offered through my future employer will
allow me to receive access to better doctors at a lower overall price. Just as auto insurance and renter's/home insurance is needed to help offset the
costs of accidents that may occur, the cost of not having health insurance is much higher than the rates I am currently paying so not having insurance
is not an option (not to mention without health insurance, you now receive a fine.) I also would like to receive disability insurance through my
employer to cover lost income as a result of an accident, or illness. Other sources of disability insurance are available through social security, worker's
compensation, and private insurance companies, but as I stated, I would accept these benefits through my employer, social security or worker's
compensation but I am unlikely to purchase my own individual disability policy. I currently do not have a life insurance policy as I have limited assets
and zero

Health Insurance Case
3. Particular analysis results
Links between single variables of health insurance and all remaining variables accounted for 8.85% of all network connections (Blue and red links in
Figure 1. A full list of links is available in the supplemental material). According to general analysis results, by exploring these links with particular
emphases on those constituting the most relevant relationships with demographics, culture and income, we explain the role of health insurance in the
whole landscape of social resources for wellbeing.
Forty five pairwise links (23 incoming and 22 outgoing) constitute the relationship between health insurance and demographic characteristics. As
demographics variables such as age, sex, and relation to household head ... Show more content on Helpwriting.net ...
This variable had also high indices of closeness (Pc=99.1 z=1.5), betweenness (Pc=97.3, z=3.3) and hub weight (Pc=99.5, z=7.1). High indices as
itinerant broker (participating in 31 triads, Pc=99.1 z=7.6) and liaison (152 triads, Pc=99.8 z=12.3) signaled its mediating role within and between
social variables in resources different to health insurance. According to its high gatekeeper index (14 triads, Pc=95.0 z=1.8), it also mediated between
social variables and the health insurance subnetwork, uncovering diverse population profiles without health insurance, such of children but also elders
with low retirement incomes or people being covered by social security, some regularly out of the working force, and some with recent family

The Cost Of Health Insurance
Health care expenses are a never ending headache that create numerous liabilities. Liabilities are created when goods or services are purchased on
credit and obtained through short– term and long– term loans. Health care expenses create liabilities such that payments are made late or no payments
are made at all. In some cases, the cost of health care expenses are unaffordable resulting in those type of payments. To prevent large health care debt,
many individuals seek health insurance. Health insurance is provided by private insurance companies or by the government. It covers health care
expenses and provides the necessary health care. Although, health insurance is necessary it can also be very costly. The cost of health insurance has
changed drastically over the years as it has become more expensive. Depending on personal characteristic, the cost of health insurance may vary. For
instance, as individuals grow older the more expensive it becomes. In this case, health insurance is more costly because "older individuals require
more health care" therefore "the cost of providing health care is rising" (Madura &Atlantic, 2012). Not only does this affect the high cost of health
insurance, but the number of individuals uninsured. As stated by Madura and Atlantic (2012), "about one in every five workers is uninsured" and has
increased since then because health insurance has become unaffordable. As a result, individuals tend to seek health care elsewhere as they can no longer

The Issue Of Health Insurance
Currently, the issue of health insurance has been a bone of contention for the public regarding whether the United States government should provide
this health plan or not. People often possess different perspectives and refer to pros and cons on both sides of the spectrum. While some believes a
universal healthcare system will set a foundation for a lower quality of service, increasing governmental finance deficit, and higher taxes, others do not
hold the same thought. A universal healthcare system brings enormous advantages rather than disadvantages, such as all–inclusive population
coverage, convenient accessibility, low time cost, and affordable medical cost, all of which not only provide minimum insurance to the disadvantaged
but also improve the efficiency of medical resources distribution. When it comes to the healthcare system, the root of it can be tracked back to the
nineteenth century. At that time, compared to a private company, most of the service providers were hospitals, which provide a people free–charge
service and inexpensive medicine because they were not profit–oriented institutions. To some degree, the expenditure of a household on healthcare at
that time is lower than the one of a modern household. Hospitals played an important role in offering the disadvantaged healthcare resources and
fundamental treatment. As the number of patients increased, they still needed working capital to support their expenditure. Most sources of money
were from

Health Insurance Errors
Modern medicine has come a long ways in the past few decades. With those advances in medicine have come higher medical costs. Today, most people
rely on health insurance to cover most of those costs. Unfortunately, it is all too common for health insurance companies to deny valid claims.
Health insurance coverage can be denied for a whole host of reasons. Administrative errors are very common. Hidden gaps in coverage are also more
common than you might think. A perceived lack of medical necessity is also a commonly cited reason for denial. No matter why an insurance
company delays or denies an insurance claim, it can be extremely stressful. In those instances where the insurance company is not paying a claim, you
may need the help of a qualified

Disadvantages Of Health Insurance
Health Insurance Coverages
Health insurance coverage is a necessity used to decrease the cost of health care expense. Many individuals require some version of health care
coverage and depending on the situation, every coverage has its own requirements. In the state of New Mexico, a discussion of the various health
insurance coverages based on age, employment, and status is being compared along the contributions made to towards the premiums.
Medicare
Medicare is a federal health insurance program that targets individuals aged 65 years or older. Other criteria that may qualify for Medicare is if an
individual under the age of 65 has Lou Gehrig's disease (ALS) or end stage renal disease (ESRD) (Olmos, 2017). Residents of New Mexico have
several options for types of coverage. Types of coverages offered in New Mexico is the Original Medicare (Part A and B), Medicare Advantage,
Medicare Part D and Medicare Supplemental insurance also known as Medigap (Olmos, 2017). Part A and Part B includes hospital and medical
insurance. Medicare Advantage is considered Part C and during enrollment into this program, premiums in Medicare Part B must be paid along with
any charges from Part C. Medicare Part D is the Prescription Drug Plan that provides coverage for prescription drugs. The Medigap is a coverage that
covers certain expenses that Original Medicare does not cover. Every individual is different and may require different coverages.
Medicaid/Children's Health Insurance

Disadvantages Of Group Health Insurance
GROUP HEALTH INSURANCE
Are you running an organization with an employee–centric nature and planning to have a Group Health Insurance?
Then you are making a right decision since Group Health Insurance will be a better choice. The best gift you can give to your employees to make
their lives more secure and happier can be made possible through Group Health Insurance.
Have you still got any more doubts regarding Group Health Insurance? No worry! On the further continuation of this blog, you will be able to find the
present criteria of health issues with the explanatory solution to overcome the unwanted situations.
Firstly let us know, What is Group Health Insurance?
Group health insurance is the Medical policy which is beneficial personally ... Show more content on Helpwriting.net ...
Drawbacks of Group Health Insurance:
пЃ¬The employer is eligible to claim the policy as far as he is a part of the organization or in relation to it.Once he is out of the organization, he does
not have any access to the Group policy of the organization(but still employee can opt for the option of portability depending on the Insurance
providers)
пЃ¬The Group Health Insurance is not customized according to the individual in the group
пЃ¬Renewal premium depends on claims availed in the expiring policy, increase in number of claims also results in the increase of rate of premium
For every context, there will be pros and cons. On evaluating the pros and cons of Group Health Insurance it is advisable to have a Group Health
Insurance for a better development of the business in all streams.
To know more about group health insurance stay tuned. Also, please don't forget to give your feedback in the comment section below. Regarding
Group Health Insurance Do please let us know what you are looking for. Our experts will be more happy to understand your requirements and suggest
you the best

Health Insurance Stakeholders
The insurance system is an important topic for all providers, employees and individuals of this country to understand. Insurance allows patients to be
seen by healthcare providers without having to pay large medical bills. It is the ability for physicians to treat patients and then able to get reimbursed.
Health insurance is a privilege in our country because not only does it save families time from stressing about money, but also it allows each
individual the ability to receive good quality care. In fact, there are two forms of health insurance, social and private. Social health insurance is a
government–owned program that benefits the citizens of our country. There are three types of social insurance, Medicare that covers elderly people,
Medicaid that covers poor people and ... Show more content on Helpwriting.net ...
For example, if the patient has active insurance than the physician understands that they will get compensated if the patient is seen. If the patient does
not have insurance, most likely the patient will not been seen because the doctor will not be getting reimbursed or paid for that visit. Some hospitals
have free–care programs where patients without insurance can receive free healthcare, but the hospitals and providers are not getting paid, which can
hinder the stakeholders (physician). Therefore, if a patient has insurance, the doctor or healthcare provider is being benefitted. On the other hand, a
factor that burdens stakeholders is the fact that U.S. health insurance plans are highly variable, and even the best plans do not cover all necessary care
or provide first–dollar coverage (Scheetz, 2015). Therefore, either the patients are not receiving good quality of care or the doctors can perform the
care, but they will not get reimbursed. Also since the Affordable Care Act (ACA) was enacted, more patients are being seen, which causes the
physicians to receive a lot less money due to a lower fee

Definition of Health Insurance
Definition
Health insurance is insurance against the risk of incurring health care related expenses. It indemnifies the insured for the related financial loss. It is
important to note that health insurance is a form of short term insurance. Disability, critical illness and long–term care insurance are all subclasses of
health insurance.
When an individual buys health insurance, he/she enters into a contract (policy) with the insurance company so that for a monthly premium, the
insurance company will provide cover for medical expenses incurred. The level of cover and the health care providers allowed will range between
different products. Coverage will include visits to doctors or hospitals, prescriptions, cost of medical examinations or ... Show more content on
Helpwriting.net ...
(Obringer & Jeffries, 2006)
There are many different types of health insurance, the main forms include:
Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations: Where you choose a primary care physician. You are then cover
for care received from specifies hospitals and doctors, all other care providers are not covered.
Preferred Provider Organizations (PPOs): You pay higher fees for care received from a preferred provider list and higher fees for all hospitals and
doctors visited that are not on the list.
Point–of–Service plans (POS): Combination of HMO and PPO.
High Deductible Health Plan (HDHP): A cheap form of health insurance with higher deductibles.
Catastrophic Health Insurance Plan: Provides cover in the event of an accident or serious illness.
(HealthCare.gov, 2014)
Other health care related products that aren't indemnifying include:
Hospital Cash cover: Provides a cash lump sum per day that you are in hospital. Can also provide some cover from loss of income.
Medical Gap Cover: insures you against the event that there is a shortfall between the cover your medical scheme provides and the actual payment
required. The two main risks that all standard health insurance products provide cover for are:

Pharmaceutical expenses, doctor visits and tests: High frequency and low cost.
Hospitalization: Low frequency and high cost.
(Rosner, Leppert,

Health Insurance
President Obama 's plan to insure healthcare for all marks a positive step for the well – being of our country 's citizens. Still, the Patient Protection and
Affordable Care Act (PPACA) also known as ObamaCare has been one of the most controversial topics of our time. In order to understand why this is
such a controversial topic we must understand exactly what this act means to the people. The Patient Protection and Affordable Care Act (PPACA)
states that with limited exceptions, every resident of the United States must have health insurance that must meets certain basic requirements.
Beginning in 2014, individuals who do not acquire health insurance will be subject to a fine. This fine will rise over time, reaching $895 per person or
2.5 ... Show more content on Helpwriting.net ...
They all have to abide by the federal government 's requirement of covering 100 percent of the cost for all medically necessary visits and procedures.
Residents still pay for this indirectly through the taxes they pay to the provincial and federal government. But unlike the United States, doctors and
hospitals are required to accept the fees that are set by the government. Japan has a universal health insurance system. They require all of the residents
of the country to either (a) enroll in one of the many non – profit health insurance societies that are organized by industry or profession, or (b) enroll in
the health insurance program provided by the national government. The funds for the system come from the premiums paid by the employees and
firms as well as a payroll tax similar to the tax that funds the Medicare program in the United States. Unlike the others system this one is highly costly
for the residents; they are charged a co –payment which can be as much as 30 percent of the bill. The Japanese system does not cover preventative
health care or any pregnancy related visits. Similar to the United States system doctors are not government employees and most hospitals are privately
owned. In the United Kingdom the government, through National Health Services (NHS), owns nearly all hospitals and directly employs almost all
doctors. Because there

Health Insurance Essay
The main function for health care financing is to pay for health insurance premium and reimburse health providers for services delivered. Still, there is
a crucial challenge when creating health insurance plans, provide coverage for "health care needs without encouraging unnecessary spending." (Maas)
Over time, health care financing has been evolving, and now consumers can acquire health insurance through government programs like Medicare,
which it is for the elderly, for certain individuals with disabilities and end–stage renal disease. Therefore, any person who meets the requirements can
enroll to this program. Also, there is Medicaid, which it is the program for the poor, and Children's Health Insurance Program best known as CHIP,
which insure kids who come from low–income families. Nonetheless, there are several types of private insurance like self–insured plans, individual
private health insurance, Medigap, and group insurance program, which it is "... a substantial number of people in the group will purchase insurance
through its sponsor." (Shi, 2019, p. 224) Further, thanks to the diversity and wide range of health insurance ... Show more content on Helpwriting.net ...
219) Consequently, moral hazard has a negative impact in health care financing since people are less likely to take care of their health when they have
the ease to frequently consult a doctor and use any medical service at any time, therefore with health insurance there is an increase in health care
spending, "but the value of this care is less than its cost, generating... loss." (Nyman, 2004) Additionally, since such services are reimbursed to health
care providers by health care financing there is a "potential to increase health care costs." (Thoma,

The Cost Of Health Insurance
"In 2012, the United States of America (USA) spent more than 2.8 trillion United States dollars (US$) – i.e. more than 17% of its gross domestic
product (GDP) and more than the entire GDP of the United Kingdom and Great Britain and Northern Ireland – on its health–care system" (Rice et al.,
2014, page #). This outrageous number in the quote shows to what extent the United States government is really going to in order to provide coverage
for its citizens. The cost of health is rising day by day, and the current rate of health insurance is unable to really help those in need of it, such as the
poor or less fortunate. Therefore, in order to take preventive measures for people to treat their well being, health insurance agencies should provide ...
With a simple yet effective insurance plan that covers basic support for these poor families, they can work their way up to paying off the plan in a set
number of years as becoming a client of a health insurance agency. The United States government is basically throwing money away on trying to figure
out how to help everyone but not really implementing much. If affordable coverage could be provided to all, including those with families, through a
plan where citizens work and then receive insurance based on their ethic and employment, this could possible help with not only health care problems
but unemployment as well.
Problems of Health and Cost to Cover the Problems Lots of health issues can be focused on here, but there are some evident ones that show up in
impoverished homes. These mainly include asthma, obesity, diabetes, high/low blood pressure, an innumerable amount of cardiac conditions, and
many mental illnesses as well. The numbers of diseases are increasing day by day and now more than ever before showing up with HIV, AIDS, and
parasitic problems too. In reality, and in the eyes of the poor their problems are denied and so is their proper care, because of the lack of money and
care they are provided. The poor must compensate by overlooking agencies because of all the restrictions that they fit under. As stated in Health
Services Research (2014), "The exclusion of a substantial proportion

Health Insurance Fraud Essay
Faking a death is the most common type of life insurance fraud and has even been the plot of many movies, books and shows; although it is difficult
to pull off. This occurs after a person takes out a life insurance policy on their self and after a few months of it being in effect they disappear and are
declared dead. Then the beneficiary, a family member or spouse, then attempts to collect the life insurance policy
"Double–billing" is a scheme that is common in health insurance fraud. Doctors will bill for treatments that were not rendered or medically necessary
as well as billing for a different service that is covered under the patient's policy instead of billing for a treatment that is not covered. Patients may not
even realize they are ... Show more content on Helpwriting.net ...
Insurers can refuse to pay claims or delete claims, deny or cancel coverage as well as underpay medical expenses. Fraudulent insurance companies
can also collect premiums and pay for inexpensive care before disappearing if a large claim is filed. It has also been known for companies to look
through insurer claims to intentionally drop them saying the insurer did not disclose previously.
One of the most targeted insurance lines is auto insurance fraud. There are many known schemes that take place in this fraud that can vary in
seriousness and complexity. There are small schemes to defraud; filing multiple claims for a single injury, filing claims for vehicle damage or injuries
that were not caused by and auto accident and padding the cost of repairs. The schemes can become more complex involving staged accidents, faking
injury or falsely reporting a stolen vehicle.
Other schemes in auto insurance fraud occur mostly to avoid paying higher premiums. People might register their car in a different town so they
have cheaper rates. It is also common for fake primary drivers to be listed to avoid a bad driving record or young drivers that are indeed the sole driver.
Another scheme is a policy holder reporting a false auto insurance claim that occurred before the policy period

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