Healthcare is significant for each individual on the planet, on account of this each nation should focus on wellbeing, because of increment pace of sickness and ailments.
In India medical coverage part is an undiscovered market, still it has crying needs. There is colossal potential for this part. The medical coverage suppliers are not satisfying this interest. After 1999 the privatization of protection area, the protection segment has developed in past decade. By and by there are 25 medical coverage suppliers, in that four are with open area and twenty one private medical coverage suppliers. The piece of the overall industry of open segment is 60 rates while the rest with other private players.
This paper inspects the present status of medical coverage in India, advancement in health care coverage area and difficulties looked by it. It additionally investigates the job of both open and private medical coverage players to arrive at most extreme inclusion in health care coverage.
Wall of Protection: Health, Income, and Life InsuranceAlanna Russell
Discover how insurance can be customized and used as a financial tool to protect ALL of your life. Take control of your assets, plan your course, protect your empire.
This document provides contextual information about health insurance in India, including:
- The origin and development of health insurance in India, which began in the 1980s with government schemes and expanded to private policies.
- Key definitions of health insurance as providing financial protection against unexpected medical costs through risk pooling and premium payments.
- Statistics on health insurance coverage in India, which remains low at only a few percent of the population, with most costs paid through out-of-pocket expenses.
- An overview of the types of health insurance schemes currently operating in India through public sector insurers, private insurers, employers, and community-based programs.
Report on Health insurance and consumer, it is an overview of what health insurance is all about, what are its scenario in India. It also explains about how the regulatory authority perform its function and hoe do they deal with the consumer, faulty transaction etc. We have done a survey of
Voluntary health insurance (VHI) in India has low penetration due to several challenges:
1. VHI premiums are unaffordable for many and claim ratios are high due to increased health risks and rising costs.
2. Both private and public VHI providers lack innovation and adequate promotion of their products.
3. VHI schemes have many exclusions and complex administrative procedures that deter customers.
4. Poor regulations and inadequate healthcare supply further limit the development of the VHI sector in India despite increased need due to changing lifestyles and diseases.
The document discusses the need for health insurance in India to move beyond only covering hospitalization and toward financing primary care and chronic conditions. Currently about half the population lacks access to any health financing. As India's disease burden shifts to non-communicable diseases, outpatient funding becomes increasingly important. The rising prevalence of chronic conditions also calls for insurance that provides long-term coverage rather than excluding pre-existing illnesses. The paper focuses on developing insurance frameworks for chronic disease management and elderly care.
This document discusses health insurance in India. It provides information on four main categories of health insurance schemes in India: 1) voluntary private schemes, 2) employer-based schemes, 3) community-based schemes, and 4) mandatory government schemes. Two prominent government schemes discussed are the Central Government Health Scheme (CGHS) and Rashtriya Swasthya Bima Yojna (RSBY). CGHS provides healthcare to central government employees and pensioners. RSBY provides health insurance coverage for below poverty line families. Challenges faced by RSBY are also outlined.
The document discusses different types of sales channels used by Apollo Munich Health Insurance, including agency channels, corporate channels, partnership channels, and direct-to-customer channels. It explains the mindset behind selecting each channel and how they each fuel company growth. The agency channel focuses on relationship building and commissions, accounting for 50% of business. The corporate channel requires experience to close large deals and accounts for 30% of business. Partnership channels appeal to brokers' large client bases and account for 15% of business.
This document provides an overview of health insurance in India, including what it is, its importance, and common products. It discusses how health insurance works by pooling risks collectively. It outlines the rising costs of healthcare as a driver for health insurance penetration. Common plan types include individual, family floater, senior citizens, critical illness, daily hospital cash, and unit-linked plans. It also discusses government schemes like ESIS and CGHS, as well as community-based and employer-provided insurance options. Impediments to the industry like lack of data, pricing challenges, and government provision of care are also covered.
Wall of Protection: Health, Income, and Life InsuranceAlanna Russell
Discover how insurance can be customized and used as a financial tool to protect ALL of your life. Take control of your assets, plan your course, protect your empire.
This document provides contextual information about health insurance in India, including:
- The origin and development of health insurance in India, which began in the 1980s with government schemes and expanded to private policies.
- Key definitions of health insurance as providing financial protection against unexpected medical costs through risk pooling and premium payments.
- Statistics on health insurance coverage in India, which remains low at only a few percent of the population, with most costs paid through out-of-pocket expenses.
- An overview of the types of health insurance schemes currently operating in India through public sector insurers, private insurers, employers, and community-based programs.
Report on Health insurance and consumer, it is an overview of what health insurance is all about, what are its scenario in India. It also explains about how the regulatory authority perform its function and hoe do they deal with the consumer, faulty transaction etc. We have done a survey of
Voluntary health insurance (VHI) in India has low penetration due to several challenges:
1. VHI premiums are unaffordable for many and claim ratios are high due to increased health risks and rising costs.
2. Both private and public VHI providers lack innovation and adequate promotion of their products.
3. VHI schemes have many exclusions and complex administrative procedures that deter customers.
4. Poor regulations and inadequate healthcare supply further limit the development of the VHI sector in India despite increased need due to changing lifestyles and diseases.
The document discusses the need for health insurance in India to move beyond only covering hospitalization and toward financing primary care and chronic conditions. Currently about half the population lacks access to any health financing. As India's disease burden shifts to non-communicable diseases, outpatient funding becomes increasingly important. The rising prevalence of chronic conditions also calls for insurance that provides long-term coverage rather than excluding pre-existing illnesses. The paper focuses on developing insurance frameworks for chronic disease management and elderly care.
This document discusses health insurance in India. It provides information on four main categories of health insurance schemes in India: 1) voluntary private schemes, 2) employer-based schemes, 3) community-based schemes, and 4) mandatory government schemes. Two prominent government schemes discussed are the Central Government Health Scheme (CGHS) and Rashtriya Swasthya Bima Yojna (RSBY). CGHS provides healthcare to central government employees and pensioners. RSBY provides health insurance coverage for below poverty line families. Challenges faced by RSBY are also outlined.
The document discusses different types of sales channels used by Apollo Munich Health Insurance, including agency channels, corporate channels, partnership channels, and direct-to-customer channels. It explains the mindset behind selecting each channel and how they each fuel company growth. The agency channel focuses on relationship building and commissions, accounting for 50% of business. The corporate channel requires experience to close large deals and accounts for 30% of business. Partnership channels appeal to brokers' large client bases and account for 15% of business.
This document provides an overview of health insurance in India, including what it is, its importance, and common products. It discusses how health insurance works by pooling risks collectively. It outlines the rising costs of healthcare as a driver for health insurance penetration. Common plan types include individual, family floater, senior citizens, critical illness, daily hospital cash, and unit-linked plans. It also discusses government schemes like ESIS and CGHS, as well as community-based and employer-provided insurance options. Impediments to the industry like lack of data, pricing challenges, and government provision of care are also covered.
The document discusses healthcare financing in India. It notes that healthcare spending as a percentage of GDP and per capita is much lower in India than other countries. Most healthcare financing in India is private and out-of-pocket. Community-based health insurance has potential to help cover rural and low-income populations. Reforming healthcare financing will require expanding insurance coverage through appropriate public-private models and increasing overall healthcare spending.
This document discusses the health insurance market in India. It outlines key factors needed for a thriving health insurance industry, such as availability of healthcare providers and medical cost data, and notes that many of these factors are currently lacking or poor in India. The market potential for health insurance in India is estimated to be huge, covering hundreds of millions of people currently without coverage. To develop the industry, the document recommends establishing an independent institution to standardize healthcare facilities and procedures, collect medical data, and evaluate insurance plans. It also suggests initial guidelines from IRDA to improve services from TPAs, insurers and reinsurers as the first step toward developing the proper environment for health insurance in India.
Health Insurance products offering by life insurersJaswanth Singh G
- The document discusses health insurance and various related topics such as whether it is necessary, differences between health insurance offered by life insurers versus general insurers, key proposed regulatory amendments regarding health insurance, and popular riders available under health insurance policies.
- It provides an overview of health insurance policies offered by life insurers versus general insurers, explaining that life insurers typically offer fixed-benefit plans while general insurers offer indemnity plans.
- It also summarizes some key proposed regulatory changes such as requiring uniform premiums for 3 years and incentives for policyholders who maintain good health.
Health insurance protects individuals from high medical costs by covering expenses. In India, health insurance reaches only 13% of the population through various schemes. These include private plans, employer-based coverage, community-based insurance, and government programs. The largest government scheme is the Central Government Health Scheme (CGHS), which provides services to central government employees and retirees in 17 cities. Another major program is Rashtriya Swasthya Bima Yojna (RSBY), which offers health insurance to below poverty line families. However, challenges remain in increasing awareness, improving claims processes, and reducing disputes over pre-existing conditions. Research shows that losing health insurance leads to 40% fewer emergency room visits and 61% fewer hospital
This document provides an overview of health insurance. It discusses what health insurance is, the types of health insurance plans available including individual, group, critical illness, and specific disease plans. It covers factors that determine premium costs such as age, medical history, job, and term of the policy. Tips are provided for choosing the right health insurance plan and saving on premium costs. The steps for filing a health insurance claim are outlined. Recent government incentives for health insurance in India are also mentioned.
This document summarizes various types of health insurance policies including Mediclaim, Group Mediclaim, Cancer Patients Aid Association policy, Critical Illness Insurance, Overseas Medical policy, and Corporate Frequent Travellers policy. It outlines what is covered and excluded in each policy type, such as reimbursement of hospitalization expenses, waiting periods, claim limits, and eligibility.
Health insurance in India- Dr Suraj ChawlaSuraj Chawla
The document discusses health insurance in India. It defines health insurance and outlines some key milestones in its development. It describes various social health insurance schemes run by the central and state governments like CGHS, ESI and RSBY. It also discusses private health insurance schemes like Mediclaim and the roles of IRDA and TPAs. Overall, it provides a comprehensive overview of the health insurance landscape in India.
Community based health insurance in IndiaNeetu Sharma
Community based health insurance (CBHI) schemes in India suffer from poor design and management, low membership, and sustainability issues. They typically target poorer populations, with flat-rate premiums and benefits including preventive care, ambulatory care, and inpatient care. Several CBHI schemes operating across India were described, varying in premium structure, benefits covered, management approach, and financing sources. The largest schemes cover over 100,000 members.
Know about the complete process of buying health insurance in India. Read about the types of health plans, factors, coverage and more. Know here. https://www.coverfox.com/health-insurance/articles/steps-to-buy-health-insurance/
This document provides an overview of health insurance. It defines health insurance as insurance that covers medical and surgical expenses. It explains why health insurance is needed to protect against high, unexpected medical costs and make quality treatment affordable. It then describes different types of health insurance plans including HMOs, PPOs, and high-deductible plans. The document provides steps for obtaining health insurance, filing claims, and surrendering a policy. It also outlines advantages and disadvantages of health insurance as well as tips to avoid health insurance scams.
This document discusses health insurance options in India, including social health insurance schemes like ESIS and CGHS, voluntary private health insurance, and community-based health insurance (CHI). It notes that while social health insurance covers only a small portion of the population, voluntary insurance plans are often unaffordable for the poor. CHI has potential to improve access and reduce costs for vulnerable groups, but faces challenges in India due to poverty, illiteracy, and lack of institutional support. The government has launched various initiatives over the years, including state-run insurance programs and public-private partnerships, to expand coverage.
Types of Health Insurance in India - There are three types of health insurance in India. Health Insurance plays a very important role to every ones life. Get to know more about health insurance
The document discusses the emerging trend of health insurance in India. It summarizes that the Indian health insurance market grew at a CAGR of 37% between 2002-2008 and is expected to grow at a CAGR of 42.3% between 2008-2015. The main drivers of growth are increasing awareness, rising healthcare costs, and supportive demographic trends of a prospering middle class. However, the market also faces restraints like inadequate healthcare infrastructure and lack of standardization.
The document discusses various types of health insurance policies in India. It provides details on individual health insurance, critical illness policies, travel insurance, and personal accident policies. For individual health insurance, it outlines the benefits for individuals, scope and coverage of policies, exclusions, and ancillary benefits like maternity, dental and optical coverage. It also discusses critical illness policies, common illnesses covered, waiting periods, and exclusions. For travel insurance, it summarizes typical healthcare and non-healthcare covers as well as exclusions. Personal accident policies provide compensation for accidental death or disability.
Health insurance in India is growing but still has low coverage rates. Only 18% of urban and 14% of rural populations are covered. There are various public and private health insurance options that offer individual, family, and group coverage. Coverage typically includes inpatient hospitalization but recently some policies have begun covering outpatient care as well. Premiums and policies have grown significantly in recent decades but penetration remains low due to lack of competition. Several government programs also provide health insurance coverage.
This document is a project report submitted by Dr. Vibhuti Amin to fulfill the requirements for a Postgraduate Diploma in Health Insurance Management from Symbiosis School for Open and Distance Learning. The report received approval from the director of the school to commence the project work. The project is a study on awareness of health insurance products and the claim settlement process with reference to United India Insurance Company Limited. The report includes chapters on the need for health insurance in India, factors influencing awareness, the claim settlement process, data analysis and interpretation of survey results, findings, conclusions and suggestions.
The Report is a brief overview of Healthcare Insurance Market in India. It covers Market Size and Forecasts, Competitive Structure, Growth Analysis, Impact Analysis and Recommendations.
- The Tamil Nadu government issued an order to implement a new health insurance scheme to provide healthcare assistance to government employees, public sector organizations, and their families.
- Under the scheme, employees and their families can receive up to Rs. 4 lakh (approximately $5,300 USD) for medical treatments over a four-year period.
- The government selected United India Insurance Company Limited to administer the scheme. Employees will pay Rs. 150 (approximately $2 USD) per month in premiums for coverage.
Australia vs India: Health care insuranceVedica Sethi
Health care insurance: A Comparative overview.
The retrospective review focuses on the timeline of Healthcare systems and development of Healthcare Insurance policies of India and Australia. The review also includes
the consensus and impact of Healthcare legislature in India and Australia and offers a
comparison to the development in the BRICS countries.
Health insurance provides coverage for medical expenses and loss of earnings due to illness or injury. It depends on the conditions, benefits, and treatment options covered by the policy. Premiums are paid in advance for future health coverage. There are different types of health insurance plans such as group, individual, and family floater plans. While perceptions of health insurance in India are mixed, it has become necessary due to rising medical costs, the need to share health risks, and securing one's family's health. Government initiatives aim to increase health insurance penetration and affordability, but challenges remain around healthcare delivery and costs, consumer awareness, and claim ratios.
The document discusses healthcare financing in India. It notes that healthcare spending as a percentage of GDP and per capita is much lower in India than other countries. Most healthcare financing in India is private and out-of-pocket. Community-based health insurance has potential to help cover rural and low-income populations. Reforming healthcare financing will require expanding insurance coverage through appropriate public-private models and increasing overall healthcare spending.
This document discusses the health insurance market in India. It outlines key factors needed for a thriving health insurance industry, such as availability of healthcare providers and medical cost data, and notes that many of these factors are currently lacking or poor in India. The market potential for health insurance in India is estimated to be huge, covering hundreds of millions of people currently without coverage. To develop the industry, the document recommends establishing an independent institution to standardize healthcare facilities and procedures, collect medical data, and evaluate insurance plans. It also suggests initial guidelines from IRDA to improve services from TPAs, insurers and reinsurers as the first step toward developing the proper environment for health insurance in India.
Health Insurance products offering by life insurersJaswanth Singh G
- The document discusses health insurance and various related topics such as whether it is necessary, differences between health insurance offered by life insurers versus general insurers, key proposed regulatory amendments regarding health insurance, and popular riders available under health insurance policies.
- It provides an overview of health insurance policies offered by life insurers versus general insurers, explaining that life insurers typically offer fixed-benefit plans while general insurers offer indemnity plans.
- It also summarizes some key proposed regulatory changes such as requiring uniform premiums for 3 years and incentives for policyholders who maintain good health.
Health insurance protects individuals from high medical costs by covering expenses. In India, health insurance reaches only 13% of the population through various schemes. These include private plans, employer-based coverage, community-based insurance, and government programs. The largest government scheme is the Central Government Health Scheme (CGHS), which provides services to central government employees and retirees in 17 cities. Another major program is Rashtriya Swasthya Bima Yojna (RSBY), which offers health insurance to below poverty line families. However, challenges remain in increasing awareness, improving claims processes, and reducing disputes over pre-existing conditions. Research shows that losing health insurance leads to 40% fewer emergency room visits and 61% fewer hospital
This document provides an overview of health insurance. It discusses what health insurance is, the types of health insurance plans available including individual, group, critical illness, and specific disease plans. It covers factors that determine premium costs such as age, medical history, job, and term of the policy. Tips are provided for choosing the right health insurance plan and saving on premium costs. The steps for filing a health insurance claim are outlined. Recent government incentives for health insurance in India are also mentioned.
This document summarizes various types of health insurance policies including Mediclaim, Group Mediclaim, Cancer Patients Aid Association policy, Critical Illness Insurance, Overseas Medical policy, and Corporate Frequent Travellers policy. It outlines what is covered and excluded in each policy type, such as reimbursement of hospitalization expenses, waiting periods, claim limits, and eligibility.
Health insurance in India- Dr Suraj ChawlaSuraj Chawla
The document discusses health insurance in India. It defines health insurance and outlines some key milestones in its development. It describes various social health insurance schemes run by the central and state governments like CGHS, ESI and RSBY. It also discusses private health insurance schemes like Mediclaim and the roles of IRDA and TPAs. Overall, it provides a comprehensive overview of the health insurance landscape in India.
Community based health insurance in IndiaNeetu Sharma
Community based health insurance (CBHI) schemes in India suffer from poor design and management, low membership, and sustainability issues. They typically target poorer populations, with flat-rate premiums and benefits including preventive care, ambulatory care, and inpatient care. Several CBHI schemes operating across India were described, varying in premium structure, benefits covered, management approach, and financing sources. The largest schemes cover over 100,000 members.
Know about the complete process of buying health insurance in India. Read about the types of health plans, factors, coverage and more. Know here. https://www.coverfox.com/health-insurance/articles/steps-to-buy-health-insurance/
This document provides an overview of health insurance. It defines health insurance as insurance that covers medical and surgical expenses. It explains why health insurance is needed to protect against high, unexpected medical costs and make quality treatment affordable. It then describes different types of health insurance plans including HMOs, PPOs, and high-deductible plans. The document provides steps for obtaining health insurance, filing claims, and surrendering a policy. It also outlines advantages and disadvantages of health insurance as well as tips to avoid health insurance scams.
This document discusses health insurance options in India, including social health insurance schemes like ESIS and CGHS, voluntary private health insurance, and community-based health insurance (CHI). It notes that while social health insurance covers only a small portion of the population, voluntary insurance plans are often unaffordable for the poor. CHI has potential to improve access and reduce costs for vulnerable groups, but faces challenges in India due to poverty, illiteracy, and lack of institutional support. The government has launched various initiatives over the years, including state-run insurance programs and public-private partnerships, to expand coverage.
Types of Health Insurance in India - There are three types of health insurance in India. Health Insurance plays a very important role to every ones life. Get to know more about health insurance
The document discusses the emerging trend of health insurance in India. It summarizes that the Indian health insurance market grew at a CAGR of 37% between 2002-2008 and is expected to grow at a CAGR of 42.3% between 2008-2015. The main drivers of growth are increasing awareness, rising healthcare costs, and supportive demographic trends of a prospering middle class. However, the market also faces restraints like inadequate healthcare infrastructure and lack of standardization.
The document discusses various types of health insurance policies in India. It provides details on individual health insurance, critical illness policies, travel insurance, and personal accident policies. For individual health insurance, it outlines the benefits for individuals, scope and coverage of policies, exclusions, and ancillary benefits like maternity, dental and optical coverage. It also discusses critical illness policies, common illnesses covered, waiting periods, and exclusions. For travel insurance, it summarizes typical healthcare and non-healthcare covers as well as exclusions. Personal accident policies provide compensation for accidental death or disability.
Health insurance in India is growing but still has low coverage rates. Only 18% of urban and 14% of rural populations are covered. There are various public and private health insurance options that offer individual, family, and group coverage. Coverage typically includes inpatient hospitalization but recently some policies have begun covering outpatient care as well. Premiums and policies have grown significantly in recent decades but penetration remains low due to lack of competition. Several government programs also provide health insurance coverage.
This document is a project report submitted by Dr. Vibhuti Amin to fulfill the requirements for a Postgraduate Diploma in Health Insurance Management from Symbiosis School for Open and Distance Learning. The report received approval from the director of the school to commence the project work. The project is a study on awareness of health insurance products and the claim settlement process with reference to United India Insurance Company Limited. The report includes chapters on the need for health insurance in India, factors influencing awareness, the claim settlement process, data analysis and interpretation of survey results, findings, conclusions and suggestions.
The Report is a brief overview of Healthcare Insurance Market in India. It covers Market Size and Forecasts, Competitive Structure, Growth Analysis, Impact Analysis and Recommendations.
- The Tamil Nadu government issued an order to implement a new health insurance scheme to provide healthcare assistance to government employees, public sector organizations, and their families.
- Under the scheme, employees and their families can receive up to Rs. 4 lakh (approximately $5,300 USD) for medical treatments over a four-year period.
- The government selected United India Insurance Company Limited to administer the scheme. Employees will pay Rs. 150 (approximately $2 USD) per month in premiums for coverage.
Australia vs India: Health care insuranceVedica Sethi
Health care insurance: A Comparative overview.
The retrospective review focuses on the timeline of Healthcare systems and development of Healthcare Insurance policies of India and Australia. The review also includes
the consensus and impact of Healthcare legislature in India and Australia and offers a
comparison to the development in the BRICS countries.
Health insurance provides coverage for medical expenses and loss of earnings due to illness or injury. It depends on the conditions, benefits, and treatment options covered by the policy. Premiums are paid in advance for future health coverage. There are different types of health insurance plans such as group, individual, and family floater plans. While perceptions of health insurance in India are mixed, it has become necessary due to rising medical costs, the need to share health risks, and securing one's family's health. Government initiatives aim to increase health insurance penetration and affordability, but challenges remain around healthcare delivery and costs, consumer awareness, and claim ratios.
This document provides an overview of health insurance in Bangladesh. It discusses key concepts like social health insurance and private health insurance. It notes that household out-of-pocket expenses are currently the main source of healthcare financing in Bangladesh. The document also examines the government's policies around developing health insurance, including a 2000 report that outlined steps to create an enabling framework. It analyzes the potential and limitations of different approaches like private insurance, social insurance, and community-based insurance in the Bangladeshi context.
The document provides an overview of health insurance in India. It defines health insurance and describes what a typical health insurance policy covers, including room and boarding expenses, nursing costs, surgeon fees, and medical treatment costs. It notes that over 80% of Indians lack health insurance coverage. The major types of health insurance policies in India include hospitalization plans, pre-existing disease plans, senior citizen plans, maternity plans, daily cash plans, and critical illness plans. The document also outlines several government-run health insurance schemes in India like RSBY, Ayushman Bharat, and state-specific programs. It concludes with a discussion of public and private agencies involved in providing health insurance in India.
The document discusses various types of insurance, including life, general, health, and property insurance. It provides definitions and classifications of insurance, explains concepts like premiums and insurers, and gives examples of specific insurance policies and plans like health, home, and renter's insurance. Key details covered include classifications of insurance, definitions of terms, common policy elements and exclusions, health insurance initiatives and schemes in India, and importance of property and health insurance.
1. The document discusses health insurance in India, including its principles, risks, and current status.
2. It defines health insurance as a method to finance healthcare and minimize uncertainty from illness and treatment costs through risk pooling.
3. Key values of health insurance include solidarity, risk pooling, equity, and participation. There are three main types - social health insurance, private health insurance, and community health insurance.
Chapter 18 Private and Government Healthcare Systems PriMorganLudwig40
Chapter 18
Private and Government Healthcare Systems
Private and Government Healthcare Systems
In the United States, health insurance coverage is generally classified as either private (non-government) coverage or government-sponsored coverage.
Healthcare Coverage vs. Uninsured
The National Center for Health Statistics defines health insurance as public and private payers who cover medical expenditures incurred by a defined population in a variety of settings.
In the United States, the risk of becoming uninsured increases significantly for those earning low wages, the unemployed, and when employers are unable to provide insurance to workers.
Table 5-2 presents the trend of declining health insurance coverage.
Private Health Insurance
The concept of insurance is to combine the healthcare experiences of many enrollees in order to reduce expenses for any one individual to a manageable prepayment amount.
Employment-Based Plans is coverage offered through one’s own employment or a relative’s employment.
It may be offered by an employer or by a union.
Private Health Insurance Continued
Direct-Purchase/Fee-For-Service Plans are the traditional type of healthcare policy.
The physician sets a price for each type of service delivered, and then the client or insurance company pays the fee.
This type of health insurance provides the most choices of doctors and hospitals.
Private Health Insurance Continued
The two kinds of fee-for-service coverage are basic and major medical.
Basic covers some hospital services and supplies, such as X-rays and prescribed medicine.
Major medical insurance covers the cost of long-term, high-cost illnesses or injuries plus whatever basic did not cover.
Private Health Insurance Continued
Group Contract Insurance—to make hospitals and physicians products and services affordable to ordinary people in the United States.
With unmanaged care (fee-for-service) payments, healthcare providers could increase the number of single services they deliver in order to increase profit.
Private Health Insurance Continued
Managed Care—manages the cost and delivery of healthcare services, the quality of that healthcare, and access to care.
Managed care influences how much healthcare clients can use.
Health Maintenance Organizations (HMOs) are prepaid health plans.
The goal of an HMO is to provide affordable, well-organized healthcare by allowing clients to prepay (capitation payment) on a regular monthly basis for all services provided.
Private Health Insurance Continued
Including physicians’ visits, hospital stays emergency care, surgery, laboratory (lab) tests, X-rays, and therapy for all members and their families.
There may be a small co-payment for each office visit, such as $15 for a doctor’s visit or $50 for hospital emergency room treatment.
Private Health Insurance Continued
Point-of-Service Plans (POS) offer enrollees the option of receiving services from participating or nonparticipating prov ...
This document provides an overview of health insurance. It discusses why health insurance is needed given rising healthcare costs. It outlines the types of medical expenses that can be incurred and that most health insurance policies cover expenses related to hospitalization. There are two major types of health insurance plans - indemnity plans which reimburse expenses, and managed care plans which provide incentives to use selected healthcare providers. When determining an appropriate level of health insurance coverage, factors to consider include age, health history, income, financial obligations, profession, and the option of a floater policy that provides coverage for a family rather than individuals.
Kanoe India Healthcare, A division Of Kanoe Softwares proposes a special Medical insurance plan sponsored by Universal Sompo General insurance Co. Limited in joint venture with Allahabad Bank Limited, Indian Overseas Bank, Karnataka Bank Limited, Dabur Investments Corp and Sompo Japan Insurance Incorporation in Public Private Partnership (PPP), aiming to provide assurance of Government/Public sector and superb, hassle free service from private bodies.
The document discusses health insurance in India. It notes that India has a large population but low ranking on healthcare indexes and high out-of-pocket healthcare costs. There is a need to increase government health spending and expand health insurance coverage given its implications for economic development. It then discusses what health insurance is, the history of health insurance in India, common product types, trends in the industry, and low insurance penetration rates in India currently.
A health insurance roadmap takes a look at some simple solutions to the complex issues facing health insurance, medicare, medicaid, long term care insurance, and the high cost of health expenses in retirement.
This will work because so much of this is already in place and a lot of the rest would be quick and easy to implement. As in all areas, knowledge is power. Consumers can take control of your insurance portfolio by becoming educated about insurance. Better education and understanding will lead to positive results for consumers and for the insurance industry.
This is based on Health assurance, what will be the benefit for purchasing health assurnace. just check it out and plz give comment on lokeshpayasi@gmail.com
This document discusses health care financing in India. It defines health care financing as mobilizing funds for health care through mechanisms like taxes, insurance contributions, and out-of-pocket payments. In India, most health spending comes from private out-of-pocket payments rather than public sources. The government spends a low proportion of its budget on health care. Various mechanisms for health financing exist in India, including mandatory insurance programs, voluntary private insurance, employer-based coverage, and community-based schemes, but overall insurance penetration is low.
Presentation from INTEGRATED's Chuck Gooder, senior advisor, and Blake Sternard, the business analyst. The presentation focuses on the ways to identify the major changes of healthcare, with specific attention to the potential challenges posed to enrollees, physicians, hospitals, and healthcare organizations associated with the implementation of Obamacare.
This document provides an overview of the major types of health insurance plans in the United States. It discusses employer-based group plans that cover over half of Americans, as well as self-paid private plans for individuals. It also outlines the government programs of Medicare for seniors and disabled, Medicaid for low-income individuals, and SCHIP for children. Other sources of coverage discussed include other government programs, private charities, and Health Savings Accounts. Around 8% of the population, or 26 million people, lacked health insurance in 2019.
This document discusses healthcare options in Thailand. It provides an overview of the three main government healthcare schemes: Universal Healthcare Scheme (UHS), Civil Servant Medical Benefits Scheme (CSMBS), and Social Security Scheme (SSS). UHS covers nearly 49 million people but has limited facilities and long wait times. CSMBS covers government employees and dependents through public hospitals. SSS covers 14 million private sector employees through contributions from employers and employees. Many Thais also opt for private health insurance for quality care at private hospitals without long wait times. The document outlines types of private insurance like life, non-life, critical illness, and cancer policies that provide supplemental coverage. It advises readers to assess coverage from their government
Employee benefits can be complicated but are important protections. This document provides an overview of health insurance basics and terminology. It explains that health insurance spreads costs among groups and improves access to care. There are different types of plans including group insurance through employers and individual plans. Key terms are defined, such as premiums, deductibles, copays, coinsurance, and out-of-pocket maximums. Understanding these concepts makes health insurance easier to navigate.
The document discusses health insurance and community health insurance (CHI) schemes in India. It outlines the Rashtriya Swasthya Bima Yojana (RSBY) scheme launched by the Indian government in 2007 to provide health insurance to below poverty line (BPL) families. The key objectives of RSBY are to facilitate health insurance projects in all districts to provide BPL workers and their families up to Rs. 30,000 of annual health coverage. It also discusses issues around regulating private health insurance and ensuring financial sustainability and coverage of key diseases.
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The first cases of COVID-19 pandemic were identified in people with pneumonia in Wuhan, China, in late December 2019. It is first and foremost the most publicized pandemic, which has taken the lives of many people. It has thrown everyone into doubt and has created a collective moment of contemplation about the future. The clinical enlistment organization MedWorld of New Zealand offered for resigned and low maintenance specialists to help endeavors by the health care division and Government to battle the spread of COVID-19, in New Zealand. ( ) Starting in April, more than 20,000 tests have been done in Iraq in general (counting the Kurdistan Region), with 1202 of them turning out positive. Of those tests, half of the,m were finished by the Kurdish Ministry of Health, which implies that the other tests were finished by the Iraqi Ministry of Health. ( ) While KRG populace has been tried, just 0.05% of the remainder of the nation has been tried, along these lines featuring the conceivable difference between absolute positive case numbers between locales. Iraq is considered "particularly powerless against the plague due to being desolated" – by war and United Nations sanctions, and by partisan clash in the course of recent decades.
This paper primarily focuses on analyzing the accessible information through research papers, peer- reviewed and non-peer reviewed to understand the pandemic affecting two different countries like New Zealand- a developed country and Iraq- a developing country.
The document summarizes key aspects of CRISPR genome editing technology. It describes how CRISPR uses Cas9 and guide RNA to precisely target and edit DNA sequences. It provides a brief history of CRISPR discovery and outlines its components and mechanism of action. The document also discusses several medical applications of CRISPR including treating Duchenne muscular dystrophy, beta-thalassemia, and testing for viruses. It concludes that CRISPR is a flexible and accurate gene editing tool being explored for various applications in agriculture, biotechnology, and medicine.
Coronavirus: medical management in a developed country that is china versus a...Vedica Sethi
The systemic review has focused on to compare the available treatment options applied by China and India to manage the current pandemic situation, in their respective countries.
Abstract: Uremia is a clinical manifestation of chronic kidney failure (CKD) and is defined as the elevation of urea levels in plasma associated to fluid, electrolytes and hormonal imbalances and metabolic abnormalities. Uremia even though arises from CKD, it can also occur with Acute Kidney injury (AKI). The terms uremia was first coined by Piorry which translates to urine in blood. Also, Uremia and uremic syndrome have been used interchangeably for a long time. Comparatively, Azotemia is also uremia but the only difference is that the urea elevation in azotemia is not high enough to have manifesting signs or symptoms. Thus, Uremia is pathological and symptomatic manifestations of severe azotemia.
Urea itself has direct and indirect toxic effects on our body; parathyroid hormone (PTH), beta2 microglobulin, polyamines, advanced glycosylation end products, and other middle molecules, are thought to contribute to the clinical syndrome. Patient’s symptoms range from mild bleeds to severe congestive heart failure. If left untreated complications include seizure, coma, cardiac arrest, and death. He most severe is cardiac arrest secondary to electrolyte abnormalities such as hyperkalemia, metabolic acidosis, or hypocalcemia. The patients, who are diabetic, tend to develop severe hypoglycemic reactions if the medications are not adjusted for creatinine clearance. Renal failure and renal osteodystrophy may cause early onset osteoporosis or formation of adynamic bone which predisposes the patient to fractures on mild trauma. Also medications the patient was previously on can lead to unwanted side effects due to impaired clearance e.g. Digoxin toxicity secondary to renal failure, increased sensitivity to narcotics.
Key Words: Uremia, Uremic syndrome, Chronic kidney failure, azotemia, beta 2 microglobulins, congestive heart failure, electrolyte abnormalities, hyperkalemia, hyocalcemia, metabolic acidosis, creatinine, osteodystrophy
Postexposure prophylaxis after needle sticks injuryVedica Sethi
Needle stick injury is defined as penetration of skin by a needle or other sharp object that has been in contact with blood products, tissue or any other body fluids before exposure. Even though the effect is negligible, it predisposes the patient to occupational exposure of human immunodeficiency virus (HIV), hepatitis B virus (HVB), and hepatitis C Virus (HVC). ( ) The most common population to be affected is health care workers and lab personnel. The occupational exposure of such viruses is not only transmission via needle stick injury but also via contamination of mucous membranes e.g. eyes, blood or body fluids, even though needle stick injuries make up the majority of all percutaneous exposure cases. Other occupations with increased risk of needle stick injury are tattoo artists, agriculture workers, law enforcement workers, and laborers. ( )
Recognizing the occupational hazard posed by needle stick injury and the long term effect it could have on a health care worker is the most important need, with developing interventions to minimize it.
Abstract: Bening Rolandic Epilepsy 3 1.Abstract Benign rolandic epilepsy or Bening epilepsy of childhood with centro-temporal spikes (BECT) is the most widely recognized epilepsy disorder in the pediatric age group, with a beginning between age 3 and 13 years. The average introduction is a fractional seizure with parasthesias and tonic or clonic action of the lower face related with drooling and dysarthria. Seizures regularly happen around evening time and may turn out to be generalized. They are typically rare and may not require antiepileptic medicates in any case, whenever treated, they will in general be effectively controlled. Youngsters with BECT are neurologically and psychologically normal. The EEG shows trademark high-voltage sharp waves in the centro-temporal districts, which are enacted with sleepiness and rest. Right now, BECT is effectively perceived. Be that as it may, atypical cases are normal and the meaning of BECT can get obscured. Albeit further examinations are not required in cases with common clinical and EEG discoveries and typical neurologic assessments, neuro-imaging studies might be required in atypical cases to preclude other pathology. The long-term. medical and psychosocial forecast of BECT is magnificent, with basically all children entering long- term remission by mid-adolescene.
Abstract Lung Abscess is a liquefactive necrosis of the lung tissue and arrangement of cavitation (in excess of 2 cm) containing necrotic debris and liquid brought about by parenchymal infection. It very well may be brought about by yearning, which may happen during changed cognizance and it for the most part causes a discharge filled depression. In addition, liquor addiction is the most widely recognized condition inclining to lung abscesses. Lung abscess is viewed as essential (60%) when it comes about because of existing lung parenchymal process and is named auxiliary when it entangles another procedure, e.g., vascular emboli or follows rupture of extrapulmonary abscess into lung. There are a few imaging strategies which can distinguish the material inside the thorax, for example, electronic tomography (CT) output of the thorax and ultrasound of the thorax. Broad Spectrum anti-biotics to cover blended vegetation is the pillar of treatment. Pneumonic physiotherapy and postural drainage are additionally significant. Surgeries are required in specific patients for pneumonic resection Keywords: Lung abscess, anti-bodies, video-assissted thoracoscopic medical procedure (VATS), thoracoscopy
Abstract Transplant- associated Thrombotic Microangiopathy (TA- TMA) is a hematopoietic disorder that leads to inflammatory and thrombotic changes of microvasculature with associated hemolytic anemia, thrombocytopenia and organ failure i.e. acute renal failure. This syndrome is visualized more commonly in allogeneic hematopoietic stem cell transplants (HSCTs) compared to autologous transplant. TA- TMA offers a diagnostic challenge as it can’t be categorized in the two most recognized TMA’s i.e. Atypical Hemolytic Uremic Syndrome (aHUS) or Thrombotic Thrombocytopenic Purpura (TTP). Despite the fact, that the patient receiving the transplant might face complications associated with the transplant i.e. infection, graft-versus-host disease (GVHD) , and disseminated intravascular coagulation (DIC), as well as the side effects of immunosuppressive drugs, all of which can be misdiagnosed as TMA. Since, the pathophysiology of this syndrome is not understood; management of the syndrome is suboptimal with a high mortality rate. A recent study of TA-TMA patients has identified the patients diagnosed with TA-TMA lack suppression of ADAMTS13 which is a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 1 and do not have a complete response to plasma exchange, thus indicating characteristics a TTP-like disorder is not involved. Recent advances in the treatment of aHUS may offer a therapeutic option in the aHUS-like TMAs associated with HSCTs, which still faces the difficulties associated with the diagnosis and treatment of TA-TMA. Keywords: Transplant- associated Thrombotic Microangiopathy (TA- TMA), hematopoetic, hemolytic anemia, thrombocytopenia, acutre renal failure, Atypical Hemolytic Uremic Syndrome (aHUS), Thrombotic Thrombocytopenic Purpura (TTP), graft-versus-host disease (GVHD) , disseminated intravascular coagulation (DIC)
Cardiology: Treatment of Heart FailureVedica Sethi
Abstract Heart Failure (HF) is the most widely recognized cardiovascular disorder behind medical clinic affirmation for individuals more established than 60 years old. Hardly any regions in medication have advanced as surprisingly as HF treatment in the course of recent decades. Be that as it may, progress has been reliable just for ceaseless HF with diminished discharge part. In intensely decompensated HF and HF with safeguarded discharge part, none of the medications tried to date have been conclusively demonstrated to improve endurance. Deferring or forestalling HF has gotten progressively significant in patients who are inclined to HF. The anticipation of declining interminable HF and hospitalisations for intense decompensation is likewise critical. The target of this paper is to give a compact and down to earth rundown of the accessible medication medicines for HF. The most ideal proof based medication treatment (counting inhibitors of the renin–angiotensin– aldosterone framework and β blockers) is helpful just when ideally actualized. Notwithstanding, usage may be testing. To accept that ailment the executives projects can be useful in giving a multidisciplinary, comprehensive way to deal with the conveyance of ideal clinical consideration. Keywords; heart failure, multidisciplinary approach, Beat-blocker, RAAS framework
Surgical vs Conservative Management of Colonic DiverticulitisVedica Sethi
The document summarizes the treatment options for colonic diverticulitis, including conservative, medical, and surgical approaches. Conservative treatment involves antibiotics, bed rest, and fluid diets for uncomplicated cases. Medical management uses antibiotics both as outpatient treatment for mild cases or inpatient IV antibiotics for severe cases. Surgical options include resection of the affected colon either with or without anastomosis, with laparoscopic procedures becoming more common due to lower complication rates. While guidelines favor initially conservative approaches, optimal treatment remains complex and individualized based on each patient's presentation and risk factors.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Chapters Download Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Download Stuvia Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Study Guide Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Ebook Download Stuvia Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Questions and Answers Quizlet Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Studocu Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Quizlet Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Chapters Download Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Download Course Hero Community and Public Health Nursing: Evidence for Practice 3rd Edition Answers Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Ebook Download Course hero Community and Public Health Nursing: Evidence for Practice 3rd Edition Questions and Answers Community and Public Health Nursing: Evidence for Practice 3rd Edition Studocu Community and Public Health Nursing: Evidence for Practice 3rd Edition Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Pdf Chapters Download Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Pdf Download Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Study Guide Questions and Answers Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Ebook Download Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Questions Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Studocu Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Stuvia
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
2. 1
Overview
1.Introduction………………………………………………………………………………………..4-5
1.1 Difference between life insurance and health insurance
1.2 Importance of health insurance
2.Types ofhealth insurance………………………………………………………………………….5-8
2.1 Individual health insurance
2.2 Family health insurance floater
2.3 Senior citizen health insurance
2.4 Critical illness health insurance
2.5 Maternity health insurance
2.6 Group health insurance
2.7 Preventive healthcare
2.8 Personal accident insurance
3.Government health insurance scheme…………………………………………………………….8-10
3.1 Rashtriya swasthiya bima yojana
3.2 Central government health scheme
3.2 Universal health insurance scheme
3.3 Employment state insurance scheme
3.4 Ayushman bharat yojana
4. Private health insurance scheme………………………………………………………………….10-12
4.1 Bajaj allianz tax gain plan.
4.2 Apollo munich maxima plan.
4.3 Max bupa hearbeat platinum plan.
4.4 Cigna ttk pro health plan.
5.Understanding and awareness ofpublic regarding insurance…………………………………12-14
5.1.Factors that frustrate the growth of private sector health insurance.
5.2.Pricing hurdles in out-patient insurance.
3. 2
6.Innovative ideas on government health sector and private health sector……………………14-16
7.Conclusion…………………………………………………………………………………………16
References………………………………………………………………………..17
4. 3
Abstract
Background:
Healthcare is significant for each individual on the planet, on account of this each nation should
focus on wellbeing, because of increment pace of sickness and ailments.
In India medical coverage part is an undiscovered market, still it has crying needs. There is
colossal potential for this part. The medical coverage suppliers are not satisfying this interest.
After 1999 the privatization of protection area, the protection segment has developed in past
decade. By and by there are 25 medical coverage suppliers, in that four are with open area and
twenty one private medical coverage suppliers. The piece of the overall industry of open segment
is 60 rates while the rest with other private players.
This paper inspects the present status of medical coverage in India, advancement in health care
coverage area and difficulties looked by it. It additionally investigates the job of both open and
private medical coverage players to arrive at most extreme inclusion in health care coverage.
Aim:
To aim of this study is to provide information and assess the current status of government and
private sector insurance with regard to coverage of India citizen.
Materials and Methods:
The study is a retrospective review of current healthcare insurance policies and a comparison
between the private and public insurances and their status of projection The primary focal point
of the present survey would be on the legislature and private medical coverage part with a focus
on the indian resident and different hindrances looked by the administration and private medical
coverage division.
Conclusion:
Private health insurance is firmly being upheld and accepted is of developing thought by our
nation than government health insurance. The Medical coverage assumes an exceptionally
significant job in limiting the monetary weight of poor because of sickness and illnesses. With
our nation expecting two fold digit development throughout the following five years its
healthcare that will assume a significant job in giving a not so youthful and enthusiastic
workforce to the nation. The government policy plan has just underscored the requirement for
and has progressively sorted out medical coverage inclusion all together give minimum monetary
related insurance to an enormous Indian populace. Notwithstanding, it isn't the main choice.
5. 4
INTRODUCTION:
Health insurance is a kind of protection inclusion that pays for restorative, careful, brought
about by the guaranteed. Health insurance can repay the safeguarded for costs caused from
ailment or damage, or pay the consideration supplier legitimately. It is frequently remembered
for business advantage bundles as a methods for tempting quality workers, with premiums
halfway secured by the business yet regularly likewise deducted from representative checks. [1]
The expense of medical coverage premiums is deductible to the payer, and the advantages got
are tax-exempt.
1.1 Difference between Life insurance vs Health insurance
Extra security and Health protection are not quite the same as one another. In Life, you get
benefits simply after death of the protected (or at development as on account of Endowment
strategy). [2]
Nonetheless, in Health protection, insurance agencies give you money related assistance when
you are hospitalized or when you guarantee for spending on medications and other related
spending.
1.2 Importance of health insurance
For each person in india, medical coverage has become a need. It gives hazard inclusion against
use which is brought about by unexpected health related crises. Today, when the therapeutic
expansion rates are so high, neglecting to hold a sufficient wellbeing spread can demonstrate
expensive monetarily.
India is without a doubt one of the quickest developing economy on the planet, however on the
opposite side it is additionally a home to numerous sicknesses. On account of advancement in
restorative science, in India numerous infirmities are treatable however what squeezes your
pocket is the expense to treat those illnesses. Many get this need cooked by their manager's
wellbeing spread; anyway that isn't the changeless arrangement. The business' medical
advantages or protection spread endures just till the time you are working in the organization
once you quit you lose all the collected advantages and inclusion as well. Likely, at that point
your age could be over 30 years so odds of premium climb wins, in addition to your previous
sicknesses stay revealed at the hour of purchasing the protection. Henceforth, it's significant in
India that individuals purchase a medical coverage intend to verify their medicinal needs.
1 “Health Insurance,” December 24, 2019.
2 “Life Insurance vs Medical Insurance: What’s The Difference?”
6. 5
1.3 History of health insurance in india
Propelled in 1986, the health insurance industry has become fundamentally for the most part
because of advancement of economy and general mindfulness. As indicated by the World Bank,
by 2010, over 25% of India's populace approached some type of health insurance. There are
independent wellbeing safety net providers alongside government supported health insurance
suppliers. As of not long ago, to improve the mindfulness and diminish the hesitation for
purchasing medical coverage, the General Insurance Corporation of India and the Insurance
Regulatory and Development Authority (IRDA) had propelled a mindfulness battle for all
sections of the populace.[3]
Propelled in 2007, the National Health Insurance Program (Rashtriya Swasthya Bima Yojana-
RSBY) is driven by the Ministry of Health and was received by 29 states in 2014. It is subsidized
75% by the administration and 25% by the states. The laborer and 4 of his wards profit by
medical coverage on the off chance that they are not secured by any framework and live beneath
the neediness line. RSBY recipients are required to pay a yearly enlistment charge of INR 30 for
emergency clinic inclusion up to INR 30,000 every year for each family.
September 25th, 2018, the Indian government declared the dispatch of another medical coverage
for the least fortunate residents. Indian Prime Minister, Narendra Modi reported that the new
framework is required to arrive at in excess of 500 million individuals and is classified
"Modicare". The change is still in progress and means to introduce all inclusive government
disability in the nation.
2.TYPES OF HEALTH INSURANCE IN INDIA
2.1 Individual Health Insurance
As the name recommends, Individual wellbeing plans are made for singular policyholders. The
premiums may be low under such plans, yet there are an assortment of variables that add to the
cost of a strategy. Past ailments, age, area, and so on are a couple of the parameters that impact
the premium.
3 “Private Health Insurance Act 2007.”
7. 6
2.2 Family Health Insurance Floater
Rather than purchasing separate arrangements for each part, a family floater plan covers the
whole family under one arrangement. Ordinarily, guardians and kids (up to 2 youngsters) can be
secured under this arrangement. A few back up plans even give inclusion to up to 15 relatives.
Under such plans, the whole protected is shared by all the included relatives. Despite the fact that
family floater plans have a higher premium than singular plans, the value is as yet less expensive
when contrasted with the costs engaged with purchasing an alternate arrangement for every
part.[4]
2.3 Senior Citizen Health Insurance
Intended to take into account the requirements of the senior residents, such plans are just
for the ones who are 60 years of age or more. Senior resident plans for the most part
accompany limits. In spite of the fact that solitary a couple of safety net providers give
such strategies, they may request a therapeutic registration before selling the
arrangement. Additionally, these arrangements may cost significantly higher than the
wellbeing covers for more youthful buyers as senior residents are progressively inclined
to sicknesses and diseases.
2.4 Critical Illness Health Insurance
Basic disease plans spread perilous ailments. Malignant growth, coronary episode,
organ transplant, kidney disappointment, and so forth., are a couple of the ailments
secured under such arrangements. A basic sickness spread is particularly helpful if the
guaranteed has a past filled with certain basic diseases in the family.
4 Ilangovan, “HEALTH INSURANCE IN INDIA.”
8. 7
2.5 Maternity Health Insurance
Maternity plans are intended to cover ladies who are anticipating a youngster. It covers
the costs acquired in the pre-natal stage, conveyance, and post-natal stage. Both the
mother and the infant are secured under such plans. Maternity plans can likewise be
purchased as a rider to a current essential strategy.
2.6 Group Health Insurance
Such plans are normally offered by bosses and are intended to incorporate and avoid
individuals as they join and leave the organization. Gathering wellbeing arrangements are
commonly low in premiums because of the decreased dangers included. Such plans
additionally permit mercy as far as covering previous ailments in addition to other things.
2.7 Preventive Healthcare
A preventive medicinal services strategy covers the costs acquired during
medications/measures taken to counteract a specific ailment, sickness, or malignant
growth. Yearly registration and screening tests are not many of the administrations that
are secured under preventive human services.
2.8 Personal Accident Insurance
9. 8
Individual mishap designs explicitly spread the costs identified with unanticipated
mishaps. Such arrangements give pay in instances of disablement, demise, damage, or
debilitation brought about by street, rail, water, or air mishaps.[5]
3.GOVERNMENT HEALTH INSURANCE SCHEMES
3.1 Rashtriya Swasthiya Bima Yojana:
The Ministry of Labor and Employment of the Indian Government propelled the Rashtriya
Swasthiya Bima Yojana with an end goal to give medical coverage to the individuals who are
Below Poverty Line. People safeguarded under the plan get spread against restorative costs
(predominantly hospitalization) to the degree of Rs.30,000. The enrollment expenses for the
Rashtriya Swasthiya Bima Yojana are Rs.30 which the recipients should pay, and the Central and
State governments make the top notch installment to the medical coverage supplier. By and
large, the state governments pick the plans by means of a procedure of offering. Under the plan,
up to 5 individuals from the family can be secured, including the leader of the family and his/her
life partner alongside a limit of 3 wards. Probably the greatest advantage of the Rashtriya
Swasthiya Bima Yojana is the cashless hospitalization office, if treatment is profited at one of the
system medical clinics recorded under the plan.
Helping the BPL family units and laborers having a place with the uncategorized parts to benefit
security against restorative costs in case of a wellbeing hazard.
To give the qualified people simple entry to better human services offices with moderate
hospitalization costs.
5 “Types Of Health Insurance Plans In India.”
10. 9
3.2 Central Government Health Scheme:
The Central Government Health Scheme offered by the Government of India gives therapeutic
protection to Central Government representatives alongside their wards. Retired people are
additionally qualified for this plan. To profit this protection, people must dwell in urban
communities that are secured under the Central Government Health Scheme. Focal government
wellbeing plan dispensaries, or health focuses as they are additionally called, are available in
various urban communities the nation over with the goal that recipients can get to Unani,
Homeopathic, Ayurveda, Allopathic, Sidha, and Yoga framework meds.
3.3 Universal Health Insurance Scheme:
The point of the Universal Health Insurance Scheme is to offer human services access to
poor families in India. 4 open division general insurance agencies worked together to make this
plan accessible to Indian residents. Under the Universal Health Insurance Scheme, the protected
individual and his/her family is qualified for a repayment of Rs.30,000 for therapeutic costs
caused in the event of hospitalization. If there should arise an occurrence of the unplanned
downfall of the provider of the family, this plan offers Rs.25,000 to the group of the person as
pay. Moreover, the group of the person, in such cases, will likewise get Rs.50 consistently for 15
days after the destruction of the provider. The plan is perfect for families that are Below Poverty
Line. The charges for this plan are Rs.200 for an individual, Rs.300 for families with up to 5
individuals, and Rs.400 for families with 7 individuals.[6]
3.4 Employment State Insurance Scheme:
The Employment State Insurance Scheme was intended to offer multi-dimensional
human services security to representatives and their families. The plan gives total human services
to the safeguarded individual just as his/her wards. The plan likewise gives money related focal
points to the guaranteed and his/her family. A recipient is qualified for money benefits if there is
transitory or lasting disablement of the protected and he/she loses his/her acquiring capacity.
Generally, an association or a plant with at least 10 representatives can pick the Employment
State Insurance Scheme for its workers. Representatives who acquire under Rs.21,000 every
month should pay 1.75% of their wages towards the plan, while the business will contribute
4.75%.
3.5 Ayushman Bharat Yojana or Pradhan Mantri Jan Arogya
Yojana:
This National Health Protection Scheme covers in excess of 10 crore poor families
crosswise over India, offering an inclusion of up to Rs.5 lakh per family per annum. The plan's
6 “National Health Insurance Schemes | National Health Portal Of India.”
11. 10
advantages reaches out to all pieces of India and those secured under the Ayushman Bharat
Yojana can profit cashless advantages at any of the empanelled emergency clinics crosswise over
India. This plan offers spread to practically 40% of the Indian masses and covers all optional just
as a few tertiary hospitalisations.7
4.PRIVATE HEALTH INSURANCE SCHEMES
PHI in India started with the foundation of General Insurance Corporation (GIC).]Private
wellbeing safety net providers perceive India as a potential market because of its expanding
obtaining power, developing interest for human services, a growing aggressive private medicinal
services market, and rising paces of ceaseless sickness. Looking at this rewarding business
opportunity, number of outside protection firms have put resources into India during the most
recent couple of years. Be that as it may, in a nation like India, giving protection is an unsafe
business adventure because of a low degree of protection mindfulness just as poor social
insurance framework in provincial territories. Predominantly the white collar class populace is
focused by private wellbeing safety net providers because of this benefit situated methodology.
The expense of protection approaches for working class families go from Rs 4000 for every part
and covering just in-persistent treatment for a limit of Rs 400000. There is more prominent
wellbeing divergence and rising wellbeing costs for the poor because of this restricted inclusion
(in-persistent) and focusing on especially this pay gathering, which serves to undermine national
wellbeing value objectives. There is plentiful hypothetical premise and experimental proof from
different pieces of the globe that private protection drives up medicinal services use.
Additionally, in Indian setting, where PHI basically contracts with urban-based corporate clinics,
it is probably going to expand cost. Pundits call for guideline of advantage bundles, limitations
on hazard choice systems, and more noteworthy insurance of clients.[8]
4.1 Bajaj Allianz Tax Gain Plan
This is a family floater medical coverage arrangement offered by Bajaj Allianz that spreads
hospitalization costs just as OPD costs.
Approach holder can profit incredible tax reductions under Section 80D of the Income Tax.
Safeguarded cashless office is given under the Tax Gain plan through 5000+network clinics in
India.
Simple and speedy case settlement of OPD costs.
The costs took care of under this incorporate expense of false teeth, scenes, props,
7 “India’s Government Launches a Vast Health-Insurance Scheme - Modicare.”
8 “Top 5 Health Insurance Plans in India You May Consider - Moneycontrol.Com.”
12. 11
dental treatment and methods, and so forth.
Emergency vehicle charges upto Rs 1000 are secured under this arrangement.
4.2 Apollo Munich Maxima Plan
Apollo Munich offers the Maxima Health Insurance plan that spreads Out Patient Department
costs too. It offers cashless office for OPD costs from approved analytic focuses, drug stores,
dental consideration focuses and optical consideration focuses. [9]
An individual is qualified for section at an early age of 91 days and the most extreme age is 65
years for picking up entry.Factors which are considered for deciding premium are-age of the
safeguarded and if the approach is taken for a family and the age of the oldest guaranteed
member.Cost of dental treatment and methods, cost of eyewear, contact focal points, portable
hearing assistants, and so forth., are likewise secured under this arrangement. Every one of these
advantages can be profited under Maxima Health Insurance Plan. Under this arrangement
different out-patients benefits are likewise included like specialist's meeting, drug store costs,
master administrations (for certain dental medicines, exhibitions and contact focal points just),
cost brought about for analytic tests, wellbeing registration benefits for the protected who is over
18 years old.Maternity benefits-These incorporate spread for costs acquired when childbirth.50%
of the OPD spread will be conveyed forward to the following strategy time frame in the event
that out-quiet treatment isn't profited during an approach year.
4.3 Max Bupa Heartbeat Platinum Plan
Max Bupa Heartbeat Platinum Plan, is a far reaching singular/family floater plan that offers a
base aggregate safeguarded worth Rs. 15, 00,000. For OPD claims made under this strategy, the
most extreme point of confinement is Rs. 30,000
Maternity benefits incorporate spread for costs caused when labor, spread for the infant,
immunizations during the primary year, kid care spread, etc. This arrangement doesn't put a
limitation on the time of passage, i.e., there is no base/most extreme age for entry. If the
OutPatient treatment spread isn't used during an approach year, 80% of a similar will be
conveyed forward to the following strategy period.[10]The age of the oldest guaranteed part in
the family is considered to decide the premium.This arrangement additionally offers
extraordinary tax breaks to the approach holder, as gave under Section 80D of the Income Tax.
9 “Private Health Insurance Companies | National Health Portal Of India.”
10 “Top 5 Health Insurance Plans in India You May Consider - Moneycontrol.Com.”
13. 12
4.4 Cigna TTK ProHealth Accumulate Plan
The Cigna TTK ProHealth Accumulate Plan offers OPD spread for outpatient treatment, optical
consideration and dental treatment, interview charges, drug store bills, etc. This approach
likewise gives an "Individual Health Wallet" in which policyholders can keep their assets they
have aggregated that can be utilized to pay OPD costs. [11]
The approach gives a base front of worth Rs. 5, 50,000-Rs. 25, 00,000.The Cigna TTK
ProHealth Accumulate Plan-Personal wellbeing wallet advantage alternative accessible for sums
worth Rs. 20,000, Rs. 15,000, Rs. 10,000 and Rs. 5,000.There is no expiry of the non-used cash
collected in the wallet. This sum is conveyed forward during arrangement renewal. An extra
advantage of 5% climb on the sum accessible in the wallet can likewise be profited by the
strategy holder. You can likewise benefit reward focuses by taking part in health programs that
can be balanced against your premium.
5.Understanding and awareness of public regarding insurance
Late reports recommend that open mindfulness and comprehension of medical coverage in
India is poor. In any case, overall population attention to medical coverage in Kerala and in some
different parts in India is expanding because of the endeavors of private health care coverage
specialists. Absence of fundamental instruction and "culture" are seen as "obstructions" because
of which individuals experience issues in overseeing cash and wellbeing and trouble in learning
this new innovation. Poor and less taught individuals living in both the provincial and urban
territories, counsel private specialists more than government professionals and spend about twice
as much on treatment from them than from government experts. This thing has prompted the
extending of neediness in both country and urban zones, pushing the a great many individuals
into destitution every year. As indicated by ongoing studies and field works completed in India,
comprehension of the entitled advantages and benefits stays confounding not exclusively to poor
people and ignorant individuals yet in addition to the informed white collar class residents. This
could be because of special dialects of the protection dealers that is hard to comprehend for the
overall population having a place with various instructive foundations.[12]
11 “Health Insurance.”
12 “Public Awareness and Knowledge of the National Health Insurance in South Africa.”
14. 13
5.1. Factors that frustrate the growth of private sector health
insurance
1. There are sure factors that have reduced the development of private medical coverage before
and are probably going to have an impact in the close future.
2. Absence of mindfulness in elevating medical coverage to the overall population on the loose
3. Non-accessibility of dependable information and epidemiological data on the illness example
and treatment cost that is required for structuring medical coverage item particulars
4. Danger of unfriendly determination of individuals with prior diseases and undesirable people
settle on the inclusion
5. Spirit and confidence danger have had negative ramifications on the protection business
6. Absence of actuarial information for the advancement of new item
7. Absence of in fact talented labor that has sound information in the innovative work exercises
related with restorative parts of the medical coverage and well-prepared staff to meet the desires
for the customers
8. Trouble and coordination with social insurance suppliers in regards to preparing and
settlement of cases
9. Absence of nonpartisan bodies to do "Accreditation and Categorization" of medicinal services
suppliers.[13]
5.2.Pricing hurdles in out-patient
insurance
As indicated by late reports, a few safety net
providers have purchased out-persistent (OP) spread
under cashless plan for those emergency clinics that
are connected with that specific insurance agency.
Notwithstanding, many accept that it would take
some time before OPD spread gets basic as an item
classification in private wellbeing insurance.Some
organizations broaden OP spread under cashless plan
by installment of some extra premiums. Guarantee
the board would not be a simple undertaking if OP
13 “Healthcare in India.”
15. 14
turns into an undeniable contribution under medical coverage. [14]This is on the grounds that
there are visit visits to a doctor (in the event of way of life infection) in the event of OP spread
while hospitalization is certainly not an incessant occasion and prompts one-time guarantee
settlement. Some different issues like nonappearance of a national brand in the OP space be it
dental, eye or even indicative, controlling cheats in issues relating in charging and consistency in
administration for claims evaluation and installment are jumps in regularizing the OP cover.
The pros and cons of public health insurance.
Public health insurance is surely more affordable than its private counterpart, as it often requires
no co-pays or deductibles, and has lower administrative costs than private health insurance.[15]
However, public health insurance is at the same time less flexible, as policyholders are often
given a limited selection of medical service providers. This is because a lot of medical
establishments still refuse to accept government-sponsored health insurance plans. Furthermore,
even if a therapy is deemed necessary, it may not be reimbursed by public health insurance.
The pros and cons of private health insurance
Private health insurance policies are more flexible than group policies, and give the
policyholders more options as to which doctor or medical facility to visit. There are also more
plan choices on the market, so policyholders have more plans and a wider network of providers
to choose from.
Having said that, private health insurance plans have a heftier price tag than public health
insurance. Furthermore, unlike public health insurance, private health insurance requires you to
pay a monthly/yearly premium, which is not something everyone can afford.
14 Oyekale, “Factors Influencing Households’Willingness to Pay for National Health Insurance Scheme (NHIS) in
Osun State, Nigeria.”
15 Ilangovan, “HEALTH INSURANCE IN INDIA.”
16. 15
6. Discussion: Innovative ideas on government health sector and
private health sector.
Modernization of center inheritance frameworks, new protection trades and changing plans of
action (stage and shared) characterized the year. They will keep on doing as such as bearers
receive advanced systems… Juggling the assault of new development and seeing how it tends to
be utilized to make a focused edge rapidly can be unsettling. Be that as it may, these problematic
powers ought to be viewed as the impetus essential for the sort of emotional change required to
spike development and new protection items.
The main problems to address:
1. Internal processes of insurance companies are often too complicated.
2. Insurants are not satisfied with their service providers. [16]
Reclassifying Traditional Ways of Claims and Policy Management in the Age of Digital Insurance
1. Other than AI-driven robotization, claims the board gets affected by a more extensive range of
programming arrangements.
2. Here is a case of the advanced business standard. Expect an insurance agency working in the
human services fragment.
3. Guarantee the board programming robotizes data trade among protection and social insurance
supplier frameworks.
4. In the event that the organization manages various little private practices – which still work
with paper reports – the import is streamlined by picture acknowledgment calculations that
digitize the archives.
5. The framework computes inclusion and installment for each guarantee as indicated by set
strategies.
6. The framework forms assert and send them to an extortion identification module.
7. When the cases are affirmed, insurants get their installments. [17]
8. The approach the executives programming must be the incorporated piece of the framework so
as to give business clients instruments to oversee compromises, tweak business rationale, oversee
arrangement rights, and so forth.
16 Aggarwal, Kapoor, and Gupta, “Health Insurance: Innovation and Challenges Ahead.”
17 Townsend, “Eleven Ideas For Healthcare Innovation.”
17. 16
[18
]
7.Conclusion
India, a nation with generally created economy and a significant white collar class populace,
offers most appropriate condition for the advancement of government and private medical
coverage. At present, just a minor job is played by private medical coverage in human services
framework yet it is step by step picking up significance. Private medical coverage is absolutely
not by any means the only other option or a definitive arrangement that can manage disturbing
social insurance challenges in India. In any case, it is a choice that is firmly being supported and
getting developing thought by our nation's strategy creators. In this manner, the inquiry isn't if
this apparatus will be utilized later on however whether it will be applied to the best of its
capability to address the developing and approaching needs of the medicinal services
arrangement of the nation. The fundamental test is to see that poor and the feeble are profited as
far as better inclusion (both inpatient and out-patient) and wellbeing administrations at lower
costs without negative parts of cost increment and abuse of techniques and innovation in
arrangement of social insurance.
A critical challenge in years to come is how to address competitive dynamics between private
and public realms, so that public sector facilities are not stripped of resources that are given to
the private sector as subsidies, and so that the ability of public clinics and hospitals to retain
skilled healthcare workers is not compromised, especially as both types of systems attempt to
coexist in the healthcare delivery environment of low- and middle-income countries. These
findings are consistent with earlier findings of an “infrastructure inequality trap” in some
18 “Insurance Technology: 11 Innovation Ideas to Transform Insurance Company | AltexSoft.”
18. 17
countries, in which government funding is increasingly attracted towards private hospitals and
away from the public sector hospitals. This occurs when private patients can afford to pay for
greater infrastructure at private hospitals. Those hospitals then report greater “absorptive
capacity” for future funds, and higher numbers of healthcare personnel, thereby attracting more
funding from government institutions, shifting budgets away from public sector facilities that
struggle to maintain human and physical infrastructure.
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