Early detection can help you save on health cost

By: Vidyalaxmi, ET Bureau

Prevention is better than cure, as they say. The growing health insurance segment bears this truism out, which is witnessing almost 100% claims ratio. Insurers say that some 16 out of every 100 policyholders register claims under the health policy every year. In other words, the cost of treating 16 policyholders is equal to the premium collected from 100.

Insurers have now discovered that they can make substantial money out of health insurance if they can prevent one out of 100 policyholders from falling ill. To this effect, they are now offering freebies like free health check-ups and discounts on gym memberships to policyholders.

The same financial logic applies to individuals as well. For instance, getting a cavity filled in early will help save several times the amount on a root canal treatment. Most ailments requiring surgery do not occur overnight, but build-up over a period of time and in many cases, can be detected early through regular checks.

Doctors say, you almost save up to 50% on health costs with regular check-ups, exercise and balanced diet. The idea is to avoid severe health complications which could also take a toll on your biological as well as financial health.

http://economictimes.indiatimes.com/quickiearticleshow/5688272.cms

Get critical illness cover for peace of mind

Illnesses that used to be fatal are now survivable, so it makes sense to protect yourself from the fallout.

By Emma Wall
Published: 12:14PM GMT 23 Feb 2010

Phil Smith received £1.2m payout from his critical illness insurance after being diagnosed with skin cancer. He now has the all-clear and his family has financial security. Photo: Christopher Jones

Nearly two-thirds of the population have no form of financial protection if they die or become critically ill, despite advances in medicine and technology that mean more people are living longer and surviving illnesses that used to be fatal. In research conducted by insurer Aviva, most people aged 45 to 54, the age group most likely to claim, say they cannot afford protection.

But a debilitating illness can take years to recover from – and while your company may readily allow you sick leave, it can be restricted to a pay percentage or term length. Without a source of income, family savings can quickly dwindle on the essentials – let alone expensive medical care, or unexpected costs.

Although most homebuyers take out life cover to ensure loved ones are provided for in the event of their death, few people realise the financial implications of surviving – but in serious ill health.

"The diagnosis of a life-threatening illness can mean you will have to give up work temporarily or permanently and you may decide to pay for complementary treatments that are not available through the NHS to aid your recovery," warned Stephen Crosbie, of Aegon. "You're also still likely to incur costs such as mortgage repayments, loan repayments, utility bills and other living expenses."

Critical illness cover typically provides an individual with a lump-sum payment or monthly income if they survive for at least 14 days after being diagnosed with an illness that meets the policy's criteria. These can include cancer, Alzheimer's, multiple sclerosis, organ transplants, a stroke or heart attack among others. Cover cannot be purchased for a pre-existing illness and the younger and healthier you are, the lower your monthly premium – so it pays to be prepared. Premiums can be guaranteed or reviewable, meaning monthly payments are fixed for the term of the policy or can change on an annual basis. Customers can choose which type is best for them depending on their needs, as reviewable rates are initially cheaper, but the rates are reviewed every five years at which point they could increase. Guaranteed rates ensure customers pay the same premiums throughout the life of the policy.

As technology allows us to live longer, illness blights lives. Assuming you will be one of the lucky few is not practical – nearly two thirds of the population has not bought any form of protection, such as life insurance or critical illness cover, but one in three of us will be diagnosed with cancer, and every year about 146,000 people in Britain have a heart attack. Each year, 10,000 people under the age of 55 suffer a stroke.

Axa says that the average age at which people claim for critical illness cover is 43 for a man and 40 for a woman – a time when expenses are high, with children still at home and a mortgage outstanding. This means that without cover they may struggle.

You can buy critical illness cover in conjunction with life cover, and some company health policies include it as standard, so it is advisable to check what cover you have before taking out a new policy. Some life insurance policies may pay out if you are diagnosed with a terminal illness – but not if it is in the final year of the benefit term. If you are self-employed or run your own business, critical illness cover will not just protect your family should you become ill, but your business, too. Company policies may pay for your bills and mortgage, but they often won't stretch to other expenses such as child care or travel. Aviva offers ''integrated'' critical illness cover that includes life cover to a selected sum – usually the amount outstanding on the policy holder's mortgage.

When buying a critical illness cover, consider whether the policy matches your needs. For example, some insurers will automatically include children's critical illness cover to your plan – while others will have an option to include a spouse. You may want overseas cover should you spend time abroad, or are planning to retire overseas.

All of these inclusions will affect your premiums. Because of the individual requirements of a policy, these quotes from Axa are generalised, but

• a monthly premium for a healthy, non-smoking, 40-year-old male requiring £150,000 of critical illness cover over a 20-year term is £77. 
• The monthly premium for a healthy, non-smoking, 40-year-old female requiring £150,000 over a 20-year term is £73. 
• In comparison with life insurance, a monthly premium for a healthy, non-smoking, 40-year-old female requiring £150,000 of life cover over a 20-year term is £12. 
• The monthly premium for a healthy, non-smoking, 40-year-old male requiring £150,000 of life cover over a 20-year term is £15.

Life cover may be affordable, but you are much more likely to become seriously ill than die before you reach retirement age.

To illustrate how the later you leave it, the more expensive cover is, just five years on, 

• Axa's quote for a non-smoking male aged 45 years, based on a smaller benefit of £100,000 over a 20-year term, is £85 a month. 
• Fortis quotes the same individual £75 a month, and 
• PruProtect £96.

Statistics show that the number of critical illness claims paid out is increasing. In the past, insurers would have required a letter from the claimant's doctor detailing their full medical history. Due to new guidelines from the Association of British Insurers, now assurers require only medical details relating to the critical illness claim – so you are less likely to have your claim about cancer dismissed because of your non-disclosure about an ingrown toenail.

Additional information may be required if the insurer suspects the claim is fraudulent or the claimant is guilty of non-disclosure. 

• Non-disclosure can lead to a claim being dismissed, but only if the insurer can prove it was deliberate. 
• Alternatively, innocent or negligent non-disclosure relating to a misleading question or misinterpretation of the application form can still result in a payout.

It is not worth risking voiding your policy over misinterpretation, however, so it is always advisable to contact the insurer with any questions.

Do you require Life Insurance?

Telegraph Life Insurance, provided by Click, enables you to compare prices from major life insurances in one simple call. To find more, please call 0800 180 4158 or visit life-insurance.telegraph.co.uk.

http://www.telegraph.co.uk/finance/personalfinance/insurance/criticalillness/7298359/Get-critical-illness-cover-for-peace-of-mind.html

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Health Insurance: What You Need to Know

Health Insurance: What You Need to Know

By LESLEY ALDERMAN
Published: February 2, 2009

With Americans spending an ever increasing amount on medical costs, it’s more important than ever to have insurance that fits your health care needs. So when you start shopping for a plan, don’t just look for one with the lowest premiums. Consider the services that are most important to you.

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The best place to get health insurance, of course, is from your employer. Group plans are typically cheaper, and your employer will probably cover much of the cost.

There are three main types of coverage you can choose from: H.M.O.s (health maintenance organizations), P.P.O.s (preferred provider organizations) and the newer option called an H.D.H.P. (high deductible health plan) paired with a savings account. A small number of companies still offer old-fashioned, fee-for-service plans, but their ranks are dwindling.

Here’s what you need to know about the most common plans:

H.M.O.S provide comprehensive coverage at a low cost to the consumer. In general, you don’t pay any deductibles or co-payments for basic care (and if you do, they will be relatively low). But your choices will be limited. You can generally use only the doctors and hospitals within the H.M.O.’s network, though more plans are easing up on this restriction, and your designated primary-care physician will determine the level of care you require and when you need to see a specialist.
Pros: Low cost. Coordinated care.
Cons: A limited choice of providers. If you go out of network, for example to a specialist, you will probably not be reimbursed.

PREFERRED PROVIDER ORGANIZATION AND POINT OF SERVICE plans were created in response to consumer frustrations with the limitations of H.M.O.s. You can choose to go to network providers and pay a small co-payment, or go out of network and have only a portion — typically around 60 to 70 percent — of your costs reimbursed. The main difference between the two is that a point of service plan requires a referral from your primary care physician to see a specialist, while the preferred provider plan does not.
Pros: More flexibility than an H.M.O.; lower overall out-of-pocket costs than a fee for service plan.
Cons: It’s tricky to predict your costs unless you’re willing to stay within the network. Getting reimbursed for out-of-network claims can be a hassle.

HIGH-DEDUCTIBLE HEALTH PLAN Over the past few years, more employers have begun to offer the option to sign up for a high deductible health plan that is linked to a health savings account or health reimbursement account. Some employers may offer the high-deductible health plan on its own and allow the employees to set up a savings account with the bank of their choice.
The plans work like the preferred provider option, but the deductible is much higher — at least $1,150 for coverage of a single person and $2,300 for families. To compensate for the larger deductible, employers typically offer different two savings options:

• A health savings account allows you to put away pretax dollars and then withdraw the money to pay your out-of-pocket costs. (Your employer may kick in some money, too.) In 2009, you and your employer can put up to a combined limit of $5,950 in a health savings account if you opt for family coverage ($3,000 for singles). The money rolls over from year to year, so you can basically store up a medical emergency fund. When you’re 65, you can take the remaining money out without paying a penalty, though you’ll pay taxes on the withdrawal if you’re not using it to pay for medical costs.
• A health reimbursement account is financed solely by your employer. Typically, an employer will contribute an amount equal to about half the employee’s deductible The money rolls over from year to year, but you cannot take the money with you when you leave the company.

Pros: Low premiums. Tax-free savings (in the case of the health savings account).
Cons: Potentially high costs, especially if you or a family member becomes chronically ill. Don’t choose this option unless you have the money to pay the deductible.

INDEMNITY, OR FEE-FOR-SERVICE, PLANS are offered by fewer and fewer employers because of their expense. They allow you to go to any doctor, hospital or medical provider you choose. The plan typically reimburses 80 percent of your out-of-pocket costs after you fulfill an annual deductible.
Pros: Flexibility. You can go to any medical provider, anywhere, without seeking plan approval first.
Cons: Your total out-of-pocket costs will probably be higher than in a preferred provider plan or H.M.O. Most fee-for-service plans don’t cover preventive care like flu shots or mental health services.

To help narrow your choice, here are the steps you should take:
1. Ask your favorite doctors which insurance plans they accept. If you find that one or more of your doctors do not accept any insurance plans, then you’ll want to select a plan that reimburses you for your costs when you go out of the network.
2. Make a list of all the services you and your family use. Include on the list things like vision care, dental, physical therapy, acupuncture and mental health care. Find out how the plans you like best will cover these services and at what cost.
3. Compare costs. Write down the costs associated with each plan, including premiums, out-of-network costs, and extras like vision or mental health care.

The Joint Commission on the Accreditation of Healthcare Organizations has put together a comprehensive list of helpful questions.

In addition to offering low-cost health insurance, your employer may also offer a health care flexible spending account, which lets you set aside pretax dollars to pay for your out-of-pocket medical costs. (If you have already signed up for a health savings account, you can only use the flexible spending account for dental, vision or post-deductible medical expenses.) You can deposit up to $5,000 a year in a flexible spending account, depending on the limit set by your employer. The money will be deducted from your paycheck and you can’t change the amount midyear. If you have high medical costs, using a flexible spending account can save you hundreds of dollars a year in taxes. But calculate your costs carefully. The money does not roll over to the next year. Any money you don’t use will be lost.

If you need to buy insurance on your own — there are a number of options to consider, including these:

First, if you are about to lose your job and work for a company with more than 20 employees, you can remain on your employer’s plan for up to 18 months, under a federal law called Cobra, the Consolidated Omnibus Budget Reconciliation Act. But you will have to pay the full premium plus 2 percent for administrative costs, and the expense is often quite high. This may be a good temporary measure, though, until you can find a more affordable option.

If you’re out on your own, try to find a group plan to join since group plans typically cost less and offer more benefits than individual plans. Can you join your spouse’s plan? Do you belong to (or can you join) a union, professional organization or alumni group that offers insurance? You may also be able to find a group plan for freelance workers. If you are over age 50, look at the plans offered by the AARP.

If a group plan is not an option for you, you’ll have to buy an independent policy. Fortunately, there are numerous plans to consider. The simplest way to compare policies and prices is by going to an online insurance broker like eHealthInsurance.com. At EHealthInsurance, for instance, you simply fill in your gender, ZIP code and date of birth -- and, if you want, the names of your doctors — and the site comes up with a list of policies for you to consider. You can apply online.

If the prospect of sorting and sifting through dozens of policies seems daunting, consider using an independent insurance agent, who sells many different kinds of health insurance. You can find agents in your area at the Web site for the Independent Insurance Agents & Brokers of America.
Individuals with modest incomes may be eligible for Medicaid. You may be able to get coverage for your children through the State Children’s Health Insurance Program, a federal-state partnership.

If you have a serious health problem and are unable to find coverage through a private insurer, find out whether your state has a high-risk pool that you can join. While these plans are not low in cost, they are often the only option for people with pre-existing conditions.

http://www.nytimes.com/2009/02/03/your-money/health-insurance/primerhealth.html?em=&pagewanted=all