Health Insurance - It's Important To Know What's Not Insured!

Around 7 million people in the UK are covered by health insurance, the majority being covered through their employers. The problem is that few have really studied their policy documents and many misunderstand what is covered. And perhaps just as important, what isn't. If you expect health insurance to pay all your health costs, you're mistaken.

Health insurance is designed to provide protection for curable, short-term health problems and allow policyholders to jump the NHS queues to see consultants, be diagnosed, receive surgery or be treated. That sounds fine, but before you buy you need to appreciate the treatments and situations that fall outside the scope of the cover.

But first a word of warning. This article does not relate to any specific policy and the terms and conditions issued by individual insurers do vary. So please ensure you also check your policy documents. After reading this article, you'll know what to look out for!

Sorry - it's a chronic condition

If a condition can be cured and is not a long-term problem, your insurance company will classify it as acute and should meet the cost. If your problem is incurable or it's a problem that, despite appropriate treatment, will be with you for a long time, then your insurance company will classify it as chronic - and no, you won't be covered.

But drawing a firm line between what is acute and what is chronic is fraught with problems, and leads to the biggest area of conflict between insurer and policyholder.

Everyone agrees that diabetes and asthma are chronic conditions as you're likely to suffer from them for the rest of your life. So those sorts of condition are not covered.

Problems arise when the medical team initially considers a patients' illness to be curable, but the condition subsequently deteriorates and the doctors change their mind, it's now become incurable. This can happen especially in the treatment of some types of cancer.

In these circumstances, the condition is initially defined as acute and is therefore insured, but deteriorates and becomes chronic - and outside the terms of cover. This is possible as insurers retain the right to reclassify a condition from acute to chronic during treatment.

Sorry - it's too long term The insurance company will not pay out for long term treatment. But you need to check your policy documents to see how they define "long-term". You can find the situation where a course of drugs extends for say 12 months, but the insurer will only pay for ten months.

Sorry - it's preventative Your insurance is designed to pay for the treatment and cure of conditions when they arise. It is not designed to pay for treatments that are used to prevent an illness.

Again, the problem of definition arises. Sometimes it is arguable whether a treatment is preventative or a cure. Take the drug Herceptin for example. This drug can be used in the early stages of breast cancer. Research shows that Herceptin can halve the incidence of cancer returning for women who have a particularly virulent form of the cancer known as HER2. In this situation, is Herceptin offering a cure or is it a preventative?

Insurance companies are split on the debate. Norwich Union, WPA, BUPA and Standard Life Healthcare will pay for Herceptin for HER2 patients whereas Legal and General and Axa PPP will not.

Sorry - the drug is not approved Two of the main attractions for taking out health insurance are: to jump the queues at the NHS, and to get the latest treatments and drugs. But there's a rider.

Unless the drug has been approved for use by the NHS in England and Wales, by the Institute for Health and Clinical Excellence, your insurer is unlikely to approve its use. The problem is that the Institute's brief is not simply to decide whether a drug works, but to carry out a cost/benefit analysis to ensure that the benefits to the nation outweigh the financial costs of using it in the NHS. Not an easy brief - and one that has placed the Institute under scrutiny for the extended delays in drug approval.

The compromise hit on by the Financial Ombudsman is that if a health policy won't pay for the use of experimental treatments, then it should meet the cost of an approved conventional treatment with the policyholder footing the bill for the balance if the experimental treatment is more expensive.

Sorry - it's a pre-existing condition

The basic principle is that if you are already suffering from a condition when you start a policy, then that condition "pre-exists" the policy and any claims for its treatment are invalid.

For this reason, insurance companies insist you complete an exhaustive questionnaire before they agree to insure you. After all they need a clear picture of your medical condition before they quote. For many applications, the insurer will, with your approval, also write to your GP for specific details of your medical history. They like to have a complete picture.

So lets say some years ago you injured your knee playing football. It appeared to recover but now it turns out that you have a torn cartilage and need an operation. The insurer could argue that this is a pre-existing condition and you have to pay for its' treatment.

Some insurers try to accommodate these grey areas with a moratorium provision within your policy. These provisions typically say that so long as you have been symptom free for two years relating to any condition you've suffered from within the last 5 years, then they will pay for subsequent treatment. Not all policies have these moratorium provisions and the time periods do vary between insurers. You should carefully read your policy.

Sorry - its not covered

Health Insurance is an annual contract - just like your car insurance. So when it comes to renewal, your insurer is at liberty to review not only your premium but also change the conditions on which your cover is provided.

Therefore, if your policy comes up for renewal mid way through a course of treatment, it's possible to find that your new policy no longer covers that particular treatment. This means that you will have to foot the bill for the balance of the treatment.

Furthermore, with ongoing advances in medical research, more and more conditions are becoming treatable. This progress has the effect of shifting back the dividing line between chronic and acute conditions.

This hits the insurers' pocket in two ways. With more conditions being reclassified as acute, the number of claims is increasing. And there's also a trend for new treatments to cost more - Herceptin being a good example. The net result is that the insurers are finding themselves having to pay out far more. This is inevitably passed back to you through increased renewal premiums. And in an attempt to reduce their risk exposure, insurers have a tendency to adjust their definitions and exclusions. This means that you must read your renewal notice closely before you decide to renew.

So when you are considering Health Insurance, be aware that everything is not always black and white. And if you've got insurance and need treatment, always contact your insurer without delay and get them to confirm that your treatment is indeed covered

Fortis Health Insurance Is a Name You Can Trust!

Fortis Health Insurance Is a Name You Can Trust!

Fortis health insurance has been a widely recognized name in the insurance since 1892. It has proven itself and won the trust of people around the world. Fortis health insurance is committed to providing the best solutions possible to meet your insurance needs.

There are a great variety of plans available. Fortis short term health insurance is of great use to those who are temporarily uninsured. Students can find Fortis short term health insurance tailored especially for them. From complete coverage to a specific prescription plan, Fortis health insurance will have what you are looking for.

Fortis health insurance is a driving force behind the new Health Savings Accounts, known as HSAs. An HSA works like an IRA, except that the money is used to pay health care costs. The money deposited and the interest earned are tax-deductible, and the money can be withdrawn to pay medical bills, tax-free. This is becoming a very popular method of helping pay for your current medical needs, and safe-guarding for your future.

Fortis health insurance is changing its name to Assurant Health. Rest assured that there will be no change at all in the high quality service and dependability that people around the world have come to expect from Fortis health insurance.

http://www.a1-healthinsurance-4u.com/

Is Pet Health Insurance an Option?

Most pet owners arent aware that health insurance for their loved animals has been available for about 15 years now. However, both the availability and restrictions on most plans have made this type of health insurance out of reach for most pet owners.

Interestingly enough, pet health insurance has changed in the past couple of years. Now, animal owners are able to afford medical procedures previously prohibitive because of the cost. But many skeptics are concerned that health insurance for pets will see an increase in the red tape us humans already encounter every day.

Animal medicine is one of the few health care services that isnt financially dependent on health insurance. Medical, dental, surgical and pharmaceuticals are all pretty much covered by health insurance in humans, but veterinary patients are responsible for all of that, themselves. Or, at least their owners are.

Health insurance for pets is very similar to insurance for humans. The same fees, deductibles, coverage rates and plans are all in place, with different plans based on the age, species, and general health of your pet.

Most health insurance policies for animals start around the 6-8 week range, but when the policies end depend on a variety of factors, mostly decided by the health insurance company. Some have age limits, and some dont.

And just like with humans, some health insurance companies will only accept your pet on their plan if they are healthy; others will accept them only if they have had a stable condition for more than six months in a row.

Currently, deductibles stand around $100 for pet health insurance. Policy costs vary as much as human health insurance does, unfortunately. Some depend on what types and kind of coverage is desired, and yet others are just blanket coverage catch-alls. Some may only cover accidents and illnesses. And more pets usually means a reduced health insurance rate for subsequent animals.

But what if you decide that an health insurance policy is not right for you, and your pet? There are other options, of course!

First, discuss your situation with your Veterinarian. Some animal hospitals offer packages that arent quite health insurance, but can offer a rate deal of some sorts on more mundane medical procedures (spaying/neutering, vaccinations, etc.), or packages for your aging animal.

Secondly, research plans that offer discounts on animal health services. PetAssure is one of these companies, but there are a myriad of not-for-profits that may offer this as a side benefit when you join. Or, these same animal not-for-profits may offer financial assistance for pet owners whose health costs are beyond their means a sort of emergency fund, if you will.

All in all, it depends on you, and your pet(s), whether or not pet health insurance is the right choice. Hopefully, with the help of this article, your choice will be an informed one.

For more more information about pet health insurance please visit http://www.1health-center.com/articles/The-Important-of-Health-Insurance.php

The Modern Medical Office: Balancing Success, Technology, and HIPAA

The medical field has always depended on technology for improving patient care. Thanks to advances in technology, administrative functions of healthcare offices have greatly increased their efficiency and customer relations. For example, there is technology that allows doctors to share information with offices across street or across the nation instantly with just a few clicks of the mouse. These advances not only free up hours of paperwork, but also quickly provides information vital to patient’s care.

The Electronic Medical Office & HIPAA

A clinic can in the end be more profitable by offering these innovative services. Nearly half of the people interviewed in a Forrester Research study said they would be willing to pay more for online features; such email access to their doctors. (1)

While technology can be tremendously beneficial there are serious cautions that must be heeded. In 2003, the privacy rule of HIPAA was enacted and the rules governing protected health information (PHI) of patients became far more stringent. The rule governs the way in which information is handled. It requires every level of communication and storage of the PHI to be secure and private.(2) Examples of the ways violations occur are:

• Computer screens visible from waiting room
• Files left out around the office
• PHI not disposed of properly, such as securely shredded
• Records sent to the wrong home or email address

 

Due to these changes all modes of communication have a heavier burden of responsibility placed upon them since the inclusion of the privacy rule, but none more than electronic transmissions. Keeping the information protected when sending emails, which can be intercepted, can in itself be a daunting task.

HIPAA’s Penalties

If an action taken by any employee, whether intentional, unintentional, or simply neglectful leads to improper recipient of PHI, the practice involved could face serious consequences.

 

• The civil penalties range from "$100 per incident, up to $25,000 per person, per year, per standard that is violated."(3)
• The criminal penalties range in three main groups. The first is up to $50,000 and 1 year in prison, moving up to $100,000 and 5 years, or $250,000 and 10 years in prison.

 

Each tier of the criminal penalties has different qualifications leading up to the knowingly disclosing PHI with the intent for malicious harm. (3)

Keeping Your Practice HIPAA Compliant

It’s important for today’s electronic medical office to have several layers of digital protection. This ensures PHI or any other private information cannot go outside the confines of the practices’ systems without the proper digital rights. These rights can be controlled by moderators or even the sender and have the ability to dictate what permissions the receiver may have.

One large step is to protect your practice from accidentally sending information into the wrong hands. This can be done through email anti-theft solutions which encrypts the data sent via email. By using these types of programs, the sender may control not only the security of the file but also subsequent actions that may be carried out by the file’s recipient(s).

email anti-theft programs allow the user to establish who can view, edit, print and forwarding these important health records. Permissions set with email anti-theft software stays with the documents once they’ve left the clinic’s computer.

What Happens if My Practice’s Computer is Stolen?

Email anti-theft software can also protect the data on the computer if the machine is ever misplaced or stolen. This can be done through remote laptop security. All the victim of theft has to do is log into the program and there remotely block access to all protected files on the missing laptop. Without improvement in the means of securing and transmitting their files many practices will continue to commit violations of HIPAA, losing money and patients along the way.

HIPAA Compliance & Patient Trust

It is obvious that one must comply with HIPAA because of the financial penalties that go with noncompliance. There are however, far better reasons for compliance than avoiding punishment.

HIPAA Violations can break the trust between doctors and patients, but compliance along with new technology can strengthen relationships. When patients have new services such as the ability to ask questions to doctors via email the doctors can enhance their trust levels. This is especially important for small practices as interpersonal relationships play key roles for the retention of patients.

The advantages of technology will continue to provide new ways of serving patients. As the digital age comes the computer will increasingly become the focus of record keeping. With an industries like medical & healthcare so dependent on keeping detailed yet secure records, it is going to be ever important to stay current with strong security programs to encrypt and protect files.

 

1. Bradford J. Holmes, Eric G. Brown, Elizabeth W. Boehm, Lynne Bishop, "Trends In Healthcare Consumer Technology Adoption" Forrester Research, 15 July 2004.
2. Title 45 Code of Federal Regulations, Pt 164.
3. United States Department of Health and Human Services. Protecting the Privacy of Patients' Health Information Summary of the Final Regulation. 2005. http://aspe.hhs.gov/admnsimp/final/pvcfact1.htm

   Michael L. David is a member of the marketing team at Essential Security Software (ESS), the leading provider of email anti-theft software for small business. He is a regular contributor to http://www.Iwantmyess.com