Inclusion Of Ayurveda, Unani & Siddha In Health Insurance A Possibility
Domestic Healthcare systems such as Ayurveda, Unani & Siddha might very soon be treated on par with Allopathy when it comes to medical insurance. This might be recommended by a committee formed by the insurance council. The Department of Ayurveda has asked the General Insurance Council to look into the possibility of including the non-allopathic means treatment for accepting claims under health insurance. A presentation has been made to the council members, who in turn, have formed a 3 member committee to look into the matter.
The committee comprises of CEOs from Star Health, Max BUPA & Apollo. This committee would examine the merits & demerits of the proposal & would then recommend processes to implement if it is convinced about the inclusion of such medicines under health insurance. The IRDA will take a call on the matter. A majority of Indias population resort to alternative means of treatment which is recognized by the Indian Government but not by the insurance industry. Most of the insurers who operate under a joint venture with a global company say that there is no established way to verify such claims and no data to rely upon as well.
In allopathic treatments there are scientific studies and they know how long a treatment will take & how much would it cost. But under alternative means such as Ayurvedic they do not have enough data to cover them. Curing an ailment under alternative medicine means mostly takes a long time (in some cases years) and they do not have a structured way of looking at the data. But under allopathy, its more immediate and easily manageable.
Practitioners under alternative means have no registrations and theres no one body that recognizes hospitals/institutes that treats such patients.
The Health & Family Welfare ministry has been pushing such alternative means so hard because these are affordable & a majority of people make use of domestic expertise in these areas. Allopathic medicines are quite expensive even for people living in the urban areas.
The Department of Indian Systems of Medicine and Homeopathy was created in March 1995 and re-named as Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy, or Ayush, in November 2003 to develop education & research in those fields. In conclusion the inclusion of Ayurveda, Unani & Siddha in Health Insurance is a Possibility.
Health Benefit Options For Freelancers And Independent Consultants
Freelance workers, independent consultants and independent contractors enjoy many advantages. Their schedules are flexible, they set their own agenda, and with a little planning, they can take extended time off. However, while these benefits can improve quality of life, there are other benefits that these workers do not receive, such as health insurance. Finding health insurance as a freelancer or independent consultant is one of the most challenging aspects of being a sole proprietor. A variety of insurance options are available to these workers, however finding a plan that the worker qualifies for and can afford is the difficult part. Of the many choices in insurance available, independent contractors and independent consultants may be surprised once they start shopping that some are unavailable to them, some are too expensive, and others offer poor or unnecessary coverage. By the time these workers narrow down the choices to the affordable insurers that will accept them, the list may be very short indeed.
Group Insurance
Group insurance coverage is undoubtedly the best insurance plan overall. In a group plan there is no need to qualify, no medical exams, no health questions to answer and the rates are the same for everyone and do not raise with claims. That being said, if you are self-employed, group health insurance is very difficult to find. Group health insurance is typically provided by employers, and, since an independent contractor works for themselves, there is no employer. If your spouse is employed, you have recently been employed and qualify for COBRA, or you can get your employment covered under an umbrella company, it may be possible to receive group coverage. If you can qualify for group insurance, you will probably find it to be the most affordable and most inclusive of the insurance options that you find.
Insurance through an Association or Chamber of Commerce
In their effort to ease the financial hardships for sole proprietors, many professional organizations and local chambers of commerce offer insurance to their members. These policies are not true group policies, but pooled risk policies. A pooled risk policy can still be affordable, particularly if you are young, have no serious medical conditions, and have low risk of an accident. Because you generally receive an individual insurance premium rate, members with pre-existing conditions or those in poor health may find that they pay a higher rate. Also, unlike in a group plan, your rate can, and will, change as a result of claims. Even those in good health that are in a pooled risk policy will usually pay more for coverage than someone with group coverage, but, overall, the insurance choices provided by professional organizations can be a good choice for self-employed workers.
Coverage through the State
Some states offer medical insurance benefits programs. In many cases, health insurance that is offered through your state is not a great choice. While each state offers its own plan and they vary widely, a state plan does not typically cover the full spectrum of preventative care and may be very limited with regard to prescription coverage. Coverage through the state is sometimes called catastrophic coverage, intended to prevent financial ruin if a self employed worker becomes seriously ill or injured. State coverage may also have income limits (intended for lower income individuals) or other qualifying factors. State coverage can be an option to explore, but you should also make sure that you have money in your savings to cover routine preventative office visits, the cost of medications, and reserve funds in case you need to come up with partial payments for something more serious.
Individual Coverage
Buying an insurance plan directly from the insurance company is an expensive way to get health coverage. If you have pre-existing conditions or are in poor health it may be impossible to find a company that will cover you affordably. Individual coverage is typically the last choice for independent contractors and freelancers because of the expense, the limits, and the aggravation of attempting to secure this type of coverage.
Getting the Coverage That You Want
Group health insurance is, hands down, the best all-around choice. Qualifying for a group plan as a self employed individual can be tricky, but there are ways to do it. The benefit is affordable coverage and the knowledge that you can protect your health and wellbeing affordably. If you cannot qualify for group insurance through your spouse or COBRA, and you are working as an independent consultant or freelancer, your best choice may be to get benefits coverage through employment by an umbrella company or “employer of record”. An umbrella company often offers benefits to their employees, such as insurance. The work you perform is not for the umbrella company however, it is for your existing clients. The umbrella company invoices the clients, and pays you. This allows your client to be free of maintaining your paperwork, while allowing you to receive benefits from the umbrella company.
Umbrella firms commonly employ only “white collar” professionals, so if you are an independent contractor in trucking, construction, or other more labor-oriented industries, then an umbrella firm may not be right for you. Also, it is important to ask many questions about the insurance and benefits provided by any umbrella firm. Many umbrella firms offer complete insurance packages that include health, life and disability coverage with a true group program. Other firms offer “group discount” health plans that may not be truly corporate group health. Find out who the insurance company is, and ask lots of questions to be sure – if you can get a cost estimate of the insurance premiums right away, then that can indicate a real group program, as everyone in a group program will have the same rates. If you have to give personal health information such as age or health conditions to get a rate quote, then chances are, the plan is not truly a group plan. While getting benefits through an umbrella firm is a good deal for many individuals who are a good fit for that kind of program, for those who only want health insurance, it may not be the best choice because these companies are not only providing health benefits, but a full suite of employer of record services.
For any independent consultant or freelancer, it is important to protect your physical and financial well being by having solid health insurance coverage. Even a short amount of time away from work due to an unforeseen health problem could be very damaging to a “company of one” – not to mention sky high medical costs if youre uninsured and the unthinkable happens. If youre working solo, make sure you have great coverage. Shop around, ask questions, and compare your options. Always look for a true corporate group health plan, – whether through a spouse, through COBRA coverage, or through an employer of record, as this is the safest and most stable option for great benefits protection.
[Top]Health Positive Aspects Of Practicing Jiu Jitsu
Health is very important in all our existence’s and we ought to take care of our well-being. Some even say that health is prosperity. This statement is usually correct since when you did not have wellbeing you may be healthy adequate to take pleasure in your variety, so in order to be rich you must be nutritious. Enable’s make your investigation for finding the best sport to be part of so you can get the optimum benefit in the bodily health, effectively that sport could well be Jiu Jitsu.
Jiu Jitsu is just not only the fastest rising martial artwork but it is also confirmed to be by far the most productive martial artwork inside planet. So just by studying Jiu Jitsu you definitely have an edge through absolutely everyone else. Nonetheless, the health and fitness advantages of coaching in Brazilian Jiu Jitsu are just incredible. It’s claimed you may reduce anywhere from 700 – 1,500 calories in one teaching session of Bjj. To shed that same total in jogging for the treadmill you’ll ought to run for numerous a lot of hrs to achieve a similar result from Bjj. If you coach in such a sport your cardiovascular is beating really swiftly along with the more rapidly your heart beats indicates the more extra fat burning your get the job done out is. And also however chances are you’ll not come to feel it in the course of teaching, your muscles are functioning like crazy all through your coaching sessions. Consider me in case you train five moments per week and eat appropriate you may have a six pack having a lil little bit of sit ups and you will see that your body is pretty toned.
Another excellent health profit if Jiu Jitsu is the fact that it keeps you active being a pastime. When you might be active and use a wholesome cardiovascular that also signifies that your sexual acts existence would reach more heights. Ask several wifes of Bjj practitioners and they’ll tell you how it has helped them. In fact, many individuals now take this martial art as a way of lifestyle for them. Many individuals also use this as being a coping mechanism. What I imply by that is certainly, when people today get stressed some people drink, smoke, or do different factors but Jiu Jitsu is the best of coping mechanisms. If you’re stressed out this will get a whole lot of stress away from your every day everyday living. Bjj decreases stress dramatically.
[Top]A Look At Some Of The Health Issues Caused By Black Mold
Black mold produces irritating odour and it is a common characteristic of most molds. If you are a sensitive individual, this odour might act as an allergen. This irritating odour might aggravate or develop allergies and illnesses that you might not have experienced before.
Therefore, if you feel that your experience might be related to mold infestation, you should discuss your concern with your doctor. Apart from just causing allergies, it also produces a toxic substance which affects the nervous system and that is why it must be treated as early as possible.
Black mold and mold spores both may trigger allergic reactions. These are the most common health issues cause by them. If you are sensitive or your immune system is weak, you will experience these allergies right away; or on the other hand, they might develop sometime after the first exposure.
The allergic reaction usually depends on how severe the growth of black mold is. It produces toxins known as mycotoxin, which can cause irritation of skin, eyes and air ways in most individuals, even if you do not suffer from any allergies.
People with chronic lung diseases can experience serious breathing infections due to toxic molds. Some individuals may also face severe reactions to this toxic odour, which may include fever and difficulty in breathing.
These risks also depend on the medical condition of the affected person at the time of exposure and is not only limited to the extent of its growth. Since the reaction to mold exposure varies from one individual to another, it is quite impossible to assess the severity of health risks associated with black mold infestation.
Other symptoms caused by black mold toxins include: uneasiness in respiration, headaches, nausea, cough, red eyes, development of rashes and hives on skin, and memory loss. In some cases, individuals experience bleeding in lungs, lethargy, lack in concentration, asthma, irregularity in blood pressure, damaged digestion and respiratory system, pain in liver and other internal organs, infections of urinary track, and problems in urination etc. Severe or prolonged exposure to them can even affect infertility in some patients.
Therefore, it is better to take preventive measures and stop black mold growth in the first place. If you suspect mold infestation, you should quickly seek help.
[Top]Getting Insurance To Pay For Preventive Health Under The Aca
The Affordable Care Act (ACA) mandates that health insurance companies pay for preventive health visits. However, that term is somewhat deceptive, as consumers may feel they can visit the doctor for just a general checkup, talk about anything, and the visit will be paid 100% with no copay. In fact, some, and perhaps most, health insurance companies only cover the A and B recommendations of the U.S. Preventive Services Task Force. These recommendations cover such topics as providing counseling on smoking cessation, alcohol abuse, obesity, and tests for blood pressure, cholesterol, and diabetes (for at risk patients), and some cancer screening physical exams. BUT if a patient mentions casually that he or she is feeling generally fatigued, the doctor could write down a diagnosis related to that fatigue and effectively transform the “wellness visit” into a “sick visit.” The same is true if the patient mentions occasional sleeplessness, upset stomach, stress, headaches, or any other medical condition. In order to get the “free preventive health” visit paid for 100%, the visit needs to be confined to a very narrow group of topics that most people will find vert constrained.
Similarly, the ACA calls for insurance companies to pay for preventive colonoscopy screenings for colon cancer. However, once again there is a catch. If the doctor finds any kind of problem during the colonoscopy and writes down a diagnosis code other than “routine preventive health screening,” the insurance company may not, and probably will not, pay for the colonoscopy directly. Instead, the costs would be applied to the annual deductible, which means most patients would get stuck paying for the cost of the screening.
This latter possibility frustrates the intention of the ACA. The law was written to encourage everyone – those at risk as well as those facing no known risk – to get checked. But if people go into the procedure expecting insurance to pay the cost, and then a week later receive a surprise letter indicating they are responsible for the $2,000 – $2,500 cost, it will give people a strong financial disincentive to getting tested.
As an attorney, I wonder how the law could get twisted around to this extent. The purpose of a colonoscopy is determined at the moment an appointment is made, not ex post facto during or after the colonoscopy. If the patient has no symptoms and is simply getting a colonoscopy to screen for colon cancer because the patient has reached age 45 or 50 or 55, then that purpose or intent cannot be negated by subsequent findings of any condition. What if the doctor finds a minor noncancerous infection and notes that on the claim form? Will that diagnosis void the 100% payment for preventive service? If so, it gives patients a strong incentive to tell their GI doctors that they are only to note on the claim form “yes or no” in response to colon cancer and nothing else. Normally, we would want to encourage doctors to share all information with patients, and the patients would want that as well. But securing payment for preventive services requires the doctor code up the entire procedure as routine preventive screening.
The question is how do consumers inform the government of the need for a special coding or otherwise provide guidance on preventive screening based on intent at time of service, not on subsequent findings? I could write my local congressman, but he is a newly elected conservative Republican who opposes health care and everything else proposed by Obama. If I wrote him on the need for clarification of preventive health visits, he would interpret that as a letter advising him to vote against health care reform at every opportunity. I doubt my two conservative Republican senators would be any different. They have stand pat reply letters on health care reform that they send to all constituents who write in regarding health care matters.
To my knowledge, there is no way to make effective suggestions to the Obama administration. Perhaps the only solution is to publicize the problem in articles and raise these issues in discussion forums
There is a clear and absolute need for government to get involved in the health care sector. You seem to forget how upset people were with the non-government, pure private sector-based health care system that left 49 million Americans uninsured. When those facts are mentioned to people abroad, they think of America as having a Third World type health care system. Few Japanese, Canadians, or Europeans would trade their existing health care coverage for what they perceive as the gross inequities in the US Health Care System.
The Affordable Care Act, I agree, completely fails to address the fundamental cost driver of health care. For example, it perpetuates and even exacerbates the tendency of consumers to purchase health services without any regard to price. Efficiency in private markets requires cost-conscious consumers; we don’t have that in health care.
I am glad the ACA was passed. It is a step in the right direction. As noted, there are problems with the ACA including the “preventive health visits” to the doctor, which are supposed to be covered 100% by insurance but may not be if any diagnostic code is entered on the claim form.
Congress is so polarized on health care that the only way to get changes is with a groundswell of popular support. I don’t think a letter writing campaign is the correct way to reform payment for the “preventive health visits.” If enough consumers advise their doctors that this particular visit is to be treated solely as a preventive health visit, and they will not pay for any service in the event the doctor’s office miscodes the visit with anything else, then the medical establishment will take notice and use its lobbying arm to make Congress aware of the problem.
COMMENT: Should there not be an agreement up front between both parties on what actions that will be taken if said item is found or said event should be seen or occur? Should their be a box on the pre-surgical form giving the patient the right to denying the doctor to take proper action (deemed by whom?) if they see a need to? Checking this box would save the patient the cost of the procedure, and give them time for a consult. If there is not a box to check, why isn’t there one?
There are two separate questions posed by the checkbox election for procedures. First, does a patient have a legal right to check such a box or instruct a physician/surgeon orally or in writing that he does not give consent for that procedure to be performed? The answer to that question is yes.
The second question is does it serve the economic interest of the patient to check that box? For the colonoscopy, in theory the patient would get his or her free preventive screening, but then be told the patient needs to schedule a second colonoscopy for removal of a suspicious polyp. In that case, the patient would eventually have to pay for a colonoscopy out of pocket (unless he had already met his yearly deductible), so there is no clear economic rationale for denying the physician the right to remove the polyp during the screening colonoscopy.
But we are using the much less common colonoscopy example. Instead, let’s return to preventive care with a primary care doctor. Should a patient have the right to check a box and say “I want this visit to cover routine preventive care and nothing more”? Certainly. There is way too much discretion afforded physicians to code up whatever they want on claim forms such that two physicians seeing the exact same patient might code up different procedures and diagnostics for the exact same preventive health screening visit.
When I expect to receive a “zero cost to me” preventive screening, I do not imply that I am willing to accept a “bait and switch” change of procedure and payment due to the doctor from me. The “zero cost to me” induces consumers to go to the office visit; it is actually paid for out of the profits earned by the health insurance firms to whom consumers pay monthly premiums. Consumers need to hold doctors financially accountable for their claim billing practices. If you are quoted a “zero price” for a visit, the doctor’s office better honor that price, or it amounts to fraud.
It is all too easy to find any little old thing to justify billing a patient for a sick visit instead of a wellness visit. However, it is up to the patient to prevent that kind of profiteering at his or her expense.
It would be wonderful if HHS would give carriers the proper code or specify that other diagnostic codes cannot negate the preventive screening code used for a wellness visit. That is not happening now. DHS has been bombarded with so many questions and suggestions for health care reform that the department has a fortress like mentality. So realistically, consumers cannot expect DHS to address the coding issue for preventive health screenings any time soon. That leaves the full burden to fall on each consumer to ensure the doctor’s billing practices match the patient’s expectations for a free preventive health office visit.
I investigated the web site http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html and discovered some inconsistencies. For example, the site purports to list the services covered under the “preventive health” coverage benefit, yet it omits the annual physical exam. Also, the site states that colorectal cancer screening are provided for people age 50 or older. However, I have been advised in writing that United Healthcare will cover preventive screening colonoscopies for people under age 50. In essence, that government web page is a good start to learn about preventive health care benefits, but a better source would be each consumer’s own health insurance carrier. For those with temporary insurance or who are without any insurance coverage, unfortunately, the preventive health benefit of the ACA will not have any practical consequence.
Where will the money come from for the preventive health screening visit to a primary care doctor as well as the screening colonoscopy? We have to look at different scenarios. If the patient indeed has preventive health screenings with no other medical diagnoses, then the patient will be charged $0 for these services, and they will be paid for by the insurance carrier. The insurance carrier will pay these costs out of its operating income or profits. There is simply no other source for payment. The government has not offered to pay the insurance companies for these services.
If the patient is hit with various medical diagnostic codes during these preventive health screenings, then he or she will pay his customary charge for the primary care doctor’s office visit and the contract-negotiated price for the diagnostic colonoscopy. In that scenario, the consumer will be paying most of these costs, although the visit to the primary doc may be limited up to any applicable copay amount.
It is not a big shock or surprise to say preventive health care is going to be borne by health insurance carriers. The extent to which these carriers can pass along costs to consumers through higher rates depends on the degree of competition in their markets. Ehealthinsurance.com advises me that for the vast majority of states, the insurance carriers have NOT been able to shift these costs onto consumers through higher rates. That may change in 2013 or 2014. However, the trend is clearly moving in the direction of more power for consumers, more options and carriers available to supply health insurance in their states, which means greater competition and lower prices.
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