Facts Indian Health Insurance 2010

Facts Indian Health Insurance 2010

IRDA has released statistics pertaining to Indian Health Insurance Industry for the year 2008 -09 and some of the facts are:
This is the truth. If you do not agree the do let us have your comments.

Health Insurance Policy with sum assured of Rs 50 Lakhs seems to be a favourite number of Indian Insurance Companies – Yes the time has changed

Health Insurance Policy with sum assured of Rs 50 Lakhs seems to be a favourite number of Indian Insurance Companies – Yes the time has changed

Max Bupa made the beginning in our country by coming up with Health Insurance Policy for maximum sum assured of Rs 50 Lakhs and within few weeks it has been able to sell 15 policies. This shows that there was an unfulfilled demand for such product. May be the initial success of this product has appealed so much to other insurance companies that now we hear:

•New India Assurance
•Apollo Munich
•Iffco Tokio

all of them have started working actively for coming up with similar or a competitive product. An improvement being considered by New India is that its product will not be a normal domestic product (only within India) but will also be valid for overseas treatment.

We welcome this move to upgrade the Indian customer by offering premium product to him.

We have questions before us:

(i) Under the name of Medical Tourism USA Insurance Companies are sending their patients to India which shows that Indian Health Care industry has achieved certain level of acceptance in the world and is economical also.

(ii) Under New India policy- will HNI’s of India start going to foreign countries during summer season for treatment under the policy. Will the travel expenses be also paid as part of claim? If we are charging higher premium let us charge something more and include this facility also. This is the wish of many potential customers, who talked to me in last 2 days.

(iii) Is it worth while to have a product where few hundred policies are to be issued during the year? Will these polices be handled by same TPA’s or a special team will be set up.

If you have some more questions do let us know. We will be pleased to have your comments.

Yes difficulties are being faced by portability of health insurance

Some time back I had mentioned that we went on hearing for portability of mobile phone numbers and nothing has happened for many years.The players come out with some excuse and it gets deferred.

Let us hope this does not happen with portability of health insurance.

The proposal received by the Regulator has the following conditions ;
Sum assured Rs 1 lakh only
Entry age -upto 40 only

We understand that Regulator wish is

Sum assured upto Rs 2 lakh
Entry age -upto 60 years

Proposal is going back to General Insurance Council.Let us hope it comes back with improved conditions in a short time.

Featured Condtion/Disease: Asthma

We are featuring a childhood/infant disease or condition informational post every other Friday.  Today's topic is Asthma.

Defintion

Asthma is a respiratory (the breathing system including the lungs, mouth and nose) disease. An asthma attack happens when something blocks the flow of air into the child's lungs. Asthma is different from other types of breathing problems because the block allowing air to enter the lungs is reversible. (It can be fixed.) Asthma is the most common disease in children and the leading cause of children missing school and children being admitted to hospitals.

Symptons

The most common symptoms (signs) of asthma are problems breathing, like wheezing, coughing and/or shortness of breath. Your child may start out feeling a tightness in the chest and be unable to play or exercise normally. Then he or she may start wheezing or having heavy breathing and shortness of breath. Other signs of asthma are shortness of breath or coughing when exercising and coughing at night even without shortness of breath. The symptoms can range from mild to severe. Most problems with asthma are worse at night. They also seem to be more severe in boys and in children under 5 years old.  

More Information

To get more information about Asthma, click here. 

*Most of the information provided here is from the Teach More/Love More site, click here to visit their site.

Portability of health insurance

As predicted by us vanilla product will be introduced by all general insurance / health insurance companies in near future as the product details are being sent to IRDA. New health insurance product to be sold by all companies will have following features:

•Max sum assured – Rs 2 Lakhs only

•Preexisting diseases will be covered after 4 years

•Max entry age will be 65 years

•No claim bonus – Reduced premium or increased sum assured will be given. Companies like Oriental will have to change their policy of not giving benefit to the customers as far as this policy is concerned.

•Indicative premium for Rs 1 Lakh – up to age 18 years will be Rs 1000, which means that we are sticking to existing rates. We can expect Rs 1400 for someone who is in the 18 -35 age bracket.

•To be introduced by all companies. We feel Max Bupa may not come out with this product. Let us see what will be the stand of Regulator (IRDA) with respect to this-will Max Bupa be asked to introduce this product ?

Let us see what is the ultimate outcome when the product is introduced?

Our suggestion :

Let all the companies come out with a joint advertising campaign –explain benefits of having health insurance. We should aim for 10 crores policies to be sold under this category. With an average policy size of Rs 2500 this should mean premium of Rs. 25000 crores.

Upcoming Job Fair

Career Central is offering a Medical Field Career Fair on Friday May 14th from 9am to noon. Employers from the medical field will be available to tell you about job openings.

The Career Central office is located at

4440 Grand Blvd.
New Port Richey, FL 34652

For more information call: (727) 484-3400 or go to their website

http://www.careercentral.jobs

Health Insurance is an important part of Indian Insurance market

Health Insurance is an important part of Indian Insurance market and it portfolio which growing at the highest rate. Therefore various proposals are under consideration at different levels with IRDA, Insurance Companies, Government Agencies & Corporate bodies. According to newspaper reports some of these are:-

17 General Insurance Companies and 3 Health Insurance companies are at present selling health insurance. During 2009-10 premium figure is estimated to have touched Rs. 8100 crores.

(1)- Number of stand alone Health Insurance companies is increasing at a slow pace. Star Health was the first health insurance co and it was followed by Apollo Munich which started operations in August 2007. Max Bupa has started operations in April 2010. Religare is planning to start operations in near future but without any foreign partner.

(2)- In view of increase in medication as well as health care costs the sum assured limit of Rs. 5,00,000 has been steadily increasing and now many companies are issuing policy of Rs, 10,00,000. Max Bupa has introduced a product where even a policy of Rs, 50, 00,000. can be issued and that too to a person of 80 years. It is a good charge.

(3)- More and more life Insurance Companies are now selling Health Plans –which is a combination of Health Insurance and Mutual fund. It is foreseen that SEBI view on Mutual fund will have impact on this product also.

(4)- Hospitals / Pharma Co’s may become promoters / investors in health insurance companies. It may result in better healthcare management as resources can be effectively utilized for the welfare of the society. But reach can be limited as India is a very large country. Contribution of 3 large corporates Max, Fortis & Apollo will be merely a symbolic thing.

(5)- Our projections are that by 2015 Health Insurance premium will touch Rs, 35,000 crores and by 2025 it will be Rs, 4,00,000 crore industry.

(6)- Concept of Co pay or co payment will get strengthened year by year and we foresee it will be introduced for all type of health insurance polices by 2013.

(7)- RSBY has become a success. More and more states will introduce this and coverage of those who are BOP (Below the poverty line) and are in unorganized sector will increase.

(8)- In 8 to 10 years most of the General Insurance companies in India will withdraw from Health Insurance scene as they will not be able to cope up with losses and we will see more and more stand alone Health Insurance Companies entering the field and they will become stronger year by year. Their number will also increase as Government may:

- Permit 100% foreign ownership in stand alone Health Insurance companies in near future.
- Reduce equity requirement for Health Insurance Companies at Rs 50 crores (instead of Rs 100 crores at present).

(9)- General Insurance Companies will consider setting up of 100% owned Health Insurance Companies as subsidiary companies. Reliance General may make the beginning by setting up Reliance Health Insurance.

(10)- Mergers & Acquisition will start in Indian Insurance industry and in 2011 (may be in 2010) we will see firms like Royal Sundaram getting merged with Reliance General Insurance.

At present (2009-10) Private insurance players are having market share of 40% in health insurance. Their market share has increased from 12 per cent in 2003-04 to 40.00% during this year. The market share of public sector companies has come down to 60%, which was expected by us as well as predicted on our website. We foresee 4 PSU’s may set up 1 strong Health Insurance Company as a stand alone company to face competition. They may also go in for 1 stand alone TPA fully owned by them.

Star Health has become No. 4 company as far as Health Insurance is concerned. They have beaten National Insurance.

(11)- Some of the small TPA’s may exit the scene as they will find business to be unviable as more and more insurance companies will go in for in house processing of claims.

Featured Condtion/Disease: Whooping Cough

This is the second post in our ongoing series about childhood/infant diseases or conditions on every other Friday.  Today's topic is Whooping Cough.

Defintion

Pertussis (whooping cough) is very contagious and can cause serious illness―especially in infants who are too young to be fully vaccinated. Make sure your young children get their recommended five shots.

Symptoms

Pertussis can cause serious illness in children and adults. The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever. But after 1–2 weeks, severe coughing begins. Children with the disease cough violently and rapidly, over and over, until the air is gone from their lungs and they're forced to inhale with a loud "whooping" sound. Pertussis is worse for very young children; more than half of infants less than 1 year of age who get the disease must be hospitalized. About 1 in 10 children with pertussis get pneumonia (lung infection), and about 1 in 50 will have convulsions.

More Information

To get more information about Whooping Cough, go here.

*Most of the information provided here is from the CDC site, click here to visit their site.

U.S. Health Care Reform

Curious about the new health care laws recently enacted by President Obama?  Below is a break down by year from the myfloridacfo site, located here.

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• 2010
  People with health insurance

  • Insurers may not arbitrarily cancel your coverage when you get sick, except in cases of fraud. (effective September 23, 2010)
  • Insurers may not impose lifetime coverage limits and, until 2014, may only set restricted annual limits for essential health benefits.(effective September 23, 2010)
  • Insurers must cover preventive services with no co-payments or deductibles.(effective September 23, 2010)

  
  

  Children

  • Children who don't get health care coverage from their employers may stay on their parents' plans until age 26. (effective September 23, 2010)
  • Insurers may not deny coverage to a dependent child under age 19 because of preexisting conditions. The same will be true for adults and dependent children age 19 and older beginning in 2014. (effective September 23, 2010)

  
  

  Medicare beneficiaries

  • Eligible beneficiaries with Part D coverage who enter the "donut hole" in 2010 can receive a one-time $250 rebate to pay for prescription drugs that were purchased while in the donut hole. The rebate will be less for individuals earning more than $85,000 per year and for couples earning more than $170,000. The donut hole is the period of time during which some Medicare prescription drug plans won’t contribute anything toward your prescription costs. (began January 1, 2010)

  
  

  Uninsured

  • Individuals who have been without coverage for at least six months and who have a preexisting conditions may obtain coverage through a high-risk health insurance pool to be run by the state, the federal government, or a nonprofit. The risk pools are temporary until exchanges become effective in 2014. (effective July 2010)
  • A website set up by the federal government is scheduled to be available by July 1 to help consumers shop for coverage.

  
  

  Small businesses

  • Businesses with 25 or fewer full-time employees that pay for at least 50 percent of premiums and pay average annual wages below $50,000 may be eligible for a tax credit of up to 35 percent (25 percent for nonprofits) of the premiums the business pays. The credits increase in 2014. (began January 1, 2010)

  
  
• 2011
  Insurance companies

  • For small group and individual plans, insurers must spend at least 80 percent of revenue from premiums on medical services and programs directly related to improving health care quality. The amount increases to 85 percent for large group plans. Insurers that fail to meet the minimum payment requirements must provide refunds to enrollees.

  
  

  Medicare beneficiaries

  • Seniors with Part D coverage in the donut hole will begin receiving a 50 percent discount on brand-name drugs.
  • Co-payments and deductibles for preventive services will be eliminated.

  
  
• 2013
  Wealthier individuals and families

  • For individuals earning more than $200,000 per year and couples earning more than $250,000 per year, Medicare payroll taxes will increase.

  
  
• 2014
  Uninsured

  • Health care coverage will be required for U.S. citizens and legal residents. The tax penalty will be $95 or 1 percent of taxable income in 2014; $325 or 2 percent of taxable income in 2015; $695 or 2.5 percent of taxable income in 2016; and adjusted according to income every year after. There are exceptions for religious objectors, those who can't afford coverage, individuals below the tax-filing threshold, and various others.
  • States or the federal government will create insurance marketplaces, known as "exchanges," for individuals and small businesses to buy coverage. U.S. citizens and legal residents who are not incarcerated would qualify to buy coverage in an exchange. States can expand their exchanges to provide coverage for large employers in 2017.
  • Premium subsidies will be available for individuals and families with incomes between 133 percent ($14,404 for individuals and $29,326 for a family of four) and 400 percent ($43,320 for individual or $88,200 for a family) of the federal poverty level.
  • States will be required to expand Medicaid to individuals under age 65 (children, pregnant women, parents, and adults without dependent children) who are up to 133 percent of the federal poverty level. There is an option for states to expand Medicaid in 2011.

  
  

  People with health insurance

  • Insurers may not deny you coverage because of preexisting conditions. Similar provisions prohibiting insurers from denying coverage to children with preexisting conditions begin in 2010.
  • Insurers must accept everyone who applies for coverage when they apply during a defined enrollment period.
  • Insurers can only base premiums on age, tobacco use, geographic area, and whether coverage is for an individual or a family.
  • Insurers may not deny coverage because of a person's health status, medical condition, claims experience, medication history, genetic information, or disability.

  
  

  Businesses

  • Large employers who don't offer employee health care coverage will pay $2,000 for each full-time worker who receives a tax credit for health insurance through a state exchange.
  • Tax credits for small employers increase to 50 percent (35 percent for nonprofits) of the health care premiums the business pays.
  • Businesses with more than 200 employees must automatically enroll employees in a health insurance plan. Employees can opt out.

  
  
• 2020
  Medicare beneficiaries with Part D coverage

  • The donut hole is eliminated.

Immunizations - F.A.Q.s & Facts

Immunizations - Frequently Asked Questions & Answers

Here's some frequently asked questions from the CDC about immunizations.

I heard that some vaccines can cause autism. Is this true?
No. Scientific studies and reviews have found no relationship between vaccines and autism. Groups of experts, including the American Academy of Pediatrics and the Institute of Medicine (IOM), also agree that vaccines are not responsible for the number of children now recognized to have autism.

Don't infants have natural immunity?
Babies get some temporary immunity (protection) from mom during the last few weeks of pregnancy—but only for the diseases mom is immune to. These antibodies do not last long, leaving the infant vulnerable to disease.

To see a full list of questions, go to the CDC site here.

Immunization Recommendations by Age

To see a chart of immunizations recommended for ages birth through 6 years old, click here.

To see a chart of immunizations recommended for ages seven years to 18 years old, click here.