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Health Insurance for Young Adults



As we grow older, our responsibilities add up. Having a health insurance should be one of the priorities that we should think of. By the time you are old enough to fend for yourself, you are then required to get an insurance. However, many young adults are still confused on its importance.

1. It may be Illegal

When you are living in the United States, Affordable Care Act (ACA) compels you to purchase insurance. Going without insurance for three months would force you to pay a penalty of $325 or 2% of your monthly income, whichever is higher. In developing countries, uninsured individuals have the option to purchase from private companies but laws are already drafted for completion. In cities like Jakarta, Indonesia and Bangkok, Thailand, more than half of their unemployed population goes uninsured.

2. If you are a full-time employee, your employer should provide you with insurance

Most companies require employees work for set period before benefits can be provided. It usually takes 3-6 months in a probationary period before regularization, by which insurance is given. It is in any law in any states and government to mandate to every employer to provide employee benefits.

3. Your parents may still be able to cover you

Individuals under the age of 26 can still be listed under their parents’ coverage. They can still cover even a modest premium cost.

4. You can do it alone

If you are not insured under your parents’ plan or purchasing insurance under your employer is not an option, you have the choice to purchase your own insurance from trusted private companies. If you are buying online, just make sure you are dealing with a legitimate company as there are a lot of scammers operating in the net. If you are looking for a sound advice, you can ask from consulting companies. Westhill Insurance Consulting is one of the longest running catalysts in insurance consulting and the staff can definitely guide you in buying from the best.

5. Know the Difference between HMO and PPO

Health Maintenance Organizations (HMO) and Preferred Provider Organization (PPO) are two different typed of health insurance. HMOs have lower premiums than PPO as its coverage is more limited. Doctors in HMO have to be in-network while in PPO, in-networks are more flexible and you have the option to see doctors outside of your coverage with extra coverage. Review the type you are insured into and make sure you know your coverage.

Medical Insurance for Expatriates




Expatriates may find it hard to avail of health insurance when they are in a foreign place. The system varies from that of your own nation and customs of availing is a far cry especially in developing nations.

Luckily, developing countries like Indonesia and Thailand are starting to expand its insurance’s scope to a more international level, catering to both local and foreign individuals.

Companies operating in Jakarta, Indonesia, for instance, realize the importance of a comprehensive medical plan to cover sickness and accidents that happen to the staff that they hire.

Westhill Insurance Consulting is also aware of the struggles faced by expatriates when it comes to getting insurance. What preparations do you do then?

1. Find out before you come

The company who hired you and the person you are working for should provide medical insurance for you and your family members just as they do with local folks. Ask for details from your employer to ensure that your policy will adequate cover your family members for sickness, accidents or emergencies, on home leave and when you are visiting other countries for work-related purposes.

If you are joining a new company, remember that they may never love you more than when you first join. Do not rely on promises that medical insurance coverage will be sorted out when you arrive. It could be the case that what the company considers ideal coverage may not meet your expectations. Be sure before you arrive that you understand what medical coverage your company provides for regular medical concerns, major medical situations such as surgery or deliveries, and medical evacuation both inter- and internationally.

A little warning, if you are in a country like Indonesia, for instance, being a foreigner is more likely to be scammed than locals since your lack of knowledge of the customs would be obvious. Make sure you don’t fall into fraudulent acts.

2. Know if there are Medical Evacuations

Medical evacuations are a big factor in medical coverage, as the quality of medical service available in outlying areas in Indonesia will be quite poor. In such areas, emergency medical evacuation (medevac) to a large city or a neighboring country is considered essential.

3. Options in medical insurance coverage

As an example, international medical insurance plans from the U.K. include emergency medical evacuation with the possible addition of major outpatient services to cover everything but minor outpatient claims, which are often excluded to keep costs down. Therefore, outpatient claims are typically subject to a deductible related to the illness.

A patient may have several doctor and specialist visits plus prescribed medicine for one particular bout of sickness and still be subject to only one deductible amount. A point worth noting is that a person could be undergoing outpatient treatment related to a very serious illness, which would not be covered under a local clinic scheme.

With the challenge of today’s generation, health risk is greatly increasing. Today’s citizens have greatly recognized the danger of going out every day.  Health insurance is also in demand in the market and is considered as one of the most necessary insurance to have.

Developing nations are already increasing its insurance economy and even building its own campaign towards the totality of health insurance patrons.

According to a report released by Westhill Insurance Consulting, health insurance has already been accepted as a necessary part of each household.

Indonesia is one of developing nations who has proven too slowly adapt health insurance in its system. With over 200 million citizens flocking on the national health insurance registration in Jakarta, Bali, Sumatra and major places in the country, the government has been proud to predict that it may be possible to see all of the archipelago’s population already avail of health insurance.

To cater to rural areas of developing nations on the other hand, reliable, always‐on broadband wireless connectivity makes a new health care model possible: instead of asking the patient to go to the nearest clinic or hospital, the mobile health care worker reaches out to the patients where they live and when they need care, bringing access to a broad set of medical resources through voice, data, and video applications.

The only challenge in pursuing health care insurance in developing nations is the fraudulent deeds happening among their people because of the lack of security and loose protection from the authorities.

To prevent these scams from happening and keeping more victims from losing their hard-earned money for a non-existent medical assistance, many companies and non-profit organizations are continuously seeking reforms. Universal Health Coverage (UHC) initiatives have sought to create awareness in and provide guidance to countries on how to improve the design and functioning of their health systems based on evidence of what works for achieving the goal of universal coverage. Meeting this goal is, however, challenging, because the available evidence rarely explores the causal link between the design features of these UHC schemes and the outcomes observed, and substantial heterogeneity exists regarding the robustness of the available evidence.

UHC reviews and indicates possible intervention to both low and middle-income countries for improvement. Affordability is currently the main concern for the organization to both solve the problem of the small number of health care insurance holders and keep scams from happening.

Hopefully, more solution can be presented as we look forward for a healthier life in the near future.

Clinical Trials Supported by Insurance


Trials involving human patients are crucial to the advancement of clinical science. But they’re not without risk. Fortunately, insurers are willing to cover them.

Westhill Insurance Consulting, one of the most trusted on-line insurance consultant that offer consumer information on reasonably priced health and medical coverage has these following things to review if you are planning to take part in a clinical test.

Here are the conditions the federal law requires for a health insurance to cover:

  • You must be eligible for the trial

  • The trial must be an approved clinical trial

  • The trial does not involve out-of-network doctors or hospitals, if out-of-network care is not part of your plan

  • Also, if you do join an approved clinical trial, most health plans cannot refuse to let you take part or limit your benefits.


Approved clinical trials are research studies that:

  • Test ways to prevent, detect, or treat cancer or other life-threatening diseases.

  • Are funded or approved by the federal government, have submitted an IND application to the FDA , or are exempt from the IND requirements. IND stands for Investigational New Drug. In most cases, a new drug must have an IND application submitted to the FDA in order to be given to people in a clinical trial.


Health plans are not required to cover the research costs of a clinical trial. Examples of these costs include extra blood tests or scans that are done purely for the sake of the clinical trial. Often, the research sponsor will cover such costs. Warnings must be posted days before the outcome to prevent further complaints from both the sponsor and the insurance company.

Plans are also not required to cover the costs of out-of-network doctors or hospitals, if the plan does not usually do so. But if your plan does cover out-of-network doctors or hospitals, they are required to cover these costs if you take part in a clinical trial.

Clinical tests which are made in a different city such as those in Tokyo, Japan, Jakarta, Indonesia and Kuala Lumpur, Malaysia may not be included in the coverage as well.

Challenging trials

One challenge for underwriters is the relatively small premium base measured against a trend for higher [insured] limits to be requested.

Clinical trials policies normally have “claims made” wordings which means that insurance coverage does not automatically extend beyond the trial dates. The potential gap is where you arrange insurance, let the policy end and have no insurance for an event which may occur sometime in the future that can be attached to the clinical trial.

Serious problems in clinical trials are rare, as Rossano points out. “But what I would say is that clinical trials are not without risk. The risk of a clinical trial is that the human body is very complex and in rare cases there can be unforeseen outcomes, as happened in cases like TeGenaro.”
World Health Organization (WHO) has stated that universal health coverage – ensuring that all people obtain health services they need without suffering financial hardships when paying for them – is a global priority for this year. They also declared that universal health coverage as “the single most powerful concept that public health has to offer”.

Several developing countries such as Indonesia, the Philippines, Rwanda, Vietnam, Kenya and Nigeria among others have demonstrated a strong commitment to universal health coverage, with many others slated to follow suit. Jakarta, the capital of Indonesia is already paving its way to offering a more extensive health insurance coverage that can cater different places in the inter-island archipelago.

Westhill Insurance Consulting Company, your guide to health insurance concerns located in Australia has been in partnership with varied insurance companies which has the goal of expanding the reach of health insurance.

Given this momentum, it is time to think critically about how the goals of universal health coverage can be advanced through health insurance to ensure that women worldwide are empowered to choose the size, timing, and spacing of their families.

Health insurance pays for all or part of medical or surgical expenses for the insured, mitigating out- of-pocket payments as a barrier to health care and providing financial risk protection against catastrophic health expenditures. Different types of insurance models have varying funding sources and provider payment. Many countries have some form of insurance program in place and coverage has increased considerably.

Many reviews say that it would be better for insurance companies to include family planning in their policies and terms especially in over-populated countries like Indonesia which remains the 4th most populous in the world and China which tops the chart. It is well established that family planning results in benefits beyond reducing unmet need and lowering fertility—benefits such as fewer maternal and child deaths and complications from abortions; and improved nutrition outcomes among women, infants, and children. Given the high cost of addressing maternal and child health, these benefits can lead to considerable savings for health systems and insurance providers. Critics have complaints though that if this be passed, couples can make this reason for pre-marital sex which continues to be a moral issue in countries centered by this insurance idea.
             
When developing insurance programs, governments and health insurance providers must carefully decide on a benefits package that clearly describes the types of services covered, along with levels of coverage and any applicable exclusions and/or limits on services. Since lack of access and inability to pay are important reasons women do not use family planning, inclusion of family planning services in health insurance programs could increase uptake. The Commission on Macroeconomics and Health has suggested criteria for choosing essential health interventions. Family planning is a strong match to the key criteria because it is a technically effective intervention, can be delivered successfully, addresses health issues that impose a heavy burden on society, and has benefits beyond the intervention itself.

HMO vs PPO

Most of us who are employed know that we have corresponding health insurance. For others who choose their own insurance, agents might have explained what should be provided and covered for our policies. One of the things that we should be aware of is the type of a managed care plan we need: either an HMO or PPO to avoid complaints, frustrations and disappointments added to our consultation to the doctor. If this is the first time you are hearing this, then, you are not alone. Some insurance are already fixed that agents do not care to mention it anymore.

Westhill Insurance Consulting took the liberty to differentiate each one from the other.

HMO actually stands for Health Maintenance Organization while PPO is an abbreviation of Preferred Provider Organization. Less common are point-of-service (POS) plans that combine the features of an HMO and a PPO. In developing cities like Singapore, Kuala Lumpur, Malaysia, Jakarta, Indonesia and Beijing China, HMO is mostly used by employers for their health care insurance.

To put into an outline, here are the facts that are needed to be reviewed and considered between the two:

Do I need to choose doctors, hospitals and other providers?
•              HMO: you must choose doctors, hospitals and other providers
•              PPO: you can choose doctors, hospitals and other providers.

Do I need to have a Primary Care Physician (PCP)?
•              HMO: Yes, your HMO will not provide coverage if you do not have a PCP.
•              PPO: No, you can receive care from any doctor you choose. But remember, you will pay more if the doctors you choose are not "preferred" providers.

How do I see a specialist?
•              HMO: Referral is needed from your PCP to see a specialist or if you have to undergo other special test exams such as x-rays, except in emergency situations. Your PCP also must refer you to a specialist who is in the HMO network.
•              PPO: You do not need a referral to see a specialist. However, some specialists will only see patients who are referred to them by a primary care doctor. And, some PPOs require that you get a prior approval for certain expensive services, such as MRIs.

Do I have to file any insurance claims?
•              HMO: All of the providers in the HMO network are required to file a claim to get paid. You do not have to file a claim, and your provider may not charge you directly or send you a bill.
•              PPO: If you get your healthcare from a network provider you usually do not need to file a claim. However, if you go out of network for services you may have to pay the provider in full and then file a claim with the PPO to get reimbursed. The money you receive from the PPO will most likely be only part of the bill. You are responsible for any part of the doctor's fee that the PPO does not pay.
There are a lot of health care insurance nowadays with thousands of healthcare insurance companies scattered around the world. Individuals and organizations are slowly starting to appreciate their importance in today’s practical yet expensive lifestyle and health demands. If you are a person living with cancer or a survivor or with any other critical ailment, it is important to make sure that the health insurance plan you choose covers the prescription drugs you mostly need.

Westhill Insurance Consulting gives out warnings on the spread of fraudulent insurance that are emerging targeting the need of cancer patients for insurance. Reports have already been shown in the developing city of Jakarta, Indonesia and Mumbai, India. Here are the tips that we must remember when we avail of critical health insurance for critical health ailment:

All new health insurance plans must provide a benefit package that includes prescription drugs, but the actual drugs that are covered will vary by plan. As you think about the kind of health insurance coverage you or a family member needs, look carefully at the kind of prescription drug coverage the plan offers to make sure the drugs you take will be covered. Because many cancer drugs can be extremely expensive, so making sure that your plan covers the specific drugs you take may save money.         

Things You Need to Consider

o           Medications You Take: The first step is to make a list of all of the prescription medications you currently are taking, including pain medication and anti-nausea drugs. You will need this information to be able to compare the coverage offered by different insurance plans.

o             Drug Formularies: Most insurance plans have a formulary – a list of the drugs the plan covers. Check the formulary of each insurance plan you are considering to make sure that it includes the medications you are taking. You can find out your plan’s         formulary by checking their web site or                calling the plan directly. Agents can also help you determine which health plan to choose.

o             Cost Sharing: You will want to carefully compare the cost sharing different plans charge you when you fill a prescription drug. Some plans charge co-pay, which is a flat rate the patient pays per prescription. Other plans charge a coinsurance, a percent of the total cost of the drug owed by the patient. For cancer drugs, coinsurance will almost always be more expensive than co-pay.

Finding Private Health Insurance


Many of us have to rely on the company’s health care insurance provider. Lucky for those people who can stay in one job for years. How about those people who jumps from one venture to the other? Westhill Insurance Consulting has faced queries on the best alternative whenever unemployment comes near. Private health insurance is the main source of health coverage for the majority of people in the United States alone. For elderly citizens and eligible children and families from low-income households, public programs are the primary source of health cover.

If you are not covered by a publicly funded program, or if your coverage is only partial, you will need to have some kind of private health insurance. In developing cities like Tokyo, Japan, Seoul, South Korea, Jakarta, Indonesia and Singapore, millions of people have found themselves with no health cover at all. Reviews show that uninsured people reaches up to 46 million. Tens of millions more have inadequate insurance.

Best ways to find the best suitable private insurance for you are:

One plan or separate plans - adding a spouse or offspring to a plan may be ideal, but not always so. In some cases, shoppers may find better deals by checking what is around first. It is important to balance to benefits offered against the amount that has to be paid out in premiums, in every case.

Is your doctor included? - if you are considering an interesting plan, make sure your doctor or clinic is listed in their network of healthcare professionals. Otherwise, you may either have to change doctors, or pay out-of-pocket for the one you prefer.

Only choose relevant options - do not choose a plan with options you do not need, in order to keep your premium costs to a minimum. If the purchaser or spouse is a female over 45, it is unlikely maternity coverage is a top priority. Even prescription plan coverage most likely will not cover all drugs, especially the newer, more expensive ones.

Big premiums today, or in the future? - if you have little disposable income and enjoy good health, you might find it more convenient to opt for a high-deductible plan to start with, that has progressively lower monthly premiums with the passing of time. If your health care requirements are high now, a low-deductible plan to start with may be a better choice.

The Best Fit in Healthcare Insurance


With the widespread of insurance nowadays, people are confused which one is legit and which one is a fraud; which can offer better and which one cost less. Choosing the right health coverage has never been easy, and the health reform law has made things more complicated. Besides sorting through differences in premiums, deductibles, and copayments, you need to consider new provisions in the law that have recently kicked in and could impact your coverage for the coming year. Westhill Insurance Consulting can help you clear away any confusion, doubts and complaints.

Health insurance should cover any medical need you may have, now or in the future.

Buying insurance on your own used to be riskier because many plans didn’t cover important things such as prescription drugs or mental health care. Every kind of health insurance must now cover preventive care, with no deductibles, co-pays, or other types of out-of-pocket expenses. That includes Pap and cholesterol tests, mammograms, immunizations, and colonoscopies when age- and condition-appropriate.

But even though you no longer have to worry about your basic health care needs being covered, you’ll still have to navigate lots of other confusing choices. That’s true even if you get coverage through a job, because more than half of workers have a choice of two or more types of health plans.


1. Do you want to pay for care now or later?

All health plans have to come up with enough money to pay for the medical expenses of their members.

You can choose to collect most of the money up front in the form of premiums. If you have a high premium, you’ll pay a smaller share out of your own pocket, in the form of deductibles, co-insurance, and co-pays. Or plans can go the other way, charging smaller premiums but asking you to pay a bigger share on your own.


2. Are you OK with a small network of docs?

Doctors and hospitals accept lower fees from insurers if they know they’ll be part of a small, or “narrow,” network, because that guarantees them a bigger share of the plan’s business. There’s no evidence that you’ll get worse care in narrow networks. And they can save you about 20 percent over larger networks. But make sure that the plan has enough choice of doctors and hospitals in your area—a particular consideration if you live in a rural area. In Singapore and Jakarta, Indonesia and other developing nation, seldom can you choose this kind of benefit. You might as well review and check with your insurance provider for assurance.

Lapses in Insurance Coverage



Insurance has been around since people have realized it should be. Yet sometimes, we cannot avoid not paying for our premiums especially when we encounter financial instability. These are called lapses. Westhill Insurance Consulting gives you the outlines of what you should review once you missed paying your premiums.

Grace Period Must Happen Before Lapse

To prevent a life insurance policy from lapsing each and every time a premium payment is slightly late, every state in the country requires that a life insurance policy first go through what is known as a grace period after a payment is missed. This is a period of time (usually 30 days) where despite the missed payment; the insurance policy will still provide coverage and make a full payout if the insured dies.

Only after the grace period has passed without receiving the due premiums can the life insurance company consider the policy to be lapsed. Once a life insurance policy lapses the life insurance company is not under any legal obligation to pay the beneficiaries if an insured person passes away.

Most Policies Can Be Reinstated After Lapsing

After a policy first lapses, the owner may have the option to reinstate the policy. You want to make sure that you reinstate your policy as quickly as possible after a lapse. Different companies have different rules for reinstatement so you shouldn’t file a complaint or burst into frustrations when your insurance company refuses to reinstate your policy as it should already be stated when you were reading the terms before you signed for the coverage.

Importance of Reinstatement Period Lapse

The reinstatement period is very important to policy owners and insured persons for a couple of reasons. The first reason is as discussed, the insured person may not need to go through the underwriting process. If a person has had a major health change, he/she may not necessarily be aware of the change. The underwriting process may uncover more about a person’s health than they ever knew, for better and worse. Avoiding underwriting when possible almost always leads to lower insurance premiums.

The second reason the reinstatement period is very important is that even with the same health rating, a new life insurance policy will always be more expensive than an old policy, because the insured person has aged. The older the insured person, the higher the rates will be, all else being equal. The bottom line is: Reinstating a life insurance policy rather than taking out a new policy will save money.

Reinstatement Will Cost More than One Month Premium

After a policy has lapsed, a larger payment must be made to reinstate the policy. It is in the best interest of a policy holder never to let a policy lapse. Developing cities like Bangkok, Thailand, Jakarta, Indonesia and Kuala Lumpur, Malaysia are strict in reinstatement and its cost as personal insurance are rare.


References:
https://groups.diigo.com/group/westhill-healthcare-consulting
https://www.linkedin.com/groups/Westhill-Consulting-Insurance-5110019

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