Health Insurance (Case)

Health insurance case

At the government and personal level, Pakistan is heating up the concept of health insurance as the government develops policies for low-income beneficiaries and citizens who know the importance of having a plan B if inflation is not only affecting the cost of tomatoes. in the curry or in the fridge in the summer. It also affects your choices when it comes to health. Can I postpone this blood test? Should I go to a specialist? Why can't I just look at Google's symptoms and buy antibiotics If my bladder pain doesn't kill me, let's delay that surgery. These are questions that most citizens think about.

Pakistan has begun to realize - both at the government and private levels - that it is time to move on to the idea of   health insurance. Not only is the government moving towards developing health insurance schemes for low-income beneficiaries, but also citizens who have realized their value and have begun to look at health insurance as a way of providing plan B if they are sick. Additionally, organizations especially the corporate sector are now, more than ever, providing their employees with health insurance. Universal Health Insurance Day falls on December12, an appropriate occasion to look at emerging trends in Pakistan.

Takeaways Message

• Health insurance is a type of insurance that covers the medical and surgical expenses incurred by the insured.
• Choosing a health insurance plan can be difficult because the rules of the plan about in-and-out services, deductions, fees, and more.
• Since 2010, the Affordable Care Act has banned insurance companies from denying insurance to patients with pre-existing conditions and has allowed children to remain in the parent insurance plan until they reach the age of 26.
•  Medicare also serves some people with disabilities.

How Health Insurance Works

Health insurance is difficult to get through. Managed care insurance plans require investors to receive care from a network of healthcare providers for the highest level of coverage. If patients seek care offline, they must pay a percentage of the cost. In some cases, the insurance company may even refuse to pay for all services available online.

Many managed care plans - for example, health care organizations (HMOs) and service plans (POS) - require patients to choose a health care provider who manages patient care, provides treatment advice, and provides referrals health specialist. Preferred Provider Organizations (PPOs), by contrast, do not require referrals, but have a lower cost than the use of network professionals and services.

Insurance companies can also deny insurance for certain services received without permission. In addition, insurers may refuse to pay for labeled drugs if a type or similar drug is available at a lower cost. All of these rules must be clarified in the product offered by the insurance company and must be reviewed carefully. It is also meant to directly consult the employer or the company before to bring great expense.

Increasingly, health insurance plans also have payments, which set fees for customers who plan to pay for services such as doctor visits and prescription drugs; deductions that must be met before health insurance can pay or pay claims; and the guarantee, the percentage of the cost of health care that the insured has to pay even after experiencing something deductible (and before it reaches their pocket maximum for a period of time).

Top-of-the-line insurance plans generally have a lower monthly fee than deductible plans. When serving plans, individuals should weigh the benefits of low monthly expenses against the potential risk of high pocket expenses in the event of a major illness or accident.

One of the most popular types of health insurance is the deductible health plan (HDHP), which, by 2020, must have an IRS deduction of at least $ 1,400 per person or $ 2,800 per household, and maximum pocket money $ 6,900 per person / $ 13,800 per household. These plans have a lower cost than the equivalent health insurance plan that can be deducted. Another benefit: If you have one, you are allowed to open - and contribute to your pre-tax income - a health savings account, which can be used to pay eligible medical expenses.

Public Health Insurance

Sehat Sahulat is a flagship program of the National Health and Coordination of Health Services, and participating states. It is a social health protection, which works to provide protection to the financial health of poor households to meet suffering extreme poverty because of the cost of health care than normal. In doing so, every registered family is provided with free health insurance so that they can access local health care services at the hospital where they are recorded.

The Sehat Sahulat program began in January 2016. To date, nearly 5.9 million households have been registered; The program has been implemented in over 75 districts of Pakistan, and Sehat Sahulat is a government department project, funded by the Government of Pakistan (GoP). Federal pay the amount of ICT, GB, AJK, newly united districts of Khyber Pakhtunkhwa, Tharparkar district, and people with disabilities, workers of Pakistan abroad, and members of the transgender community.

Health is a human right; Universal Health Insurance (UHC) expiration December 12 is a very important day because it allows us to draw attention to the importance of health coverage. UHC is one of the most powerful policies we can achieve by doing this,” said Dr Sania Nishtar, the prime minister's special assistant on social protection and poverty reduction. She explained that when a person talks about health insurance, one should be careful to point out three things - geographic coverage, access to health care, and quality of health care.

“Within the Ehusas umbrella, there are many activities. One is Tahafuz which is the Ehsaas' social protection unit to ensure economic access to health care. We look forward to launching operations by the year 2020 and planning to grow at the national level,”

Health is a human right; Sania Nishtar said: "UHC Health Day (December 12) is a very important day because it enables us to pay attention to the importance of health coverage," said Dr Sania Nishtar.

A representative from the Punjab Healthcare Management Corporation (PHIMC) explained how government-backed health insurance programs are working in Punjab. Although there is a lot of health insurance, beneficiaries do not need to pay; instead, the government pays for insurance on their behalf. The coverage has recently expanded from 13 to all, 36 districts of Punjab.

There are some important exclusions in terms of health insurance. For example, mental health care and dental insurance coverage are limited. However, expensive and long-term treatments such as cancer treatment, bladder, and surgical procedures like coronary heart disease are covered.

A representative for PHIMC said "so far the government-backed health insurance programs in Pakistan are only targeting the poor."

Private Health Insurance

Dr Harris Shahzad, an eye surgeon who is one of the directors of Shahzad Eye Hospital in Karachi, says his hospital receives a lot of patients covered by insurance.

Insurance does not usually cover OPD fees or tests. They cover the surgical procedure, but they prefer 'inpatient / inpatient' rather than day-care, often in eye care centers. We typically do between 15 and 30 cases a month with insurance for eye surgery, Shahzad said. He said patients covered by insurance have received discounts in hospitals, as well as cover major surgeries to treat genital surgery.

The emergence of a large financial commodity market such as Smart Choice that allows people to compare the range of insurance options available and make informed decisions, shows that Pakistan is moving towards insurance. Health insurance is the most important factor in this regard. Working as an important player in the insurance sector, it is a one-stop shop for insurance. The awareness has increased. Online comparisons have a lot to do with this,” said Majid Shah Bukkari, head of sales and operations at Smart Choice.

He said people now also buy private health insurance "for their own safety. It is easy to pay Rs 1,500 a month, for example, and know that you have medical insurance for up to Rs 500,000 for unforeseen illness. At this time of inflation, the illness of one family member can throw away your budget for years and leave you in debt.

Bukhari says they spend a lot of money on buying health insurance for their aging parents, and newly acquired couples buy it to cover birth costs. There are also insurance plans available for diseases such as cancer.

The umbrella of options for health insurance policies has become widespread. Bukhari said: "Takaful's insurance policies are available now, along with standard insurance," Bukhaari said.

It's like mandatory protection, "says Dr Rukhsana Shahid, a general practitioner, who has evaluated patients for the integrity of life insurance policies since 1985 founded by killin Shahrukh.

The cost of living has increased so we see a small number of individuals buying insurance because they do not want to pay a bit more each month for insurance. However, given the cost of health care, it is inevitable that Pakistanis should move to health insurance.”

Conclusion

Health Insurance is Family Matters and is the third in a series of six reports on United Sates' health problems and addresses the impact it can have on families without health insurance. The book shows that the ownership of one or more of the consequences of the family could be anyone in the house, and the economic, physical, and wellbeing feelings - all members of the family have a negative impact if a member of the family does not get insurance. She concluded by recognizing that uninsured children have poor access and use less health care services than insured children, including important preventive services that can have long-term effects.