Hire Writer In its broader sense, it would be any arrangement that helps to defer, delay, reduce or altogether avoid payment for health care incurred by individuals and households. Given the appropriateness of this definition in the Indian context, this is the definition, we would adopt.
It will provide an analysis of government and commercial health insurance plans and programs. Topics covered include employer-sponsored health insurance, fee-for-service plans, managed fee-for-service plans, health maintenance organizations HMOpreferred provider organizations PPOpoint of service plans POSMedicare, Medicaid, and the Affordable Care Act.
The issues associated with health care reform and universal healthcare will be addressed. Keywords Employer-Sponsored Health Insurance; Fee-for-Service Plans; Health Care Reform; Health Insurance; Health Maintenance Organizations; Medicaid; Medicare; Preferred Provider Organizations Insurance Overview Health insurance, which refers to the insurance against bodily injury, disablement, or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, is available in the United States through government and private providers.
In the United States, the commercial or private health insurance industry and the government or public health insurance industry serve different populations and offer a wide range of benefits and plans. The commercial health insurance industry offers plans including fee-for-service plans, managed fee-for-service plans, health maintenance organizations HMOpreferred provider organizations PPOand point of service plans POS.
The main government health insurance programs include Medicaid and Medicare. The US private health insurance industry, as it is known today, began in when Baylor Hospital began offering prepaid hospital coverage to 1, teachers.
This program was the beginning of what later became known as Blue Cross Insurance. Private health insurance programs grew in number and popularity during World War II when most wages were frozen as part of the war effort. Private companies that could not offer increased salaries began offering health benefits packages to attract potential employees.
Blue Cross health insurance offered forty-three plans by The tax-foundation for our current employer-sponsored health insurance system and employer benefit plans in general was established in when Congress passed the Sixteenth Amendment legalizing the individual and corporate income tax.
Corporations, which were not taxed on company-paid fringe benefits, began to deduct the cost of these benefits from their corporate income taxes. Employers today continue to balance the health insurance benefits they pay to employees with the tax exemptions offered by the Internal Revenue Service.
Variance within Health Insurance Plans Health insurance plans vary in the benefits and services they offer, their costs, their eligibility requirements, and their approach to pricing or establishing premiums.
The history of Blue Cross insurance or premium pricing is illustrative of premium pricing history for the insurance industry as a whole. In the early- and mids, Blue Cross insurance practiced a community ratings system.
The community rating system refers to a pricing method used by insurers that establishes premiums based on the cost of insuring specific geographic areas. In the beginning, Blue Cross charged all plan members the same amount for coverage.
The community ratings system was replaced by experience-rated premiums in which premiums are established based on the anticipated cost of insuring a specific individual or demographic subgroup Carlstrom, Plans such as these have often had very strict guidelines regarding who they would cover and why.
For example, in past, it was likely that anyone who wanted private coverage would have to undergo a thorough medical examination. They might not receive coverage for a prior medical condition, and this could leave them paying hundreds or even thousands of dollars in out-of-pocket expenses.
Insurance companies such as the Blues have not been enthusiastic about health care reform. Reforms enacted under the Affordable Care Act ACA forced insurers to accept everyone, regardless of their state of health, and to cover them for prior conditions. This means insurers must pay out hundreds of thousands of dollars possibly millions in coverage that they formerly would never have paid.
Health insurance, possibly more than any other employee benefit or social insurance, is considered necessary for health and well-being. As a result, government, business, and society are in constant negotiation over how vital healthcare should be provided and financed.
Applications Private In the United States, private and public health insurance is available based on eligibility factors. Variables that have influenced health insurance eligibility include employment status, employer coverage, age, income, disability, pre-existing conditions, and location.
The following sections describe and analyze private and public health insurances. Issues addressed include benefit plans, government regulation, benefit financing, and member perception of benefits. Private Health Insurance Private health insurance plans include group coverage or individual coverage.
Group health insurance is generally available through an employer. Factors that influence the availability of group health insurance include the size of the company and job classification. For example, hourly-wage workers are less likely to be eligible for group health insurance through their employers than salaried workers.
Individual health insurance, generally more expensive than group health insurance, is available for purchase outside of an employment relationship. Individual health insurance plans tend to have more limited coverage and more pre-existing condition clauses than group health insurance.
Individuals have historically chosen private health insurance plans based on factors such as availability, eligibility, individual health needs and history, pre-existing health conditions, the services provided, the costs and affordability, the location of services, and limitations on services.
Differing Health Insurance Plans There are a wide range of private health insurance plans including fee-for-service plans, managed fee-for-service plans, health maintenance organizations HMOpreferred provider organizations PPOand point of service plans POS.
These plans vary in costs and services provided Sullivan, Plans that pay the full benefit no matter where employees or their dependents receive treatment.Mediclaim insurance run by government owned insurance company General Insurance Corporation of India (GIC) is the only private voluntary health insurance scheme available in India currently.
This article will focus on health insurance. It will provide an analysis of government and commercial health insurance plans and programs. Topics covered include employer-sponsored health. Emerging Health Insurance in India – An overview. By J Anita.
Introduction. Evolution of Health Insurance.
Health Insurance Market in India – The Way Forward Research Methodology This paper only based on theoretical and secondary data, which was sourced from various research publications, periodicals, online journals, printed journals, magazines, books, web sites etc. Health insurance in India generally falls under the general insurance sector and covers the Research Methodology This paper only based on theoretical and secondary data, which was sourced from various research publications, periodicals, online journals, printed journals, magazines, books, web sites etc. Health insurance in India: Issues and challenges. Present paper tries to present the health insurance scenario and some of the issues and challenges facing by the health insurance sector in India. The study discusses the issues and challenges such as high Incurred Claims Ratio, skewed distribution of health business, low level of consumer.
The concept of Health Insurance was proposed in the year by Hugh the elder Chamberlen from Peter Chamberlen family. In 19th Century “Accident Assurance” began to be available which operated much like modern disability insurance. Mediclaim insurance run by government owned insurance company General Insurance Corporation of India (GIC) is the only private voluntary health insurance scheme available in India currently.
This . International Journal of Scientific and Research Publications, Volume 2, Issue 8, August 1 ISSN regardbouddhiste.com Health Care Industry in India regardbouddhiste.coma Assistant Professor, Department of Commerce, Padmavani Arts & Science College for Women, Salem- 11, Tamilnadu Employer benefit based health insurance remains quite common.
The basic objective of the research paper is thus to offer an insight into the growth pattern and overall scenario of the health insurance prevailing in the country.