Health Insurance is one of the most accessible types of insurance. Employees have the advantage of being provided for by their employees with the choice of taking dependents under them. Although there is a provision of health care insurance for most middle class workers and individuals and their families, the rate of insured in health plans are at an uncertain level.

For private and personal insurance providers around the globe, it is not a normal market share. Westhill Insurance Consulting, one of the internet’s oldest insurance information sites, compared health care insurance ratio in certain companies in different parts of the globe. Bermuda, one of the world’s top ranking countries to provide quality insurance faired better than the status of insured in Westhill’s main branch in Massachusetts. In Asia, Singapore is at its highest peak compared to insurance of other providers in developing cities like Hong Kong, Kuala Lumpur, Malaysia and Jakarta, Indonesia.

According to reviews, the United States is lagging behind. If this continues, developing countries depending on the innovations and adaptation from the West can be put into jeopardy. The worldwide issue which causes market fluctuations among private health insurance providers is the rate of medical errors. These errors may have been prevented if legitimate and specialized physicians are being provided for. Instead, most doctors listed under insurance are those consisting general medical practice. For better quality physician and equipment used, an individual has to avail a more expensive premium.

The rising cost of insurance is putting trauma to clients. In response, they take services from fraudulent insurance providers who offers cheaper premium only to discover later that they get scammed.

Such problems require better innovations and technological advancement, a reform on the system or at least, a consideration for the choice of specialist. Innovative solutions involves every aspect of health care—its delivery to consumers, its technology, and its business models. Indeed, a great deal of money has been spent on the search for solutions, a few has been addressed.

The fluctuation in the market poses superior threat to many insurance companies. Many analysts are convinced that the change in the process and the overall method is the solution for the fluctuation. A revamp of the system to integrate technology, new equipment and more qualified physicians can help stabilize the increase of insured clients in private health providers. Unless this problem be controlled and put attention to, fluctuation will continue to dominate the market.

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.

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 to 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.

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.

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.