Health Insurance Daily Blog

By Aileen Banting

Health insurance coverage are usually provided for athletes by the employer of the athlete’s parent or guardian, or the athlete him or herself. Insurance coverage is basically wide-ranging. An example of an insurance coverage would be the individual health insurance plans. This coverage is set and acquired by the athlete. It is very imperative for an athlete to find and select or choose a complete health insurance plan. Some organizations require health insurance coverage that should include hospitalization, professional and extensive benefits to meet athletic requirements, etc. Some organizations do not recognize accident insurance plans or catastrophic health insurance plans that has nominal benefits.

Just like any other insurance policy, it is important to research and compare before buying an insurance policy for your pet.

Can I choose a veterinarian?
Like human health insurance, pet insurance providers may have affiliate clinics and veterinarians, and you should check whether your present veterinarian is included in the list.

Is there a waiting period?
For some policies, there is a waiting period before your pet is covered. Any incidents occurring before the end of the waiting period will not be covered.

Which conditions are covered?
Know the details of which conditions and incidents are covered. Some breeds have limited coverage, and those with pre-existing conditions may have limited coverage, or an additional premium might be needed to include the pre-existing condition in the coverage. Also find out the limits for specific incidents per year.

Is there a deductible?
A deductible is the amount you pay before your pet is attended to. For policies with lower deductibles, the premium is higher, and vise versa.

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Who says only humans are entitled to health insurance?

Pet insurance is available for pet owners in countries such as the US, UK and Australia. Pets are considered family members, and investing in their health is important, not only in terms of saving money in the animals’ health care, but in protecting the family members from getting sick due to a pet’s untreated condition.

The amount of premiums vary depending on the pet’s age, overall health condition and breed. Some breeds are covered for accident insurance only such as Chinese Shar-pei and Shar-pei cross-breeds. Premiums may be paid monthly or annually. Most insurers require the pets to have updated immunization for it to continue coverage.

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By Aileen Banting

Most schools have or require each of their students to have an insurance plan. These insurance plans grants some benefits for sudden medical expenses in case of injury or sickness. In some schools, residence life students, international students and athlete students are obliged to hold a wide-ranging insurance policy. Available insurance for all registered students have a certain time period for an annual cost, depending on the insurance company. Courses that require physical activities as well as medical courses are usually top on eon the list to have insurance plans. For some international students, their insurance most likely provides insurance good for on and off the campus.

In other countries, pregnancy-related healthcare are not covered by health insurance policies. Pre-natal and post-natal check ups are covered, but procedures and laboratory tests are not. US citizens are very fortunate to have the Pregnancy Discrimination Act, approved in 1978 as an amendment to Title VII of the Civil Rights Act of 1964. Pregnant employees will have the same benefits as any other employee that has medical conditions. Health insurance provided by employers should cover pregnancy related expenses. This benefit is not limited to married employees. However, abortion procedures are not covered, except when the mother’s life is in danger.

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Insurance companies have identified fraudulent practices and united themselves to develop systems that will detect suspicious billing patterns. The National Health Care Anti-Fraud Association was formed for this purpose. A public advocacy and educational organization - Coalition Against Insurance Fraud - was formed in 1993 to increase public awareness and track these deceptive companies.

The Health Insurance Portability and Accountability Act of 1996 gave the U.S. Inspector General the jurisdiction overall insurance plans. It organized Operation Restor Trust which targeted fraud, waste and abuse in Medicare and Medicard, particularly fraudulent activities in home health agencies, nursing homes and durable medical equipment suppliers.

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The Coalition Against Insurance Fraud provides these warning to help you avoid signing up with illegal, fake insurance companies:

- very cheap premium for a wide variety of benefits
- accepts people with medical conditions that are usually rejected by other plans
- has few or no underwriting guidelines
- insurance agent approaches individuals directly, and not through an employer
- insurance company is not licensed in your state and assures you that it is exempted from securing a license
- the insurance representative uses the term “benefit” rather than “insurance”
- insurance rep does not provide clear, straight forward answers to your questions
- you’ve never heard of the insurance company

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Other fraudulent procedures include:

- charging for services that were not performed
- unbundling of claims: where a series of procedures that may be covered by a single fee is charged separately for higher fees
- double billing: where a service is charged twice
- upcoding: where a more complex procedure is declared and billed for a simple procedure actually done
- miscoding: where a wrong code is used for a procedure
- kickbacks: where payment is received for making a referral, usually the payment for such referral is sourced from an overcharged procedure, and is “kept hidden” by declaring these as mere rental payments.

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