Title: Health insurance
1http//www.policyadvisor.in
2 What is Health Insurance?
- Health insurance is a type of insurance coverage
that covers the cost of an insured individual's
medical and surgical. - Health Insurance is a contract between an
individual/group and the insurer. - In health insurance terminology, the "provider"
is a clinic, hospital, doctor, laboratory, health
care practitioner, or pharmacy.
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3Reasons for Health Problems
- Physical Activity and Nutrition
- Overweight and Obesity
- Tobacco
- Substance Abuse
- HIV/AIDS
- Mental Health
- Injury and Violence
- Environmental Quality
- Immunization
- Access to Health Care
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4Rising Health Care Costs - Reasons
- Specialty drugs, higher medical bills
- Technology advancements
- Cost of trained healthcare staff
- Hospital infrastructure
- Medical equipment
- Cost of living
- Inflation Rising drug prices
- Super specialty doctors
- Defensive Medical practice
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5Why is health insurance essential?
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance abuse disorder
services (including behavioral health treatment) - Prescription drugs
- Rehabilitative and habilitative services and
devices - Laboratory services
- Preventive and wellness services and chronic
disease management - Pediatric services, including oral and vision care
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6Health Insurance Market in India
India consists of 52 insurance companies of
which 24 are in life insurance business and 28
are non-life insurers. Among the life insurers,
Life Insurance Corporation (LIC) is the sole
public sector company. As per data reported on
websites of various general insurers, the Gross
Written Premium (GWP) for FY 2014-15 (i.e. the
period April 2014 to March 2015) generated by 27
general insurance companies in India, is INR
87,625 crore (USD 14.1 billion). The
corresponding figure for last fiscal (FY2013-14)
was INR 79,688 crore (USD 12.8 billion). The only
company whose website does not show the required
details till writing this newsletter is
Agriculture Insurance Company of India (AIC).
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7Health Insurance Role of Hospitals
Hospitals are the right place for creating
awareness of health insurance
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8Issues Challenges Healthcare providers
- Fastest growing population
- Changing disease profile and Re-emerging diseases
- Multilayered Healthcare System
- Lack of or Absence of Infrastructure
- Inaccessibility of Healthcare Services Source
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9Issues Challenges Healthcare providers
- No overcharging for insured patients
- No fraudulent medical certification
- Pre-existing diseases treatment education
- Classification of hospitals transparency
- No unwanted investigations, treatments, delays
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10www.policyadvisor.in
11Thank You