- All policies fall into one or two camps. There is a policy or a pure term insurance cover. There were several variants of the whole life, combined with a pure investment product with term insurance and make a cash value.
- Insurance is sold, not bought. The agents selling insurance products sometimes by exaggerating the product, because they expect high commissions from sales of life policies. In addition the level of competition in the life insurance industry is also more stringent.
- Whole life is expensive. Policy with an investment component cost many times higher than the policy term. As a result, people who buy whole life often can not receive the present value of adequate, leaving them under the insurance.
- Whole life policy is built upon assumptions. Agents presenting forecasts in the future, not the reality. Some companies defend this presumption of future returns on the high side to attract more buyers.
- Keep your insurance and investments strictly separate. There are better places to invest and without the high commission of a lifetime policy.
- Buy enough to fill the term of protection you need. Insurance is not the place to skimp, especially with the rates in history is always low. Use a calculator to get a rough idea of how much insurance you need.
- Customize your policy term as needed. You want a policy that would shut down as long as you rely on savings or for retirement income.
- Buy now healthy. Parents are generally health is not in the best position, they must pay a higher rate of life insurance. So buy insurance as early as possible as you can, do not wait until you start to depend on.
- Tell the truth. Just point out the facts on your application. And make sure if you make a claim in large numbers, the company will conduct an investigation before paying.
- Use the Web to shop. Buying life insurance has never been easier before the arrival of the Internet. You can get a lot of answers from a website, without the hassle of sales agents.
Ten of Life Insurance
Student Health Insurance in Australia and Canada
Australia has a special system of health insurance for international students called Overseas Student Health Cover (OSHC). When we are studying in Australia, then we need to buy OSHC before we come to Australia, to protect our health insurance since the day of arrival. The Department of Immigration and Citizenship will require the students to still have OSHC as long as living and studying in Australia on a student visa.
When our institution already have agreements with certain providers of OSHC, so we can choose to use the OSHC with this institution, or with the Australian OSHC provider that we have choosen. As of July 2008, there are five providers of OSHC in Australia, they are:Australian Health Management OSHC, BUPA Australia, Medibank Private, OSHC Worldcare, and NIB OSHC.
OSHC will help you pay all medical or hospital care you may need while you are studying in Australia, and will contribute towards the cost of most prescription medicines, and ambulances to emergencies.
This OSHC does not cover dental, optical or physiotherapy. If we want to be covered for these treatments, we have to buy additional private health insurance, such as extra OSHC that is provided by OSHC provider, international travel insurance, or coverage of general care which are provided by private health insurance companies in Australian.
Beside Australian, Canada also provides the student health insurance. All international students in Canada also must have health insurance. Health protection coverage is available to international students varies from province to province. In provinces where international students are not protected by government health plans, then students should look for private insurance to obtain insurance coverage.
When our institution already have agreements with certain providers of OSHC, so we can choose to use the OSHC with this institution, or with the Australian OSHC provider that we have choosen. As of July 2008, there are five providers of OSHC in Australia, they are:Australian Health Management OSHC, BUPA Australia, Medibank Private, OSHC Worldcare, and NIB OSHC.
OSHC will help you pay all medical or hospital care you may need while you are studying in Australia, and will contribute towards the cost of most prescription medicines, and ambulances to emergencies.
This OSHC does not cover dental, optical or physiotherapy. If we want to be covered for these treatments, we have to buy additional private health insurance, such as extra OSHC that is provided by OSHC provider, international travel insurance, or coverage of general care which are provided by private health insurance companies in Australian.
Beside Australian, Canada also provides the student health insurance. All international students in Canada also must have health insurance. Health protection coverage is available to international students varies from province to province. In provinces where international students are not protected by government health plans, then students should look for private insurance to obtain insurance coverage.
Important Things in Selecting Health Insurance
Health insurance can be a safety tool when we are sick in order that we are not worried about the cost medical care. Therefore, we need to enrich ourselves with the types of health insurance in accordance with the expected protection. Health insurance continues to grow, there is a change fee of critical illness, insurance for the early stages of critical illness, or the only guarantee of hospitalization alone.
When completing the health insurance plans, every person should ideally have health insurance, including the children because of their tends to take the medical care in a hospital is larger. Moreover, commonly, the mother easy to worry about their children's health. For instance, when children gets fever 3 days, then a mother will directly take the children to the hospital.
Currently there is a choice of insurance combined with investment or popularly called unit link. Facing this case, we still should choose a pure health insurance, because the pure health insurance has a cheaper premiums and the benefits are more appropriate.
Health insurance is currently mostly limited to medical expenses claims to replace the specified or agreed. Limits reimbursement may include the room, doctors, medicines, and other medical measures, with a limit per type of health care. There is also the only health insurance reimburse hospital room just so the customer still must pay for various medical procedures and drugs. Therefore, it will be better to choose types of health insurance which cover the entire costs of medical care even though maybe will be more expensive because it usually cover all types of medical care costs.
Before determining the amount of premiums, it is suggested to conduct a survey for firstly about the rates of hospitals that will be chosen when we sick. If when we are ill and wont to be treated in the VIP room so we can take the higher premiums. Contrary, when we would like to be treated in the common hospital with common rates, so we can select the adjusted premiums.
In addition to hospitalization insurance at the hospital, is now also available insurance for critical illnesses insurance, such as for heart attacks, diabetes, cancer, and many more. Critical illness insurance is usually not to replace the cost of hospital care. This is a type of insurance policy pays for the insurance money so customers affected by critical illness. Paid in full but after that is not covered anymore. Critical illness insurance is important for those in the family have a history of certain diseases. For example, if a parent, grandparent, or any relatives who suffer from cancer, then we should buy this insurance as a precaution. Especially now lifestyle tend to be unhealthy.
Other things that should be considered in selecting the health insurance is about reimbursement and card. Reimbursement of health care costs generally consist of two types, namely through the reimbursement system or we pay first and then replaced the insurer, or by using cards. The reimbursement system is usually supported with cheaper premiums. But we consequently have to pay first, while the system is already taken care of all the cards so we do not bother.
To prevent the occurrence of unpaid claims, especially those wearing reimbursement system. It is suggested to ask for the details to the insurance agent what the conditions are not covered by insurance.
Finally, when selecting the health insurance, never forget to be honest, for example if we are smoking, then do not say no because as soon as we entered the hospital because of smoking impact, then the claim we can not be paid.
PREVENTING THE FRAUD IN HEALTH CARE INSURANCE
Principally, the insurance business is a business based on trust. The trust was among the participants of insurance or consumer to a physician or Health Care Providers. Trust between the participants of the insurance company that has been agreed that the benefits will be actually obtained by health care insurance participants. Yet, it often also cause imbalance because the insurance company that determines all the provisions that must be followed by the participants. Trust also among the insurers against the Health Services Providers in the hope that the service provided to satisfy the participants so that will give a positive impact both to the Health Services Providers and insurance companies. With this basic of the actual trust and practices, the fraud problem can be overcome if the trust is maintained between the three parties.
Because fraud in health care insurance is an activity or action that could give an enormous impact in health care financing, so it is a necessary efforts to prevent fraud. Based on the experience of many developed countries, fraud can be prevented by among others the role of all concerned Government:
- Establish provisions of law or statute of fraud that lists about the punishment that can be imposed on those who do fraud.
- Besides, the Government needs to establish standards of care, standard therapy, standard drugs and medical devices that can be reference in all measures of health care. Thus, the existence of fraud can be traced based on the provisions that have been defined.
Health Services Providers:
- Health Services Providers should maintain the trust of insurance companies against the service provided and embodied in the form of claims that appropriate to services provided and accurate.
- Health Services Providers should maintain the trust of patients or participants of insurance by providing health care in accordance with a predetermined the standards and benefits that have been the rights of participants as well.
Insurance participants:
- Equip participants with the actual identity as and does not provide opportunities for misuse by unauthorized.
- Request information on services provided by the Health Service, doctors and nurses.
Insurance companies:
- Routine investigation of claims filed against randomly by cross-checking against the medical record.
- Consultation to the Medical Advisory Soard (MAS) to claims filed or the type of action and therapy given by the provider. Besides MAS can act as a party providing a second opinion on actions that will be given to patients Giver of Health Services.
With the progressive development of health insurance in the world will possess cases of health care insurance fraud and abuse should be a common concern. Increased health care costs that occur only because the result of fraud should be avoided. Therefore the participation of all stakeholders is crucial to take precautions and reduce the likelihood of such fraud.
FRAUD IN HEALTH CARE INSURANCE
The increasing of the awareness of people in using health care insurance, also raise the bad action of parties to try obtaining the maximum benefit in the process of health care insurance. Because of the desire to obtain such benefits then there are inevitable occurrence to do the action that are not in accordance with the applicable provisions or fraud or abuse in health care insurance practices.
Based on the experience of health insurance companies in the United States, fraud and abuse in health insurance can reach 10% of the total health care costs each year.
In the known existence of health insurance claims filed by participants individually to insurance companies and other forms of insurance are filing the claim made by the institution by the health providers. Surely these two forms of filing a claim even this is not a possibility that the fraud happens so that it can cause losses to the insurance company.
In the health insurance we recognize the existence of three parties that are interconnected that the participants as beneficiaries, health providers as the party providing the service in accordance with the benefits that the rights of participants and insurance companies as those who manage the financing of such benefits. In conjunction with the implementation of social insurance, especially health insurance, then the Government acts as the regulator and has a very large role.
Fraud in the health care services (provider) referred to as a form of a deliberate effort made to create a benefit that should not be enjoyed either by individuals or institutions and can harm others. According to the National Health Care Anti-Fraud Association's (NHCAA) states that "Health care fraud is an intentional Deception or misrepresentation That the individual or entity makes knowing That the misrepresentation Could result in some unauthorized benefit to the individual or the entity or to some other party. "
Fraud in the health care services conducted on something or circumstances and situations related to the health service, health care coverage or benefits and financing.
In health care, also known referred to as other forms of abuse that can harm the health service. However, this term is more widely used in health insurance is defined as activities or actions that harm the health care service but not included in the category of fraud. Abuse can be either malpractice or over utilization.
