The government has been offering different health insurance plans for senior citizens. The main aim of these plans is to promote health and independence of senior citizens.
National Policy
The Indian central government introduced a National Policy in 1999, to support the health and well-being of senior citizens and their families. This policy supports non-governmental organisations to provide care and protection to the elderly persons in a family. The benefits of this policy are: Strengthening of basic health care systems, in order to meet the health care requirements of older persons. Orientation programmes for elderly persons. Promoting healthy ageing. Distributing materials on geriatric care.
The Indian central government introduced a National Policy in 1999, to support the health and well-being of senior citizens and their families. This policy supports non-governmental organisations to provide care and protection to the elderly persons in a family. The benefits of this policy are: Strengthening of basic health care systems, in order to meet the health care requirements of older persons. Orientation programmes for elderly persons. Promoting healthy ageing. Distributing materials on geriatric care.
Integrated program
‘Integrated program’ for older persons is a plan that offers fiscal assistance to develop old age homes, day care centres, and medicare centres that offer non-institutional services to elderly persons. This plan helps older persons as it strengthens their family and offers productive healthy ageing.
‘Integrated program’ for older persons is a plan that offers fiscal assistance to develop old age homes, day care centres, and medicare centres that offer non-institutional services to elderly persons. This plan helps older persons as it strengthens their family and offers productive healthy ageing.
National mental health program
The national mental health program targets the requirements of senior citizens, who are affected by dementias, depression and psychological disorders. In 2007-08 budget, the finance minister proposed to offer monthly income to seniors citizens, and enhance new family health insurance plans.
The national mental health program targets the requirements of senior citizens, who are affected by dementias, depression and psychological disorders. In 2007-08 budget, the finance minister proposed to offer monthly income to seniors citizens, and enhance new family health insurance plans.
Low cost family health insurance plan
Low cost family health insurance plan provides financial assistance for families, when an unexpected illness occurs. There are many group health insurance plans, child health insurance plans for lower and middle class income people.
Managed care plan
Managed care plan is one of the significant low cost family health insurance, which creates networks of doctors, specialists and hospitals to offer medical services, with reasonable discounts. This plan offers flexible coverages, as all the family members (insured) get discounts while visiting a network physician. This coverage also includes out-of-network physicians.
HMO (Health Maintenance Organisations) is one of the most common managed cares. In this, people have to opt for a primary care physician from HMO network, and if a family member requires a specialist care, then any of the physicians from HMO network can give a referral.
Managed care plan is one of the significant low cost family health insurance, which creates networks of doctors, specialists and hospitals to offer medical services, with reasonable discounts. This plan offers flexible coverages, as all the family members (insured) get discounts while visiting a network physician. This coverage also includes out-of-network physicians.
HMO (Health Maintenance Organisations) is one of the most common managed cares. In this, people have to opt for a primary care physician from HMO network, and if a family member requires a specialist care, then any of the physicians from HMO network can give a referral.
Individual Health Insurance Plan
Almost all the employers opt for and offer only group health insurance. But, those who are not under these plans opt for individual health insurance plans. Those who seek insurance under these plans are usually self- employed individuals or freelancers. Persons not covered by individual health insurance for 62 days, may be subjected to a 12 month ‘pre-existing condition’ waiting period (pregnancy is not considered as pre-existing condition).
There are many individual health insurance plans covering the complications of pregnancy (not the process of pregnancy and child birth). Traditional medical methods are not covered under this individual health scheme. Individual health insurance plan may vary at different stages of life. Mental health and vision are not covered under this plan. There may be separate policies for dental care. Depending upon the needs, individual health insurance coverage also varies.
Almost all the employers opt for and offer only group health insurance. But, those who are not under these plans opt for individual health insurance plans. Those who seek insurance under these plans are usually self- employed individuals or freelancers. Persons not covered by individual health insurance for 62 days, may be subjected to a 12 month ‘pre-existing condition’ waiting period (pregnancy is not considered as pre-existing condition).
There are many individual health insurance plans covering the complications of pregnancy (not the process of pregnancy and child birth). Traditional medical methods are not covered under this individual health scheme. Individual health insurance plan may vary at different stages of life. Mental health and vision are not covered under this plan. There may be separate policies for dental care. Depending upon the needs, individual health insurance coverage also varies.
Comprehensive health insurance plans
‘National Common Minimum Programme’, a comprehensive health insurance plan for each district in all the states, has been originated for execution with participation of community, in the year 2004-05.
The chief characteristics of this programme are: The basic focus of health insurance in the district will be on the poorer section of the society (i.e. both BPL (Below Poverty Line) and Non-BPL). UPA government declared National Common Minimum Programme in 2004. It proposed to raise the public investment on health to at least 3 percent of the total Gross Domestic Product (GDP) for the next five years (focusing on healthcare). The present government proposed to initiate steps to ensure the accessibility of life saving drugs at reasonable prices with the renewal of Public Sector Units.
‘National Common Minimum Programme’, a comprehensive health insurance plan for each district in all the states, has been originated for execution with participation of community, in the year 2004-05.
The chief characteristics of this programme are: The basic focus of health insurance in the district will be on the poorer section of the society (i.e. both BPL (Below Poverty Line) and Non-BPL). UPA government declared National Common Minimum Programme in 2004. It proposed to raise the public investment on health to at least 3 percent of the total Gross Domestic Product (GDP) for the next five years (focusing on healthcare). The present government proposed to initiate steps to ensure the accessibility of life saving drugs at reasonable prices with the renewal of Public Sector Units.
The three major initiatives in the health sector in 2004-05 budgets are:
o Restructuring the Universal Health Insurance scheme (which was introduced in 2003) for below poverty level people with a reduced premium exclusively.
o Initiation of Group Health Insurance scheme for Self Help Groups and Credit Link Groups at a premium rate of Rs 120 per head (for a coverage cover of Rs 10000).
o Exclusion of income tax for the hospitals operating in rural areas. The public sector insurance firms will market the present channels. The settlement process of claims will be simplified on the basis of the availability of TPAs (Third Party Administrators). The programs will be going on in one district of every state, with strong help of community-based programs and organisations with health infrastructure.
o Restructuring the Universal Health Insurance scheme (which was introduced in 2003) for below poverty level people with a reduced premium exclusively.
o Initiation of Group Health Insurance scheme for Self Help Groups and Credit Link Groups at a premium rate of Rs 120 per head (for a coverage cover of Rs 10000).
o Exclusion of income tax for the hospitals operating in rural areas. The public sector insurance firms will market the present channels. The settlement process of claims will be simplified on the basis of the availability of TPAs (Third Party Administrators). The programs will be going on in one district of every state, with strong help of community-based programs and organisations with health infrastructure.
Benefits of health insurance
Health insurance is very significant for individuals and families, as it provides financial assistance during unforeseen medical crisis. Every year, the price of medical treatment in India is increasing drastically. Surgeries and blood tests can cost thousands of rupees. Health insurance enables an individual and his family to obtain medical treatment without worrying about the costs.
Health insurance in today’s scenario is very essential because of: High medical rates. Requirement for daily medical check-up and care for certain illnesses. High fees of specialist physicians. Expensive hospitalisation and medication.
Advantages of group health insurance are:
No physical tests - In a group health insurance, the insurance organisation insures all the group members, irrespective of present physical health and previous health history. The main condition for the group members is that they should apply for insurance within the particular eligibility time. This is a benefit for individuals with chronic health situations (who cannot afford individual insurance).
Less costlier than individual insurance - When a policy is issued for an entire group, the starting rates will be lower than the issuing cost of a single policy to every person. Group health insurance is less risky for insurers as the risk gets spread among larger numbers.
Advantages of individual health insurance are:
Customised health care - Individual health insurance provides the direct control over the policy and its reimbursements. Certain provisions are also included or excluded in the policy. The individuals decide the deductible amount and co-payments.
Choosing the doctors - Individual health insurance provides specialist physicians based on HMO network.
Explain family health insurance plan
![Explain family health insurance plan]()
Reviewed by enakta13
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November 24, 2019
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