An innovative Pan-India health scheme will be unveiled as announced by the PM Narendra Modi from Ramparts of the Red Fort on Independence Day on 25th September, the birth anniversary of Pandit Deen Dayal Upadhyaya. Pradhanmantri Jan Arogya Abhiyan would also go operational– it is set to get common man free treatment for serious diseases. The Pradhanmantri Jan Arogya Abhiyan and Ayushman Bharat Yojana will cover 10 crore families with a provision of 5 lakh rupees per annum health assurance for each family. It will also open new avenues of employment in the health sector for youth especially from middle-class families. New hospitals will be built in the tier-2 and tier-3 cities. They will require medical staff in large numbers. Such a gigantic plan will bring forth radical changes.

Also read: Innovation is the New Buzz Word

We, at InnoHEALTH Magazine, are confident to play a major role in highlighting the scheme for the benefit of various stakeholders – may it be public hospitals, private entities or the patients. In view of bringing focus on a slew of issues, which are constantly in debate among the medical fraternity members, our magazine aims to focus on diagnostic tools in the field of treatment through this issue.

In the global business scenario, now a witness to major changes due to growing political reasons, Trade tariffs, and Tax structure is bound to be affected badly by such developments. So, we are trying to keep the close watch on medical diagnostic tools, medicines price tags and a torrent of new diseases caused by current lifestyles. We had a discussion with Dr. Arvind Lal whose internationally famed pathology labs provide deep insight into disciplines of pathological tests and precise examination of diseases.

Since time immemorial, India is known worldwide for its ancient traditional medicines, but it is for the first time that a new protocol on Ayurveda medicines has been scripted. The AYUSH Ministry is closely studying the same while exploring ways for its effective usage. The protocol has been prepared on the basis of AI (Artificial Intelligence). In the current edition, we are also publishing a detailed report on AI that is making remarkable forays in the field.

As the old age is a natural phenomenon and each one of us has to face this stark reality, we have tried to rivet our eyes to problems afflicting the old people both socially and medically. The world is observing International Day for Older Persons on 1st October, so the topic gains more relevance.

Interesting stories list is unending and some of these are: A Consequence of Modern Day Living – Burnout; Fairy tales of Nanoparticles from Iceland to Jamia Millia Islamia; AI Engraving Footprints on Healthcare Transcontinental Canvas; National center for ageing coming in New Delhi; Lonely people run the risk of dying early; Low back pain is the leading cause of disability worldwide; Religious people live four years longer than atheists; A study has unknotted long-term impact of stroke; etc. In addition to these, we are also publishing a host of latest researches which gives scientific explanations of many usual occurrences in human beings.

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For a hawk of health insurance business, convolutedness of the insurance cover is not a hard nut to crack but for a gullible buyer, it is not a facile task to comprehend its intricacies. Amid growing awareness for the insurance coverage due to the high cost involved in medical treatment at super speciality hospitals, InnoHEALTH magazine interviewed seasoned player of the insurance discipline Mr Sethi, Vice President Insurance Foundation of India and sought answers for simple queries by people.

Mr. Sethi, who is closely following recently announced National Health Protection scheme by the Union government for ten crore poor people and enthusiastically await roll out of the full scheme, said it would herald a new era in the health sector as the country has pan India facilities to implement the plan, but “ only little bit intelligent planning” is warranted.

Also Read: Ten Crore Poor People to Get Health Insurance

EXCERPTS ABOUT INSURANCE

How is the Health Insurance Premium determines?

It depends on the age, sum assured, whether a person to be insured has any pre-existing disease or adverse health conditions. The rates are fixed (approved by IRDA) and are available in the brochure published by the insurance company.

My employer provides me with health insurance coverage. Is it advisable to take another policy on my own?

If the sum assured is good and the company is doing fine then you should think positive and do not go in for the additional sum. When you plan to leave the organization then you must verify from the new employer whether they have suitable sum assured available for you as part of compensation package. If no health insurance is available, then you must buy Health Insurance immediately so that 30 days cooling off period of the new policy (purchased by you) is matching with last 30 days with your employer. Try to have this health insurance from the same Insurance Company.

Will the agent be helpful in settling of claims in future?

Yes, your agent will be helpful. But he is getting 100% of his income from the insurance company and he may be getting .001 % of his income from you. If he has to make a choice, it is natural that he will favour Insurance Company. You are the best person to decide whether to buy directly from the company or through an agent. Theoretically, the agent is supposed to help you in claim settlement, but time will tell when the claim is to be lodged. Be positive and buy it through an agent but better buy through an Insurance Brokerage Firm as it offers a wider choice and is large enough to protect your interests.

How much should you invest in health insurance?

You have to invest according to your health the requirements and the resources you have. You can invest by deciding about your budget for health insurance. If your budget is not a constraint, you can invest by deciding about the sum assured and services required by you.

I might be laid off soon. Should I see my doctor before I lose my insurance?

No purpose will be served by seeing your doctor. You should consult an Insurance Brokerage Firm and buy a health insurance, the policy which should be issued at least 30 days before your last day in your present company. This protects your interest.

Will my health insurance coverage Clinical Trials?
We feel that if treatment is;
1. Part of hospitalization in a reputed hospital like AIIMS, capable of conducting clinical trials under controlled conditions.
2. Under the supervision of a reputed doctor
3. Medical Council (Ministry of Health) approves clinical trials

Then it will be payable. If it does not fulfill these conditions, then you may have difficulty in getting it paid as the issue is around treatment as well as the price of the medicine.

I own a pet and my vet bills are sky-high. Is there such a thing as health insurance for animals?

It depends on a pet. But definitely, it is not part of Health Insurance policy which is for human beings only. Cattle Insurance covers cow and buffalo.

Should I pay my premiums through the agent?

If he is ready to provide you with the service – yes. It is your duty that cheques should reach the insurance company well in time. Not picking up on the cheques by the agent is no excuse. If your cheque has not reached the insurance company on time, your policy may have a break and you may lose the benefits. You can also pay the premium online.

I already have a health insurance policy. Should I still buy a life insurance policy with the riders?

Health Insurance Policy covers your hospitalization needs. Life insurance covers your retirement needs. Adding of critical illness rider will take care of incidence of you getting a critical illness like cancer. Every product is different and fulfills different needs. Study it carefully and make a decision.

Are the new clinical and pathological tests, not available in India and done abroad covered under the mediclaim rules of the country? If no, are efforts being made to do?

Some insurance companies permit you to take the opinion. Your suggestion is very good, and we feel Insurance companies will start offering the same. If the Textile industry is permitted to get flammability tests done on garments in Hong Kong then why Insurance companies should not permit clinical and pathological tests (not available in India), which are to be conducted in the foreign country.

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