Tuesday, May 31, 2005

One name for 2 villains!

The term diabetes stands for two rather different diseases. Type I diabetes cannot be prevented and usually shows up in early childhood. The body’s immune system develops a genetic habit of attacking the pancreas and preventing insulin production. All that parents can do is to make sure that a child with Type 1 diabetes gets insulin in time and that diet and exercise are tightly controlled. Children with this disorder are at risk of being mentally scarred as they cannot always do the same things as their peers: enjoying a simple ice-cream or similar treat is an example. Nevertheless a Primary Care Physician can set out a program by which a child with this disease grows up almost normally and has an excellent quality of life, full of achievement and success. Halle Berry, the striking actress of James Bond fame, is a Type 1 Diabetes sufferer.

Type II diabetes is a different cup of tea. It arises because obesity and a couch-potato attitude to life prevent insulin from doing its job. The condition is largely reversible, or can be mitigated to a significant extent by shedding extra kilos and exercising regularly. These things while easy and innocuous need a doctor’s supervision as some delicate balances between the heart, kidneys and other organ functions are involved. Type II diabetes is one of the diseases that modern medicine can manage best, even when medication has to supplement diet and exercise. However such medication can be expensive and can inflate Health Insurance costs. Diabetes has no cure as yet, so the expenses continue ad-infinitum throughout life.

Diabetes regardless of its type has profound influence on Health Insurance benefits.

Some things to check during open enrollment or when changing jobs:

1. Is there a window during which a pre-existing condition of diabetes is not covered by a policy?

2. Is the Health Insurance Company’s plan legally valid in the State where you live, in terms of exclusions for some kinds of expenses for diabetes management?

3. Do co-payments suit you better than a high premium or would you rather pay once a month or a quarter?

4. How do alternate products stack up in terms of expenses for diabetes management that are not covered at all?

5. Does your Primary Care Physician believe that anyone in your family could develop glucose intolerance during the coming year?

Lifetime limits on Health Insurance benefits are other key concerns when it comes to chronic diseases such as diabetes. It is never too late to start planning for the well-being of your loved ones and yourself. It is never premature to plan ahead for the foreseeable future, though the probabilities of some very grave occurrences are hopefully low.

Web www.healthinsuranceguide.blogspot.com

Sunday, May 29, 2005

Mental Health Questions to Ask During Open Enrollment

  1. Who decides whether my family and I need a Mental Health benefit? Can I see a Clinical Psychiatrist or a Behavioral Psychologist on my own, or is coverage limited to a referral by my Primary Care Physician? How trained is the latter in diagnosing early stages of Mental Disorders? What if some physical symptoms have roots in the state of mind? Consider children as a special case as they may not express anxiety and related conditions in a manner to which adults, other than specialists, are accustomed.
  2. How often can my family and I seek counsel and consultation? Are there limits on the number of visits per year? Are there some Mental Health disorders that are not covered or for which reimbursement and benefits are restricted? Are there exclusions for pre-existing conditions?
  3. Who are the Mental Health Professionals in the local HMO? How much must I pay if I choose a specialist who I would like to consult? Is a child psychiatrist a part of the network to which I plan to subscribe? What are the credentials and track records of the doctors on whom I must rely for all of the next year, when it comes to Mental Health concerns?
  4. Do doctors I choose to manage my Mental Health and that of my family have to send reports to My Health Insurance Company? Will such disclosure protect my rights to privacy? Whose view will prevail in the event of professional disagreement on diagnosis and course of treatment? What if I am dissatisfied with the network doctor?
  5. Is there a window after I enroll, during which I have to pay for Mental Health services on my own? What are the dimensions and scope of such financial liability? What kinds of expenses related to treatment of Mental Health disorders are not covered in full? Will my policy pay for respite care and hospitals, apart from consultation and medicine? What if someone needs specialized care?
  6. What are the annual and lifetime limits on how much can be spent on Mental Health? Are these adequate for the particular needs of my family and myself? How will I cope if unfortunately someone who depends on me becomes acutely or chronically ill in terms of Mental Health and needs expensive care on an on-going basis?

These questions are not hypothetical and impact severely on your critical Mental Health interests. Read a heart wrenching story on how the Texas legislature has ruled against Mental Health benefits for common people and the devastating effect this can have on families.

The fine print on a Health Insurance Policy may leave you in doubt about the scope and extent of benefits to which you are entitled. Ask questions of professionally trained Agents and choose a Policy only after you have understood the ramifications. Keep children in particular focus and read authentic sources to understand the special Mental Health needs of young people.

Improve your understanding and knowledge of Health issues and visit and voice your concerns

Web www.healthinsuranceguide.blogspot.com

Thursday, May 26, 2005

Which tests and treatments for ovarian cancer does your health insurance policy not cover?

That is quite a mouthful of a question! Do you know the answer?

Ovarian cancer is amongst the more difficult to detect. That is a pity because this condition is so easy to nip in the bud, yet so pervasive and threatening if left undetected for some time. Some women are more vulnerable than others. Visit


for useful information on ovarian cancer.

Detection and treatment methods keep getting better and you should use open enrollment to ensure that the women in your family, including you if you are one, are adequately covered for all the protection that you can get against this insidious condition.

www.healthliteracy.blogspot.com has more on how you should plan for open enrollment each year.

You should also take a look at http://www.patientadvocate.org/index.php?p=108

for help and advice related to insurance, funding and your rights related to ovarian cancer detection and treatment.

Ovarian cancer is an important example of the kind of considerations that should go in to choosing a health insurance policy. Remember that your Primary Care Physician in an HMO or chosen Healthcare Provider in a PPO is an important authority in all matters related to health and you must not take steps or actions related to wellness without consulting them in advance.

Web www.healthinsuranceguide.blogspot.com

Tuesday, May 24, 2005

Reliable Single-Window Health Insurance

Not all of us are doctors and perhaps the very thought of medicine and doctors upsets us!

What if you want hassle-free health insurance? Pay once a month, or even once a quarter and sit back and let experts look after your health.

An HMO or Health Maintenance Organization does this for you. The steps are simple:

  1. Enroll in a plan*
  2. Choose a Primary Care Physician. This could be a Family Doctor or a Specialist, depending upon your family circumstances.

That’s it! Just 2 steps and you are covered for a year until the next open enrolment. The Primary Care Physician takes care of all your medical treatment needs. He or she will refer you to specialists when needed. These doctors would most often be part of the HMO network, but never at the cost of your best interests. You could see a specialist who is not part of your HMO is your condition requires such consultation.

Co-payments are typically $5-10 per visit and your premium covers everything you need by way of visits, tests, medicine and hospitals. It is not so much a matter of money or convenience as the reassurance that a professional Primary Care Physician takes responsibility for your medical care.

There is one thing though-you are responsible for accepting exclusions from your policy. Do you plan to start or to expand your family? Do you want to pay for coverage of even unlikely illnesses that could strike or do you prefer an economical product that protects you against common and likely expenses only. These are choices that only you can make. You have to do this during open enrollment. Visit the site linked below for more information:


Web www.healthinsuranceguide.blogspot.com