Health Coverage For Children 25 And Under And The Health Care Reform Act

If you have                           kids who are 25 years and under and you are wondering how they are going to take care of their health coverage, you are in the right place. Quite possibly your child, or young adult is just starting out in life, is college bound or getting out of college, and bouncing between jobs, better and worse jobs, especially in this economy. He has no idea how and where to get proper health coverage to protect himself financially. Many jobs do not offer insurance, colleges demand it, and health coverage prices keep going up.

But there is good news when it comes to baby and health coverage for children under 25. Included in the new health care law of 2010 there is a provision that will give many young adults a reprieve from needing to seek their own insurance in the individual health insurance market, but allow them to stay signed on with their parents on the family health insurance plan until the ripe age of 26. And there are a few other helpful provisions and new health and medical insurance options too.

In this article we will go over all the possible choices for a young adult, ages 19 to 26 to get health insurance for protection at this formative, critical, and risky age. We’ll consider getting health insurance benefits from their own employer at work, from their parent’s employer, in the private health insurance marketplace, from Medicaid, from the state based on income, and through the new federally instituted   existing condition insurance plan program.

Let’s look into the possibilities.

Getting health and medical insurance plan through a job. Even with employer’s costs rising this year for health insurance, getting an employer sponsored health insurance is still the best possible alternative for a young person. Likely, the employer will contribute part of the cost of the insurance, and offer choices between   HMO and possibly other types of coverage. Despite the possible relatively high monthly premium, this is clearly choice number one for a young adult. The insurance can kick in within weeks of person’s employment.

Getting health insurance through parents work. The new health care law has extended the eligibility for children to sign on to the parents job-based health insurance till the age of 26. Also, the conditions for a parent to claim the child are very mild, so this is a viable option for young adults whose parents are working in a job with benefits. A child will be able to sign on any time during the year. An interesting benefit of any insurance obtained through work is that it can not be declined due to the -existing condition of the child.

Getting individual insurance policy. A young adult without  -existing conditions can likely get a quite inexpensive insurance policy on an individual health insurance market place. However, chances are that a health questionnaire will have to be answered, and perhaps even a medical exam will be required as a condition for application. Despite the new health care law, persons ages 19-26 can be denied individual insurance if they have what an insurance company deems a  -existing condition.

State or federal government sponsored insurances, including   Medicaid and other income-based state insurances have been available for a while and the eligibility is mostly based on income of the applicant. A good time to apply is therefore at the time between the jobs. If, due to income, or otherwise, a young adult does not qualify for Medicare in their state, and they have been declined individual coverage due to  -existing condition, there is a way out: the new state, or federally run   -existing Condition Insurance Plan. Implemented following the new health care law of 2010, this plan provides an option whereby, at least until 2014, a person will be accepted into a reasonably-priced, high deductible, low  health insurance plan which will not reject an applicant due to a existing condition.

While long term costs and effects of these new plans are uncertain, young adults should take advantage of all of the above options that are available right now.




What Is Health Now?

The question                             in the title is a very important one, and I think all of us should have this question in mind and search for a complete answer. The truth is though, that we only ask about health when we have a serious problem. A official definition of health is given by The World Health who defined health in its broader sense in 1946 as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. For 1946 it was not a bad definition, but let’s face it, times have changed and life has evolved since then, so today we have 2 new aspects of health to consider: emotional health and spiritual health. If we take a step back and try to see the “big picture” we , for example if someone has an emotional problem it will cause physical problems, spiritual problems, mental problems and social problems too, so it’s very important to solve the problem when we first see it even if we don’t think that an emotional problem is important. In the incipient phase the emotional problem could be solved by simply talking to a friend, but if we let it develop it could need serious professional help. After this example I think you will want to know more about each aspect of health, so let’s see what they mean and how can we improve them.

Physical health – the first thing that comes to my mind when I think about perfect physical health are babies – they are the best example because they run all around the place and use their energy until they fall asleep. If we could do the same, I’m sure we would have a better physical health. A definition of physical health would be that it is a state in which all of the organs are functioning well 100% of the time, so in order for that to happen we have to give our body good nutrients, good exercise and enough rest. It may sound too simple, but it shouldn’t be more complicated than this.

Mental health – one good example for this is inventor Thomas Alva Edison, he tried and failed more thousand times to invent the light bulb, but he was strong enough mentally not to give up, and he eventually succeeded. Mental health is a state of well-being that allows you to reach your true potential and contribute to the community. It may seem strange for some of you, but actually helping others is the greatest thing that we can do and it keeps us happy and healthy, so in order to improve your mental health start by helping the people around you, I can tell you for sure that you will feel very good by doing so.

Emotional health – imagine a little girl on a Christmas evening opening her presents, that for me is an example of good emotional health, because gratitude and happiness are the healthiest emotions for us. I think emotional health is about feeling good, grateful, happy and not being afraid to share these emotions with all the people we interact with. A good way to improve our social health is by doing both physical and mental exercises that we like to do, for example if you like to play tennis and chess, please do so as often as you can.

Social health – the best indicator for social health is the ability to make friends. The social aspect of health is very important, because we are social beings and it’s scientifically proven that if someone is ill and their loved ones are with them, they recover faster than if they were to stay alone. A tip on how to improve your social health would be to understand the fact that “it’s nice to be important, but it’s more important to be nice”.

Spiritual health – is the most important aspect of health from my perspective because it influences all aspects of our health and often it is neglected. We have to take care of our soul as well as we take care of our physical body and the best way to do this is by meditation. Please don’t be scared if you don’t know what meditation is or how you can do it, because it’s a lot easier than you think, in fact you don’t have to do anything, just stay still and silent. If you can remain still and silent for 15 minutes a day and gradually increase this interval to an hour a day, it will have a great influence on your spiritual health and on your overall health too.




How Smoking Impacts Your Health Insurance Policy

It’s a well-known      fact that smoking causes an adverse effect on your health. You must have seen the warning message on all cigarette boxes – ‘Smoking is injurious to health’. Smoking tobacco is a root cause of 30% of all cancer deaths and causes 16 times higher risk of heart attack.

There are almost 120 million smokers in India. As per World Health   India accommodates around 12% of the world’s smoking population. The number of men smoking tobacco has increased from 78 million in year 1998 to 108 million in the year 2015. Tobacco consumption is accountable for the death of 6 million people each year. Direct tobacco consumption accounts for over 5 million deaths and 0.6 million deaths are due to exposure to second-hand smoke. Considering serious public health risks, the Government has banned smoking in public places from 2nd October, 2008.

Not only your health, it also causes you to pay higher premiums for a health insurance policy, due to increased health risks and shorter life expectancy. A nonsmoker however, gets premium discounts as a reward to lead a healthy lifestyle. Being a smoker, it is advisable not to hide your smoking habit from your health insurance company, as it helps you to cover the smoking-related health issues.

There is a wide curiosity among people, how smoking impacts the health insurance and its cost. Let’s educate yourself about smoking and its impact on health insurance policy.

Smoking – What It Includes

Smoking includes inhalation of of the smoke of burning tobacco in the form of cigarettes, cigars and  Whether you are an occasional smoker or frequent smoker, you will be considered as a smoker under the health insurance policy.

Smokers can buy health insurance, however an insurance company may charge extra premium or reject your application for insurance, depending on the number of cigarettes you smoke on a regular basis. A smoker may also have to go through additional health check-ups that can help an insurance company to ascertain the risk factor and then charge the premium amount accordingly.

How Smoking Affects Your Health and Insurance Premium

Smoking makes the serious impact on your health, some of them are detailed below.

Circulatory System: Smoking results in increased risk in the heartache and blood pressure. Building up of fatty acids could resulting to atherosclerosis.

Immune System: Smoking results in severe and long lasting illnesses. Smokers are more prone to develop ulcers, cancer, pneumonia, high blood pressure, bronchitis, and other viral/bacterial/fungal infections.

Respiratory System: Smoking may damage lung functions and breathlessness. It may cause damage to the air sacs of the lungs, increased chance of developing chronic bronchitis.

Oral Health: Smoking can lead to tooth loss, tooth staining, gum disease which may increase the risk of tooth decay.

Cancer: Smoking for a long time also causes cancer to various body organs.

When it comes to a health insurance policy, an insurance company considers the magnitude of illnesses and deaths caused due to smoking and that’s why, smokers need to pay higher premiums to avail health insurance cover. Typically, the insurance companies charge around 15 to 20 percent higher from a smoker policyholder. Those who smoke would need to undergo additional medical checks, before the insurer issues you the policy.

Let’s understand the difference of premium between a smoker and non-smoker individual.

(non-smoker) at 30 years of age buys an individual health plan with Rs 5  coverage, for 1 year policy term, the chargeable annual premium amount is Rs 4,656. However,   (smoker) is buying an individual health plan, he is charged with an annual premium amount of Rs 7,552. An increase in premium amount is only due to the fact that   lies in the smoker category of premium. We can see   is paying Rs 2896 extra on account of smoking.

Smoker with Existing Health Problems

If you are a frequent smoker that has caused the symptoms of the declining health condition and getting puzzled whether you can get a health insurance. The answer is yes, the only thing required is to make honest and proper disclosures.

The insurance company will then assess the risk associated with your profile and then decide on terms & conditions and the premium to be charged for providing you a health cover. The premiums charged will be higher and a waiting period will be applied for covering your  -existing diseases. Moreover, if you are seeking an immediate coverage on your deteriorating health condition, you may go for a critical illness policy.


Time Management for Physicians: 13 Ways for Hospitalists To Save an Hour

Your patient            list for the day is long, family meetings are scheduled, and you are starting your day 20 minutes late because the dog barfed on your kid’s homework. The triple latte you guzzled on the way in with a mountain dew chaser isn’t going to give you enough energy to get through the day. In addition, your pager is chirping like a manic parrot and your receptionist is waving a stack of messages at you as you stagger by, briefcase heavy with the charts and projects you optimistically thought you’d do.

Short of cloning yourself  Dolly the Lamb, what’s a conscientious doctor to do?  are extremely busy physicians, with large, high acuity patient loads and anxious patients and families. In order to be an effective, caring physician, you need to learn to manage your time.

Following are some tried and true time savers from actual physicians who walk in your shoes:

*Chunk your phone calls and family meetings: Set aside a specific time of day when you return phone calls, rather than interrupting your day constantly to talk to patients and family. It is entirely appropriate to tell a family that you will call at a certain time, and get a number where they will be. Try to do all your phone calls at the same time. A CEO of a company wouldn’t take calls at any given time and nor should you. This not only makes good time management sense, but is good patient care as well. If you have spent lots of time on phone calls before you have finished seeing your patients, you are potentially delaying timely patient care.

Delegate: as a physician, you have a certain skill set that you do best, just as nurses, ward clerks and medical assistants do. Focus on doctoring–let nurses and aides help patients get up and check vital signs. This is not to say that you shouldn’t help patients with daily needs, but remember, if you are consistently doing nurse’s aide duty, you are not doing physician duties.

*Watch chit-chat: Interaction with fellow doctors and staff is one of the things that make our days enjoyable, but watch that you aren’t hanging out at the ward clerk’s desk or in the physician lounge excessively.

*Use email: Use email when ever possible. This avoids endless telephone tag for non-urgent matters.

*Pages: When you are paged, respond to the page, and ask if anyone else wants to speak to you before hanging up. This decreases the amount of times you dial and wait for someone to come to the phone. This is especially important when dealing with the ED as frequently more than one doctor will be paging you at once.

*Charting: for pity’s sake, write legibly. That’s one less page you will get because you took the time to write   carefully so they didn’t call you to ask about the   dose. Carry admission paperwork around with you, so you are not searching for it.

*Computers: drink the  -Aid. Computers are here to stay and your secret war against them is unwinnable. Learn how to type (there’s typing programs you can do at home. My 9 year old learned to type this way, and so can you!) Learn all the short cuts you can on them to speed your charting.

*Computers: part II:  s are a great resource, but you can get sucked into finding TOO MUCH information. Did you really need to know that your patient lists as an allergy because she gets a milk   Once you have found what you need–STOP!

*Patient education: patients need to be educated by us all. Remember, studies have shown that patient material needs to be at the 5th grade level, with simple instructions. Save your long winded   explanation for your medical student and focus on the basics: “your heart doesn’t squeeze blood out very well but we have medicines that will help.” Enlist nurse educators–remember this is part of delegation!

*Start on time! Duh, but do it!

*Try NOT to multitask. Yes, do fill out a form if you are on hold, but don’t write orders while talking to a patient’s family on the phone. Focus on each task deliberately, and it will actually go much faster. Also, talk less and listen more, AND STOP INTERRUPTING! Conversations can be completed faster if you take the time to hear what the person is saying, rather then readying your response, or thinking about something else.

*Patient exams: pay attention to what you are doing. Listen to the lungs, not your pager going off! Ask the   while examining the patient. To bring the meeting to a close, ask if the patient/family has any concerns or questions. When they respond, answer accordingly, and ask “Anything else?” and then stand up and shake hands. Tell them you are available if needed and the nurse can page you if any issues arise.

*Take a break. Get a cup of tea, rest your brain and calm your senses for at least 5 minutes every two hours. Go to the bath room if you need to! A refreshed physician is much more efficient then a frazzled one.




Family Practice Doctor – How To Get One Good Enough For Your Family

Getting a good family             practice doctor requires you to consider a few issues. One of the most profitable avenues to go down with your research is consulting with a physicians review service. These types of services have become of increased importance over the past few years. In the past, it was difficult for patients and customers to get adequate information about potential medical professionals. Today, however, there are many potential service providers that pride themselves on offering unbiased reviews of physicians as well as other information that can help the decision making process of a patient. There are many things to keep in mind when consulting with a doctors review service.

Choosing a family practice doctor is a difficult process. One benefit of using a ratings service is the range of opinions offered about a potential MD. Many service providers make sure that they offer   and intensive information that is easy to access and decipher. Finding a service provider that offers more than one opinion about a potential doctor can be of great benefit. When you are exposed to the opinions of many different patients that have had different experiences with a physician, you can build an unbiased knowledge of that doctor’s strengths and weaknesses. Be sure to consider the amount of information a service offers about your potential physician, because the more information you have access to, the more informed your decision will be.

Another thing to consider when using a review service to choose a family practice doctor is the qualifications of a patient as a medical practice critic. There are many differing opinions on this issue. Some doctors and others contend that patients are not qualified to adequately review a doctor’s treatments. Some argue that it is difficult to assess the quality of health-care delivered in traditional ways, and that a patient lacks the training and expertise to do so effectively. Many also note that a failure of treatment could be attributable to many different factors. However, some doctors and patients feel that rating services are a good idea. Having access to the opinions and testimonials of patients can be of great benefit to a person who is choosing a physician. Using this information can help you choose the right health-care option for your loved ones.

A further concern when choosing a family practice doctor is the level of receptivity this physician has to criticism. By consulting a physician review service you may be able to build a more informed picture of the physician you may choose. Some patients may be able to offer insight into some aspects of the physician’s personality that will inform your decision. Also, some patients may provide information about the physician’s receptivity to criticism. If the rating service you use is highly trafficked, then it will be more likely that the physician you are researching is affected by this shared criticism. Many physicians embrace this medium as a way to more directly and effectively treat their patients. If, for example, a patient discusses failures in customer service, the physician can use this information to target that aspect of his or her business and improve it.




Insulin Update: Just the Facts

Research has shown        that tight glycemic control is beneficial to all patients in hospital, speeding up recovery and producing positive outcomes. The use of insulin during hospitalizations has increased, (including temporary use with non-diabetic patients). The variability of types of insulin available has increased since the development of synthetic products more than 30 years ago. Nurses need to be aware of the various types of insulin that are available, and how they work.

Rapid-Acting Insulin
Rapid-acting insulins are most commonly used with hospitalized patients. They are based on sliding scales to quickly correct blood sugar levels or provide coverage during meals. Short-acting insulins were previously common in hospitals, but have a longer onset than the rapid-acting variety. Intermediate-acting insulins are used in combination with rapid or short-acting insulin. The intermediate category provides coverage for approximately half a day. The long-acting insulins provide a basal coverage for about a day.

Rapid-acting insulin includes ®). The onset of action for these rapid-acting insulins is between 10-30 minutes, with a peak action time range of 30-90 minutes after administration. These insulins last for about 1-5 hours, depending on the brand used. Rapid-acting insulin acts by rapidly correcting hyperglycemia, and are designed for mealtime coverage. Thus patients must eat immediately after administration. Rapid-acting insulin should be used together with long-acting insulin to provide better hyperglycemic control.

Short- and Intermediate-Acting Insulin
Short-acting insulin is Regular (R) insulin  ). The onset of action is 30 min -1 hour, and the peak action time is 2-5 hours after administration. Regular insulin lasts for about 5-8 hours and provides coverage for meals consumed within 30-60 minutes after administration. The “R” with the insulin name helps identify it as Regular.

Intermediate-acting insulin includes NPH (N) and  (L) insulin. The onset of action is between 1-2 hours, and levels peak 3-12 hours after administration. The duration of action is between 18-24 hours. This type of insulin provides coverage for up to half a day or overnight, and is usually used in combination with rapid or short-acting insulin. If the insulin has an “N” in the brand name, this indicates it is NPH.

Long-Acting Insulin
Long). This insulin group has an onset of action between 1-2 hours and a peak action time that varies between 6-20 hours. Note that Lantus® does not peak, but provides a steady level of insulin throughout the duration time. Total duration of action is anywhere between 20-36 hours. Long-acting insulin provides basal coverage for about a day, and is usually used in combination with rapid or short-acting insulin. Also note that Lantus® cannot be mixed with any other insulin, and should be injected in a separate site.

It used to be common to have a patient with short-acting and intermediate-acting insulin. Treatment has shifted to using rapid-acting and long-acting insulin for patient therapy to address both immediate and daily insulin needs. Mixed insulins are combinations to provide daily insulin coverage; these should be reviewed prior to administration.

For more information on insulin and diabetes, the American Diabetes Association (ADA) is a good resource for nurses, patients and families. Two diabetes courses are available at Diabetes Overview is a general course that includes information about Type 1, Type 2 and Gestational Diabetes; An Overview of Patient Management Issues in Type 2 Diabetes covers new treatment modalities, an overview of management principles, blood glucose monitoring devices, an overview of insulin administration and the use of oral hypoglycemic drugs.

American Diabetes Association. (2011). Insulin basics. Retrieved from