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Time for Support 2 months ago, my left shoulder got dislocated in an accident. After my MRI, every doctor confirmed that I need surgery. Yesterday, I was supposed to be admitted, but Star Health And Allied Insurance rejected my cashless claim. They had already rejected it once before, and...

30,278 views • 28 days ago •via X (Twitter)

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American got the only health insurance she could afford for her family of 5, the cheapest plan was $2,000 per month She is learning every appointment she’s going to would have been cheaper to just do the cash pay option “$2,000 a month is paid before any person in my family walks through the door of the doctor's office and breathes the air in the room. $2,000 on top of that, my particular plan through Aetna has a $6,500 deductible, meaning I have to pay $6,500 before they cover anything.” She went to the ER and needed scans “When I show up and check in for the MRI, they tell me that I need to pay my portion, which is $960 to get the MRI that day, $960 — I turned around and said, out of curiosity, how much would this have cost me if I hadn't run it through insurance? Do you know what? Her answer was? About $400. So if I don't have insurance, it's $400, but if I do have insurance, it's $960” “Then my ER bill showed up yesterday. They would like $1,760 for my one hour visit, and by the way, $965 of that total was for two x-rays. So I called the billing department and I asked again, what would this have cost me if it was self-pay, if I didn't have insurance? She said About $1,200” “So again, without insurance, $1,200 with insurance, $1,760. And remember what I said in the beginning, I am already paying $2,000 a month just to have insurance —Why does having medical insurance make healthcare more expensive? I would love to hear your answers” US Health Insurance is a scam

Wall Street Apes

165,873 views • 4 months ago

This is yet another instance of private health insurers going back on their commitments. Many middle-class citizens are increasingly turning to private health insurance providers as a critical lifeline for themselves and their families. These plans boast of a robust coverage and hassle-free claims, while charging customers exorbitant premiums. But when insurers fail to honour genuine claims, it leaves citizens vulnerable and puts a Question mark on the safety net of health insurance. As per information given by the IBAI (Insurance Brokers Association of India), the best performer in the Claims Paid Ratio (The total number of claims paid divided by the total number of Claims available for processing) was New India (Public Sector General Insurers) with 95.04%, followed by Aditya Birla Health (Standalone Health Insurer) at 94.52%. Other Large General Insurers such as IFFCO Tokio, Bajaj Allianz, SBI General have claims paid ratio of 91.70%, 90.29% and 88.86%. Other Standalone Health Insurers such as Niva Bupa, Manipal Cigna and Care Health have around 88% claims paid ratio. However, if one takes a look at the Claims Paid Ratio on the Amount of Claims (The Total amount of Claims paid divided by the Total amount of Claims available for processing), New India, Oriental Insurance, National Insurance - all public sector - have impressive ratio of 98.74%, 97.35% and 87.95%. The same for Standalone health insurers Aditya Birla Health, Niva Bupa, Manipal Cigna, Care Health and Star Health are all less than 71%. Similarly, the Health Claims Paid Ratio based on the amount for Small Private Sector General Insurers such as Liberty General, Acko, Zurich Kotak & Royal Sundaram reflect poorly. This is not to target anyone, but highlighting the need for better regulation and grievance redressal for the customers. After all, in the 2022-23 period, the health insurance sector issued 2.26 crore health insurance policies. And these policies provide coverage to an impressive 55 crore individuals. But not even one private insurance provider reported payment of more than 90% of the amount claimed and only 3 paid more than 80% of the amount claimed in 2022-23. During a Zero Hour discussion on December 4, 2024, I had raised the need for fair claim settlements for the citizens of the country relying on health insurance. I once again urge IRDAI to look into this issue and rein in such unethical practices. Ministry of Finance Ministry of Health

Tejasvi Surya

241,961 views • 1 year ago