Care Health Insurance, formerly known as Religare Health Insurance, operates as a key player in the Indian health insurance market, established in 2012. The company strategically offers a diverse portfolio of health insurance products, targeting various segments including individual retail, family units, and corporate groups. Their product strategy encompasses a wide array of plans, such as individual health insurance, family floater policies, specialized coverage for senior citizens, maternity benefits, and critical illness riders, alongside niche products addressing specific health conditions like cardiac and diabetic care. A significant operational strength lies in their extensive nationwide network of empanelled hospitals, providing a crucial value proposition of cashless access to healthcare services. The company emphasizes efficient claims management as a core operational metric. From a market perspective, Care Health Insurance competes on product breadth and network reach. Their business model incorporates features like automatic sum insured recharge and no claim bonuses to enhance product attractiveness and customer retention. Strategic partnerships with healthcare providers and efficient underwriting processes are vital to their operational success. Like industry peers, they navigate regulatory requirements and manage risk through defined waiting periods for certain conditions. Overall, Care Health Insurance has established itself as a significant entity in the Indian health insurance landscape through a multi-segment product strategy and a substantial healthcare provider network.

Latest News on Care Insurance

Health insurance rates are skyrocketing due to several factors. Firstly, the increasing cost of medical care and services is a major contributor, as healthcare providers and facilities raise their prices to keep up with rising operational costs. Additionally, the growing prevalence of chronic diseases, such as diabetes and heart disease, leads to higher treatment costs, which are then passed on to policyholders through increased premiums. Furthermore, the rising cost of prescription medications, particularly specialty drugs, also plays a significant role in driving up health insurance rates. The impact of an aging population, with older adults requiring more frequent and costly medical care, is another factor contributing to the upward trend in health insurance costs. Moreover, the decreasing number of insured individuals, particularly among younger and healthier populations, leads to a smaller risk pool, causing premiums to rise for those who remain insured. Regulatory changes and mandates, such as the Affordable Care Act, have also had an impact on health insurance rates, as have the costs associated with administrative and regulatory compliance. Lastly, the fluctuating healthcare market and the consolidation of healthcare providers and insurers have led to reduced competition and increased costs, ultimately resulting in higher health insurance rates for consumers.

Open enrollment for health care plans has begun, allowing individuals to enroll, renew, or change their plans for the upcoming year. However, many people will experience sticker shock due to rising health care costs. According to Beth Umland, director of Employer Research for Health and Benefits at Mercer, the total health cost of health benefits is expected to increase by 6.5% next year, the highest increase in 15 years. This means that employees will likely see higher paycheck deductions as employers shift more health care costs to them.

The increased costs are driven in part by the use of weight loss drugs, such as GLP-1s, which are contributing to higher prescription drug spending for some larger firms. A survey by the non-partisan health policy research group KFF found that many employers reported higher-than-expected spending on these drugs. As a result, consumers can expect to pay more for healthcare services and goods, with the same services costing more than they did last year.

For individuals who purchase health care plans through the Affordable Care Act (ACA), the situation is even more dire. If the enhanced tax credits expire, premiums could more than double next year. Michelle Mazur, a small business owner, is facing a difficult decision as her family’s premiums could increase from $650 to $1,900-$2,000 per month for the same plan. To cope with the increased costs, Mazur may have to re-enter the workforce or have her husband come out of retirement.

To navigate the rising costs, consumers are advised to carefully review their options during open enrollment. Umland suggests that people should focus on selecting a health plan, rather than rushing through the process. By taking the time to compare plans and consider different options, individuals can make informed decisions about their health care coverage and potentially mitigate the impact of rising costs. Ultimately, consumers will need to be proactive and diligent in order to find affordable health care options in the face of increasing costs.

A tug-of-war is brewing over cashless health insurance, posing a potential threat to policy holders.

A recent standoff between hospitals and health insurance providers in India has raised concerns among policy-holders about the availability of cashless health insurance services. The Association of Healthcare Providers of India (AHPI) had advised its member hospitals to suspend cashless services provided by Bajaj Allianz, citing issues such as abrupt stoppage of services, delays in empanelment, payment disputes, and questioning of clinical decisions. The General Insurance Council (GIC) responded by calling out AHPI’s “sudden unilateral action” as creating confusion among policy-holders and denting trust in the health insurance ecosystem.

The hospitals’ concerns center around the cashless authorization process, where items like implants are left open, and costs are disputed at payment time. They also claim that insurance companies have not revised treatment rates for years, despite medical inflation, and use collective bargaining to pressurize hospitals to comply. On the other hand, health insurance companies are unhappy with hospitals over higher charges and unreasonable treatments, and are calling for a strong healthcare regulator to standardize treatment protocols and rates across hospitals.

The GIC points to initiatives like “cashless everywhere” as efforts to ensure patients get treated without financial stress, but admits that there is no apex body for them to lodge complaints of higher charges or unreasonable treatments by hospitals. Insurers say that standardization of rates across treatments at hospitals under all insurance companies could eliminate overcharging and bring down medical inflation, which is currently pegged at 12-14 percent.

The standoff has left policy-holders worried about making hefty upfront payments to admit a patient, despite having paid high health insurance premiums. While hospitals will still treat patients and insurance companies will still reimburse payments, patients will have to bear the brunt of making the initial out-of-pocket payment. The issue is not limited to Bajaj Allianz, as AHPI has raised similar issues with Care Health Insurance, and there are concerns that it could escalate to more hospitals not accepting cashless insurance.

Internal discussions are underway for a possible meeting between AHPI and GIC to resolve the outstanding issues, with the expectation of finding a workable mechanism to address the concerns of both parties. Health insurers expect hospitals to agree to come under common empanelment to provide cashless treatment to patients. The patient trust in hospitals and healthcare insurance has suffered, and it remains to be seen how the issue will be resolved to ensure that policy-holders can access cashless health insurance services without hassle.

Millions of people are facing sharply increasing health insurance premiums due to the GOP’s refusal to extend subsidies under the Affordable Care Act, also known as Obamacare.

The US federal government shutdown has entered its 28th day, with Democrats demanding that Republicans agree to extend healthcare subsidies from the Affordable Care Act that are set to expire. If Congress does not act, health insurance premiums are expected to more than double for 20 million people. Dr. Steffie Woolhandler, a distinguished professor of public health at Hunter College-CUNY and co-founder of Physicians for a National Health Program, explains that the purpose of healthcare has become profit-making rather than a public service.

The enhanced subsidies, which were put in place during the pandemic, are a crucial lifeline for many Americans who rely on the Affordable Care Act for healthcare coverage. However, Republicans have refused to extend these subsidies, leading to a standoff with Democrats who are refusing to vote to end the shutdown until the subsidies are extended. Dr. Woolhandler notes that this is just one example of how the Trump administration and Congress are prioritizing the interests of private insurance companies over the needs of the American people.

The refusal to extend the subsidies will affect not just Medicaid recipients, but also small business owners, the self-employed, and middle-income individuals who rely on the Affordable Care Act for coverage. Additionally, the Trump administration’s cuts to Medicaid will have far-reaching consequences, affecting not just the poorest Americans but also community hospitals and rural healthcare providers.

Dr. Woolhandler also criticizes the Medicare Advantage program, which she says is a “giant waste of money” that has raised costs to taxpayers by $80 billion last year alone. She argues that the program is a mistake and that the US should be moving towards a single-payer Medicare for All system, similar to those found in other developed nations.

In a global context, the US stands out for its high healthcare costs and poor health outcomes. Dr. Woolhandler notes that every other developed nation has some form of national health insurance or national health service, and that these systems have been more effective at guaranteeing universal access, making healthcare affordable, and controlling costs. She argues that the US needs to move towards a single-payer system, and that this is the vision that Senator Sanders and others have put forward.

Overall, Dr. Woolhandler emphasizes the need for a fundamental transformation of the US healthcare system, one that prioritizes people’s health over profits. She argues that the current system is unsustainable and that the US needs to learn from the experiences of other countries and move towards a more equitable and effective healthcare system.

The Business of Better Healthcare

The United States is facing a perfect storm that is driving healthcare costs to unprecedented levels. The country’s healthcare system is plagued by a combination of factors, including high drug prices, administrative waste, and rising hospital costs. These factors are contributing to a significant increase in healthcare spending, making it difficult for individuals and families to afford medical care.

One of the main drivers of high healthcare costs is the increasing price of prescription medications. The cost of drugs has skyrocketed in recent years, with some medications costing thousands of dollars per month. This has made it challenging for patients to afford the treatments they need, particularly for chronic conditions such as diabetes and cancer. The high cost of drugs is also affecting the overall cost of healthcare, as insurance companies and government programs are forced to pay more for medications.

Another factor contributing to high healthcare costs is administrative waste. The US healthcare system is complex and bureaucratic, with a significant amount of time and resources spent on administrative tasks such as billing and paperwork. This waste is estimated to cost the healthcare system hundreds of billions of dollars per year, which could be better spent on patient care. The administrative burden is also affecting healthcare providers, who are spending more time on paperwork and less time with patients.

The Affordable Care Act (ACA) marketplace has also played a role in the increasing cost of healthcare. While the ACA has provided health insurance to millions of Americans, it has also led to higher premiums and deductibles for many individuals and families. The high cost of healthcare is also affecting hospitals, which are facing financial pressures due to the increasing cost of providing care. Many hospitals are struggling to stay afloat, particularly in rural areas where the patient population is smaller and less profitable.

The rising cost of healthcare is having a significant impact on the US economy. Healthcare spending accounts for a significant portion of the country’s GDP, and the increasing cost of care is affecting businesses and individuals alike. The high cost of healthcare is also affecting the overall health and wellbeing of the population, as individuals are forced to choose between paying for medical care and other essential expenses. To address the issue of rising healthcare costs, policymakers must take a comprehensive approach that addresses the root causes of the problem, including high drug prices, administrative waste, and the increasing cost of hospital care.

A CRPF officer’s relentless battle with an insurance company for his autistic son’s treatment was a difficult and trying experience. The officer’s fight was not just about securing coverage, but also about ensuring his child received the necessary care and support. Despite the challenges, the officer persevered, driven by his determination to provide the best possible life for his son. The outcome of this struggle ultimately led to a resolution, with the insurance company covering the costs of the child’s treatment, making hospitalization unnecessary.

In India, the decision to hospitalize a patient is increasingly being made by health insurance companies rather than doctors. This was the experience of Syam Krishna, a 34-year-old Assistant Commandant in the CRPF, whose four-and-a-half-year-old autistic son, Samarth, fell critically ill in a remote town in Meghalaya. Afterinitial consultations at the local district hospital, Samarth’s condition worsened, and his parents decided to take him to a hospital in Guwahati, a six-hour journey away.

At Apollo Excel Care Hospital, doctors found Samarth’s condition serious enough to warrant immediate admission, and he was treated for viral fever with dehydration. However, when Syam submitted a cashless claim to Care Health Insurance, the insurer rejected it, stating that hospitalization “was not required.” The company claimed that Samarth’s admission was only for evaluation, not treatment, and questioned the family’s claim history, insinuating possible misuse of the policy.

Syam felt cheated and stressed that he and his wife, Spoorthi, had followed the doctor’s medical advice and had no choice but to consult the local hospital first. He argued that the insurer’s decision was wrong and that they were being penalized for making genuine claims in the past. The family eventually approached the Insurance Ombudsman, who ruled in their favor, stating that the denial of the claim was “totally unwarranted and defies logic.” The insurer was ordered to pay the claim amount of Rs 42,907, along with 7.25% interest.

This case highlights a larger issue in India’s health insurance ecosystem, where policyholders often face procedural hurdles and emotional exhaustion despite following every required step. According to the IRDAI Annual Report for FY2023-24, health insurers rejected or disallowed claims worth over Rs 26,000 crore, an increase of around 19% from the previous year. The case also raises questions about the balance of power between insurers, hospitals, and policyholders, with industry observers noting that disputes between insurers and hospitals over the necessity or cost of treatment are common.

Syam’s experience reflects a pattern of claim denial, where insurers often cite inflated billing and non-essential admissions, while hospitals defend their decisions as clinical judgment. In the end, it is often the policyholder who bears the uncertainty and delay. Syam’s story is part of a larger series highlighting cases where individuals and families have faced undue health insurance claim rejections, and it serves as a warning to others to be aware of their rights and to fight for them when necessary.

Recent Updates

A healthcare compromise appears to be nowhere in sight as the shutdown continues.

The government shutdown has reignited the debate over the future of the Affordable Care Act (ACA), also known as Obamacare. The tax credits for people who get health insurance through the ACA marketplaces are set to expire at the end of the year, and Democrats are refusing to vote to reopen the government until Republicans agree to extend the subsidies. Republicans, on the other hand, are insisting that Democrats vote to reopen the government before they will negotiate on the issue.

The ACA, passed in 2010, aimed to decrease the number of uninsured people in the country and make coverage more affordable. In 2021, Democrats expanded premium help during the pandemic, which led to a record 24 million people signing up for insurance coverage through the ACA. However, if the tax credits expire, annual out-of-pocket premiums are estimated to increase by 114%, or an average of $1,016, next year.

Democrats are pushing to extend the subsidies, with some suggesting a permanent extension, while others are open to a shorter period. Senate Democratic leader Chuck Schumer has repeatedly called for a “serious negotiation” on the issue. Republicans, on the other hand, are trying to scale back the ACA, with some wanting to scrap the expanded subsidies and overhaul the entire law. Others have proposed more modest changes, such as lowering income limits and stopping auto-enrollment.

Despite the public stalemate, lawmakers are feeling increased urgency to find a solution as the November 1 open enrollment date approaches. Some Republicans, such as Senator Josh Hawley, are open to extending the subsidies, and bipartisan groups of lawmakers have been discussing potential changes, including income limits and making the lowest-income people pay very low premiums instead of nothing.

A recent poll found that about 6 in 10 Americans are “extremely” or “very” concerned about their health costs going up in the next year, with worries extending across age groups and including people with and without health insurance. The poll highlights the importance of finding a solution to the issue, and lawmakers are under pressure to act before the subsidies expire.

As the shutdown continues, lawmakers are exploring potential compromises, including extending the enrollment dates for the ACA. Democratic Senator Jeanne Shaheen has been talking to lawmakers since the shutdown began, trying to find areas of compromise. With the clock ticking, it remains to be seen whether lawmakers can find a solution that satisfies both parties and avoids a significant increase in health care costs for millions of Americans.

Illinois residents are facing a significant increase in their Affordable Care Act (ACA) health insurance premiums, with a substantial 78% hike.

Illinois residents who purchase health insurance through the Affordable Care Act (ACA) marketplace are facing a significant increase in premiums for 2023. According to recent reports, premiums are expected to rise by an average of 78% across the state. This substantial hike is likely to affect over 300,000 Illinoisans who rely on the ACA marketplace for their health insurance coverage.

The main driver behind this increase is the expiration of temporary subsidies provided by the federal government during the COVID-19 pandemic. These subsidies, which were part of the American Rescue Plan Act, helped keep premiums low for many consumers. However, with their expiration, insurance companies are now raising their rates to account for the increased costs.

The 78% average premium hike is a statewide average, with some areas experiencing even higher increases. For example, residents in certain parts of the state may see their premiums rise by as much as 100% or more. This will undoubtedly put a significant strain on many households, particularly those with lower incomes who may struggle to afford the increased costs.

The Illinois Department of Insurance has approved the rate increases, which will take effect on January 1, 2023. The department notes that while the increases are substantial, they are still lower than what insurance companies had initially requested. Nevertheless, the hikes are likely to have a significant impact on the state’s healthcare landscape.

To mitigate the effects of the premium increases, the state is encouraging residents to explore their options and shop around for coverage during the open enrollment period, which begins on November 1. Additionally, some consumers may be eligible for financial assistance, such as subsidies or tax credits, to help offset the increased costs.

The premium hikes in Illinois are part of a broader national trend, with many states experiencing significant increases in ACA marketplace premiums. The increases highlight the ongoing challenges facing the US healthcare system, including rising healthcare costs and the need for affordable, accessible coverage. As the open enrollment period approaches, Illinois residents are urged to carefully review their options and seek assistance if needed to ensure they have adequate and affordable health insurance coverage in 2023.

Here is why health insurance rates are skyrocketing

Open enrollment for health care plans has begun, and individuals can expect to face significant increases in costs. According to Beth Umland, director of Employer Research for Health and Benefits at Mercer, the total cost of health benefits is projected to rise by 6.5% next year, the highest increase in 15 years. This means that employees can expect to see higher paycheck deductions as employers shift more health care costs to their staff. The same health care services and goods that were purchased last year will now cost more.

A survey by the non-partisan health policy research group KFF found that the use of weight loss drugs, such as GLP-1s, is driving up costs for some larger firms. Many employers reported that their spending was higher than expected, with GLP-1s making up a significant portion of their prescription drug spending. This increase in costs will likely be passed on to consumers.

Marketplace customers who purchase health insurance through the Affordable Care Act (ACA) may also see significant premium increases if the enhanced tax credits expire. For example, Michelle Mazur, a small business owner, is facing a potential premium increase of over 200%, from $650 to $1,900-$2,000 per month for the same plan. This would force her to make tough choices, such as re-entering the workforce or having her husband come out of retirement.

To navigate these increased costs, consumers are advised to carefully review their options during open enrollment. Umland suggests that people should spend more time selecting a health plan than they would picking out a television. By carefully considering all available options, individuals can make informed decisions about their health care coverage and potentially mitigate the impact of rising costs. It is essential for consumers to be proactive and take the time to understand their health care options to avoid sticker shock and make the best choices for their needs and budget.

Tata AIA Introduces ‘Shubh Family Protect’

Tata AIA Life Insurance Co. Ltd. has launched a new term plan called Tata AIA Shubh Family Protect, which offers a unique combination of an immediate lump-sum payout and a flexible monthly income for up to 30 years. This plan is designed to provide comprehensive financial protection for families in the event of a sudden loss of a loved one. The plan understands that a large lump-sum payout can be difficult to manage, especially during a time of emotional devastation, and instead offers a thoughtful solution that combines a lump-sum amount with a steady monthly income.

The lump-sum payout can be used to cover immediate expenses such as funeral costs, debts, and other urgent needs, while the monthly income provides a consistent financial cushion for the family to move forward with confidence. This approach ensures that the immediate financial needs are covered, and the family can focus on rebuilding their lives without worrying about running out of resources. The plan is particularly useful for families with dependents, such as elderly parents, spouses, and children, who may rely on the deceased for financial support.

The plan’s features include the ability to nominate multiple beneficiaries, ensuring that everyone who needs support is taken care of. This prevents confusion and disputes during an already difficult time and ensures that each dependent receives the support they need in a manner that suits their unique circumstances. The plan also offers 0% GST, making it more accessible and affordable for families.

Tata AIA Shubh Family Protect is designed to provide peace of mind, stability, and long-term security for families. It allows them to continue living their lives without the financial strain that can often accompany a sudden loss. The plan is a powerful tool for those who want to secure their family’s future without the burden of additional costs. By thinking through the needs of each family member, Tata AIA has redefined what it means to provide protection, ensuring that the life lived by the loved one is honored through long-term security for those left behind.

The plan’s benefits can be seen in various scenarios, such as elderly parents who can use the lump-sum payout to cover medical expenses and the monthly income to sustain their daily needs. A wife left behind can use the monthly income to continue managing the household and taking care of her children, while children can continue their education without interruption. Overall, Tata AIA Shubh Family Protect is a game-changing term plan that offers a unique and thoughtful solution for families seeking comprehensive financial protection.

The shutdown’s looming health care cliff – Politico

The ongoing government shutdown is posing a significant threat to the US healthcare system, with a looming “health care cliff” that could have devastating consequences for millions of Americans. The shutdown, which has been ongoing for several weeks, has already begun to affect various healthcare programs and services, and the situation is expected to worsen in the coming days and weeks.

One of the most pressing concerns is the impact on the Indian Health Service (IHS), which provides healthcare to over 2.5 million Native Americans. The IHS has already begun to reduce services, including non-emergency surgeries and wellness programs, due to the shutdown. This has left many Native American communities without access to essential healthcare services, including prenatal care, dialysis, and chemotherapy.

Another area of concern is the National Institutes of Health (NIH), which has been forced to halt many of its clinical trials and research studies due to the shutdown. This has not only delayed the development of new treatments and cures for diseases but also put the lives of patients participating in these trials at risk.

The shutdown is also affecting the Food and Drug Administration (FDA), which is responsible for ensuring the safety of the nation’s food and drug supply. The agency has been forced to reduce its inspections and oversight activities, which could lead to contaminated food and drugs entering the market.

Furthermore, the shutdown is also impacting the Centers for Disease Control and Prevention (CDC), which is responsible for monitoring and responding to public health outbreaks. The agency has been forced to reduce its staff and activities, which could lead to delayed responses to outbreaks and a increased risk of disease transmission.

The shutdown is also having a significant impact on the healthcare workforce, with many healthcare professionals, including doctors, nurses, and researchers, being furloughed or working without pay. This has not only caused financial hardship for these individuals but also disrupted the delivery of healthcare services.

In conclusion, the government shutdown is posing a significant threat to the US healthcare system, with a looming “health care cliff” that could have devastating consequences for millions of Americans. The shutdown is affecting various healthcare programs and services, including the IHS, NIH, FDA, and CDC, and is also impacting the healthcare workforce. It is essential that lawmakers take immediate action to end the shutdown and ensure that the healthcare system is protected and able to provide essential services to those in need.

Generally, it is not cheaper to pay for medical care without health insurance.

As the cost of health insurance continues to rise, some Americans are considering opting out of insurance and paying for medical care in cash. While this approach may seem appealing, experts warn that it can be a risky and potentially costly decision. Some hospitals and clinics offer self-pay or cash-only discounts for patients who pay without insurance, but these discounts may not always be the best option.

For example, an allergy test or X-ray may be a few hundred dollars cheaper when paid for in cash, but the cost may not count towards the patient’s deductible or out-of-pocket limit. Additionally, if the patient needs more medical visits than expected, they could end up worse off financially. Nonprofit hospitals are required to provide charity care, which is free or discounted, to people who cannot afford it, but this option is typically only available to those who are uninsured or underinsured.

Experts caution that paying for medical care in cash can be a gamble, as it leaves patients exposed to major medical bills if an unexpected emergency occurs. Insurance provides crucial protections, including caps on out-of-pocket costs, access to negotiated rates, and free preventive care. Without insurance, patients may be required to pay the entire cost of care upfront or see a different provider.

For those who are healthy, paying in cash may be a smart move for predictable, lower-cost services such as X-rays or CT scans. However, patients would not have access to their insurer’s negotiated rate, which could be cheaper than paying cash. Even if patients haven’t reached their deductibles, they still get the negotiated rate, which might be cheaper than paying cash.

The risks of paying for medical care in cash are significant. Emergency room visits, hospital stays, or surgeries can cost tens of thousands of dollars, and uninsured patients are billed the full amount. It’s generally not possible to sign up for health coverage after an emergency has already happened, and there’s a narrow period to enroll in health insurance.

Before considering paying for medical care in cash, experts recommend checking if there are federally qualified health centers nearby, which provide low-cost care to underserved populations. Patients can also research the average cash price hospitals may charge for certain medical procedures on websites like Turquoise Health. If a patient does get a lower rate from a doctor, they may need to get an agreement with the entire healthcare team involved.

Ultimately, paying for medical care in cash is not a viable option for people who are not healthy and are likely to use a high amount of healthcare. The self-pay option will be most attractive to the healthy and well-off patient, who may forgo adequate health insurance. Experts warn that this approach can leave patients vulnerable to financial ruin if they experience a medical emergency or require ongoing care. As one expert noted, “If you like Russian roulette, then you’ll like to approach healthcare this way.”

Planning to port your health insurance plan? Be aware of the following challenges:

With the ever-evolving landscape of health insurance in India, many individuals are considering shifting to new health insurance plans for enhanced benefits. The decision to port or migrate a health insurance plan is crucial, and it’s essential to understand the differences between the two. Porting refers to shifting to a different plan with a new insurer, while migrating involves moving to a new product with the same insurer.

When deciding between porting and migrating, it’s crucial to assess individual requirements, health needs, and satisfaction with the current insurer. Porting may be a better option when dissatisfaction with the current insurer’s claim service, network hospitals, policy features, or pricing structure arises. On the other hand, migration can be a convenient way to shift to another plan, especially when customers are satisfied with the current insurer and want to explore broader coverage.

However, porting comes with its own set of challenges, including a restrictive timeline, underwriting risk, and potential rejection of the proposal. The process of porting can be initiated only during the annual renewal of the existing policy, and the window for doing so is limited to 45-60 days before renewal. Additionally, if the policy has lapsed or does so during the process of porting, the new insurer can reject the proposal.

It’s also important to note that while benefits like waiting periods for pre-existing diseases can be transferred during porting, loyalty discounts, and features specific to the previous policy will not be carried over. Before switching insurers, it’s essential to evaluate key factors, such as the insurer’s claim settlement ratio, premium affordability, customer service quality, and co-payment or sub-limit clauses.

When selecting a new plan, consider features specific to ongoing medical conditions or future requirements, such as maternity benefits, OPD benefits, and day-care benefits. The restore benefit, which allows reinsuring the sum insured if the limit is exhausted in a given year, is also an essential feature to consider.

Ultimately, the decision to port or migrate a health insurance plan should be made after careful consideration of individual needs and circumstances. It’s crucial to assess whether the new insurer’s offering aligns with both current and future healthcare needs. By doing so, individuals can make an informed decision and choose a health insurance plan that provides comprehensive coverage and meets their evolving needs.

Health insurance premiums under the Affordable Care Act (ACA) are expected to increase by 30% in the upcoming year.

The cost of health insurance premiums on Healthcare.gov is expected to rise by an average of 30% next year, affecting approximately 17 million Americans. This increase is attributed to the expiration of enhanced Affordable Care Act (ACA) health insurance subsidies, which were temporarily extended in 2022 during the COVID-19 pandemic. The subsidies, set to end on January 1, have been a point of contention between Democratic and Republican lawmakers.

Democrats want to continue the expanded subsidies to maintain affordable insurance, while Republicans oppose the extension, citing that the subsidies were never meant to be permanent. Many Republicans aim to revise the entire ACA, rather than just extending the current financial help. The stalemate has resulted in a government shutdown, with Democrats withholding support for funding bills until Republicans agree to extend the subsidies.

The impending expiration of the subsidies has sparked concern among Americans who rely on government tax credits to pay for their health insurance. A study by the Kaiser Family Foundation found that if the enhanced premium tax credits under the ACA end, monthly health insurance premiums could more than double in 2026. This would lead to many people paying two to three times more for their health insurance, potentially forcing them to switch to cheaper plans with less coverage or drop coverage altogether.

One couple, Doug and Shadene Butchart, rely on the enhanced premium tax credits to afford their Gold plan, which costs $1,273.82 per month. They receive $670 in tax credits, leaving them to pay $603.82 monthly. Without the subsidies, they fear they will be unable to afford insurance, which would have severe consequences for Shadene, who has ALS and requires extensive medical care.

The debate over the ACA subsidies reflects the broader political standoff in Washington, with Democrats pushing to maintain the enhanced tax credits and Republicans resisting the extension. The outcome of this impasse could have far-reaching consequences for the health care coverage of millions of Americans next year. If the subsidies expire, many people may face significant increases in their health insurance premiums, potentially leading to reduced coverage or even loss of insurance altogether.

Average Obamacare premiums are set to increase by 30 percent, according to documents.

According to a report by The Washington Post, average Obamacare premiums are expected to increase by 30 percent. This significant rise in premiums is based on documents that outline the projected costs of healthcare plans under the Affordable Care Act (ACA), also known as Obamacare.

The expected 30 percent increase in premiums is a substantial jump, and it may have a considerable impact on individuals and families who rely on Obamacare for their health insurance. The rise in premiums is attributed to various factors, including the increasing costs of healthcare, the departure of several major insurance companies from the ACA market, and the uncertainty surrounding the future of the program.

The documents revealing the 30 percent premium increase are likely to be a concern for many Americans who are already struggling to afford healthcare. The ACA was enacted to make healthcare more accessible and affordable, but the rising costs of premiums may undermine this goal. The increase in premiums may lead to higher out-of-pocket costs for consumers, which could make healthcare less affordable for many individuals and families.

The reasons behind the premium increase are complex and multifaceted. One factor contributing to the rise in premiums is the growing cost of healthcare services, including hospital care, prescription medications, and other medical treatments. Additionally, the exit of several major insurance companies from the ACA market has reduced competition, which can lead to higher prices.

The uncertainty surrounding the future of the ACA is also a significant factor contributing to the premium increase. The ongoing debates and controversies surrounding the program have created uncertainty, which can make it challenging for insurance companies to predict their costs and set premiums accordingly. This uncertainty may lead to higher premiums as insurance companies factor in the potential risks and costs associated with participating in the ACA market.

The 30 percent increase in Obamacare premiums is a significant development that may have far-reaching implications for the healthcare system and individuals who rely on the ACA for their health insurance. As the healthcare landscape continues to evolve, it is essential to monitor the impact of this premium increase and explore ways to make healthcare more affordable and accessible to all Americans.

A look back at his journey through the lens of advertisements

Bollywood actor Vikrant Massey has announced his retirement from acting, surprising his fans and the entertainment industry. The actor, known for his roles in films and television shows, has also made a name for himself in the advertising world. With a relatable persona, Massey has become a popular choice for brands targeting younger, urban demographics. He has collaborated with numerous brands, including InDrive, mCaffeine, Aditya Birla Health Insurance, Man Matters, and Cornetto India, among others.

One of his recent collaborations was with InDrive, a ridesharing company, where he unveiled the brand’s new marketing campaign. He has also worked with mCaffeine, a caffeinated personal care brand, to help establish an “addiction” to the good effects of caffeine. In this campaign, he was joined by actors Radhika Apte and Shruti Hassan. Additionally, Massey has teamed up with Aditya Birla Health Insurance to showcase the features of its product, Activ One, a comprehensive health insurance plan.

Massey has also been part of campaigns that aim to break stigma and address important issues. For example, he featured in a Man Matters advertisement to address hair loss and the struggles faced by men. He was joined by media personality Raghu Ram in this campaign. The actor has also been featured in a Cornetto ice cream advertisement with actress Alia Bhatt, which focused on lovebirds and was launched before Valentine’s Day.

As the brand ambassador for Fibe (formerly EarlySalary), a fintech platform, Massey highlighted easy credit solutions and financial empowerment. He has also collaborated with other brands, including Nivea Men, Cadbury’s, and Google Pixel. Throughout his career, Massey has carved a niche for himself as a trusted face in the advertising world, and his retirement from acting has come as a surprise to his fans and the industry. His legacy in the advertising world will likely continue to be felt, given his extensive work with various brands.

Democrats’ health care demands are at the center of the government shutdown.

The US government has shut down due to a disagreement between Democratic and Republican lawmakers over healthcare demands. At the center of the issue are tax credits that have made health insurance more affordable for millions of people since the COVID-19 pandemic. These subsidies, which were first put in place in 2021 and extended a year later, are set to expire at the end of the year if Congress doesn’t extend them. Democrats are demanding that the subsidies be extended again, as well as reversing Medicaid cuts made by President Donald Trump’s mega-bill passed this summer.

If the subsidies expire, millions of people who purchase health insurance through the Affordable Care Act (ACA) will see their premiums more than double. An analysis by the Kaiser Family Foundation (KFF) estimates that annual out-of-pocket premiums will increase by 114%, or an average of $1,016, next year. Additionally, millions of people are expected to lose Medicaid coverage due to the cuts in Trump’s bill, which includes over $1 trillion in cuts to Medicaid and food assistance over the next decade.

Democrats argue that healthcare can’t wait and that an extension of the health subsidies needs to be negotiated immediately. They claim that people are already receiving notices of premium increases for next year and that the higher healthcare costs will come at a time when the cost of living is already too high. Republicans, on the other hand, say that negotiations over healthcare can happen after the government is funded and have offered a stopgap measure to keep the government open until November 21.

However, many Republicans in Congress are still strongly opposed to extending the enhanced tax credits, making it unclear if a deal can be reached. The government shutdown has significant implications for millions of Americans who rely on healthcare subsidies and Medicaid. Democrats are insisting that any government funding bill must address their healthcare demands, while Republicans are arguing that those negotiations can happen later. The standoff between the two parties has left millions of Americans facing uncertainty over their healthcare costs and coverage.

International students are calling on the Manitoba NDP to fulfill their promise regarding healthcare.

A group of international students held a rally in Winnipeg, Manitoba, to urge Premier Wab Kinew to fulfill his promise to restore their health-care coverage. During the 2023 election campaign, Kinew’s NDP party pledged to reinstate the coverage, which was rescinded by the Progressive Conservative government in 2018. However, two years later, international students are still not eligible for provincial health insurance and are forced to pay for private insurance that provides limited coverage.

The students, who gathered outside the premier’s constituency office, expressed their frustration and anxiety about the lack of adequate health-care coverage. Omega Budhathoki, vice-president of external affairs at the University of Winnipeg Students’ Association, noted that students pay over $1,300 for a basic plan that does not cover essential services like prescription drugs. This has led to a situation where students are living in fear of getting sick, as they cannot afford the costs of medical care.

Judith Oviosun-Smith, one of the authors of a 2024 report on the issue, emphasized that the lack of health-care coverage is a major concern for international students. Many students are forgoing medical care due to the high costs, which can lead to critical illnesses and even loss of life. Oviosun-Smith stressed that restoring health-care coverage for international students should be a priority for the province.

In response to the rally, a ministerial spokesperson stated that the Health and Advanced Education departments are working on a solution. Health Minister Uzoma Asagwara acknowledged that restoring programs is more challenging than cutting them but reaffirmed the government’s commitment to reinstating health-care coverage for international students. The protesters are calling for coverage to be reinstated at the start of the next school year, citing their tiredness of waiting for a solution to this critical issue.

New India Assurance Co. Ltd., Oman Receives Times of Oman Best Brand in Customer Experience Award

New India Assurance Co. Ltd., Oman, has been awarded the prestigious Times of Oman Best Brand in Customer Experience Award in the insurance category at the Oman CX Awards 2025. This award recognizes the company’s commitment to delivering exceptional service and customer satisfaction across the Sultanate. The award ceremony was attended by prominent figures, including His Highness Sayyid Mohammed Bin Salem Al Said and Mr. Ahmed Essa Al Zadjali, CEO of Muscat Media Group.

Mr. Majid Abdul Rahim Jaffer Al Bahrani, the visionary leader of New India Assurance, Oman, expressed his gratitude to customers and partners for voting for the company. Mr. Gaurav Sharma, Chief Operating Officer of New India Assurance, Oman Operations, received the award on behalf of the company and stated that it is a testament to the exceptional service delivered by the team.

The Oman CX Awards 2025 celebrated excellence across 35 product and service categories, with winners determined through nationwide consumer voting. The event highlighted the critical role customer experience plays in brand reputation and long-term success. New India Assurance has been at the forefront of customer-centric innovations, including the launch of a state-of-the-art Customer Care Centre in December 2024, which offers direct call lines and WhatsApp support to enhance client accessibility and responsiveness.

This recognition comes as New India Assurance celebrates its 50th year of operations in Oman, reflecting the enduring trust and confidence of its customers. The company continues to set industry benchmarks, and this award is a testament to its commitment to delivering exceptional service and customer satisfaction. New India Assurance, Oman, is operated by M/s. Abdul Aziz & Bros LLC, and its services can be found on their official website or by contacting their Customer Care Centre at +968 2483 8800.

The award is a significant achievement for New India Assurance, Oman, and demonstrates the company’s dedication to providing exceptional customer experience. The company’s customer-centric approach has been recognized by its customers and partners, who have voted for it as the Best Brand in Customer Experience under the Insurance category. As the company continues to grow and expand its services, it remains committed to delivering exceptional service and customer satisfaction, setting industry benchmarks, and maintaining the trust and confidence of its customers.

First-time health insurance buyer? Here are 7 smart tips to choose the right policy and avoid costly regrets:

  1. Assess Your Needs: Evaluate your health requirements, age, and pre-existing conditions to determine the type of coverage you need.
  2. Research and Compare: Look up different insurance providers, their policies, and coverage options to find the best fit for you.
  3. Understand Policy Terms: Read and comprehend the policy documents, including the fine print, to avoid surprises later.
  4. Check Network Providers: Ensure the policy covers your preferred hospitals, doctors, and medical facilities.
  5. Claim Settlement Ratio: Choose an insurer with a high claim settlement ratio to ensure hassle-free claims.
  6. Premium and Add-ons: Calculate the premium and consider add-ons, such as critical illness cover or maternity benefits, if required.
  7. Seek Professional Advice: Consult with an insurance expert or agent to guide you through the process and help you make an informed decision.

When selecting a health insurance policy, it’s crucial to consider several key factors to ensure you choose a comprehensive and reliable plan. A single medical emergency can be financially devastating, making it essential to have a solid health insurance policy in place. Here are seven key factors to keep in mind when comparing health insurance policies:

  1. Incurred Claim Ratio (ICR): This ratio indicates the percentage of claims paid out by the insurance company compared to the net premiums collected. A higher ICR suggests that the company is more likely to pay out claims. The ideal ICR range is between 70% and 90%.
  2. Claim Settlement Ratio (CSR): This ratio represents the percentage of claims settled by the insurance company. A higher CSR indicates that the company is more efficient in settling claims.
  3. Room Rent Limit: This is the maximum amount the insurance company will pay for room rent per day. A higher room rent limit can help reduce out-of-pocket expenses.
  4. Waiting Period: This is the time after which the insurance company will start covering certain diseases and medical conditions. A lower waiting period is generally preferred.
  5. Network Hospitals: Check the list of network hospitals to ensure that you have access to quality healthcare without financial worries.
  6. Exclusions: Review the policy document to understand what is excluded from coverage, such as pre-existing diseases, OPD treatments, and cosmetic surgery.
  7. Pre- and Post-Hospitalisation Coverage: Check the coverage period for pre- and post-hospitalisation expenses, such as diagnostic tests, medicines, and follow-up consultations.

Additionally, consider the following factors:

  • Co-payment and Deductible Clauses: These can increase your out-of-pocket expenses. Co-payment is a fixed percentage of the claim amount, while deductible is a fixed amount that you need to pay before the insurance company takes care of the rest.
  • Policy Document: Carefully review the policy document to understand the terms and conditions, including the waiting period, room rent limit, and exclusions.
  • Insurer’s Reputation: Research the insurance company’s reputation, financial stability, and customer service to ensure that you choose a reliable provider.

By considering these factors, you can make an informed decision when selecting a health insurance policy that meets your needs and provides comprehensive coverage. Remember to compare plans from different insurers and read the policy document carefully to avoid financial stress and ensure that you receive the best possible care.

The Regulation of Private Health Insurance

Private health insurance is regulated by a combination of federal and state laws. The primary federal law governing private health insurance is the Employee Retirement Income Security Act of 1974 (ERISA), which regulates employer-sponsored health plans. Other key laws include the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Affordable Care Act (ACA), and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

State laws and regulations also play a significant role in regulating private health insurance. States have the authority to regulate insurance companies, set standards for health insurance policies, and oversee the marketing and sales of health insurance products. State insurance departments are responsible for enforcing state laws and regulations, as well as investigating consumer complaints.

The National Association of Insurance Commissioners (NAIC) provides a framework for state insurance regulation, and many states have adopted model laws and regulations developed by the NAIC. The ACA has also imposed new requirements on private health insurance, including the prohibition on pre-existing condition exclusions, guaranteed issue, and minimum essential coverage requirements.

Regulatory agencies, such as the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), oversee the implementation of federal laws and regulations related to private health insurance. These agencies work with state regulators to ensure compliance with federal and state laws, and to protect consumers from unfair or deceptive practices.

Key aspects of private health insurance regulation include:

  1. Policy Standards: Regulations require health insurance policies to meet certain standards, such as covering essential health benefits and providing a minimum level of coverage.
  2. Rate Review: States review insurance rate increases to ensure they are reasonable and not excessive.
  3. Financial Solvency: Insurance companies must maintain sufficient financial reserves to pay claims and meet other financial obligations.
  4. Consumer Protections: Laws and regulations protect consumers from unfair or deceptive practices, such as denial of claims or cancellation of coverage.
  5. Market Conduct: Regulations govern the marketing and sales of health insurance products, including requirements for transparency and disclosure.

Overall, the regulation of private health insurance is a complex and evolving area, with multiple stakeholders and regulatory agencies working to ensure that consumers have access to affordable, high-quality health insurance.

The scope of federal regulation affecting private health coverage has increased significantly since the passage of the Affordable Care Act (ACA) in 2010. The ACA introduced a range of new provisions and requirements for insurers, employer-sponsored plans, and providers, with the goal of expanding health coverage to more individuals and improving the overall quality of care. However, the law has also been the subject of ongoing debate and litigation, with efforts to repeal and replace it, as well as numerous court challenges.

Federal regulations have been categorized into six main areas: access to health coverage, affordability of health coverage, benefit design and adequacy, reporting and disclosure of information, review and appeal of health claims, and other federal standards. The ACA established core market rules to expand coverage, including requirements for premium stabilization and efforts to protect the risk pool. The law also introduced new standards for benefit design and adequacy, such as the requirement that all private, non-grandfathered health plans cover preventive services with no cost sharing for enrollees.

Access to coverage has been a key focus of federal regulation, with efforts to address barriers to coverage, such as preexisting condition exclusions and underwriting. The ACA prohibited insurers from declining to cover or renew coverage due to a person’s health status or claims history, and introduced new rules for premium stabilization and risk pool protection. The law also introduced new standards for financial protection and affordability, such as limits on out-of-pocket costs and requirements for transparency in plan design and operation.

Benefit design and adequacy have also been subject to federal regulation, with requirements for minimum standards for plan design and operation. The ACA introduced new rules for required coverage, including preventive services, and prohibited plans from imposing annual dollar limits on coverage or requiring waiting periods longer than 90 days before employer-sponsored coverage kicks in. States may have additional benefit mandates for state-regulated plans, such as comprehensive coverage requirements for mental health or substance use disorders.

Disclosure, reporting, and transparency requirements have also been introduced, with the goal of making more information available to enrollees and federal agencies. These requirements include disclosure of information to enrollees and the public, as well as reporting to federal agencies. The ACA introduced new rules for claims and appeals processes, including faster and fairer review processes, and established a federal floor of protections for the internal claims and appeals process.

Other federal standards, such as civil rights laws, antitrust laws, and privacy laws, also apply to private health insurance. The Civil Rights Act of 1964 and the Americans With Disabilities Act of 1990 created protections against discrimination based on race, color, national origin, sex, age, and disability. Antitrust laws prohibit anticompetitive practices and mergers by health care providers, hospitals, and insurers, while privacy laws, such as HIPAA, regulate the use of certain patient information. Special privacy protections for substance use disorder information are also regulated under a law known as “Part 2.” Plans and issuers are prohibited from entering into agreements that restrict access to claim, cost, or quality information, known as “gag clauses.”

Five things to know about expiring federal health care subsidies:

  1. Expiration Date: The enhanced federal health care subsidies, which were introduced as part of the American Rescue Plan Act (ARPA) in 2021, are set to expire at the end of 2025 unless extended by Congress.
  2. Impact on Consumers: If the subsidies expire, millions of Americans who receive financial assistance to purchase health insurance through the Affordable Care Act (ACA) marketplaces will face significant increases in their premiums, making health care less affordable for many.
  3. Subsidy Eligibility: The ARPA subsidies expanded eligibility for financial assistance to more people, including those with higher incomes, and increased the amount of assistance available to those who were already eligible. If the subsidies expire, these individuals and families may no longer be eligible for the same level of financial assistance.
  4. Potential Consequences: The expiration of the subsidies could lead to a decrease in health insurance enrollment, as some people may no longer be able to afford coverage. This could have negative consequences for the overall health and well-being of affected individuals, as well as the stability of the health insurance market.
  5. Legislative Uncertainty: The future of the federal health care subsidies is uncertain, as Congress has not yet acted to extend or make permanent the enhanced subsidies. Lawmakers are debating various proposals to address the issue, but it is unclear what action, if any, will be taken before the subsidies expire.

As the COVID-19 pandemic continues to evolve, many individuals and families who received federal health care subsidies during the public health emergency are facing a critical deadline. The enhanced subsidies, which were introduced as part of the American Rescue Plan Act (ARPA), are set to expire at the end of 2022. Here are five key things to know about the expiring federal health care subsidies:

  1. Temporary subsidies: The ARPA subsidies were designed to be temporary, providing financial assistance to individuals and families who purchased health insurance through the Affordable Care Act (ACA) marketplace. The subsidies were intended to help people who had lost their jobs or experienced a reduction in income due to the pandemic. With the subsidies set to expire, many individuals and families will need to reassess their health insurance options.

  2. Impact on health insurance premiums: The expiration of the subsidies will likely lead to an increase in health insurance premiums for many people. Without the subsidies, individuals and families may face higher out-of-pocket costs, which could make health insurance unaffordable for some. This may lead to a decrease in the number of people with health insurance, potentially exacerbating existing health disparities.

  3. Changes to eligibility: The ARPA subsidies expanded eligibility for health insurance subsidies to more people, including those who had previously been ineligible due to their income level. With the expiration of the subsidies, eligibility will revert to pre-ARPA levels, which may mean that some individuals and families will no longer qualify for financial assistance. This could lead to a loss of health insurance coverage for some people.

  4. Options for those losing subsidies: Individuals and families who are losing their subsidies may have other options for affordable health insurance. For example, they may be eligible for Medicaid or the Children’s Health Insurance Program (CHIP), or they may be able to purchase health insurance through their employer. Additionally, some states have established their own subsidy programs to help residents afford health insurance.

  5. Uncertainty about future subsidies: The future of the federal health care subsidies is uncertain, and it is unclear whether Congress will extend or modify the subsidies. Some lawmakers have proposed making the ARPA subsidies permanent, while others have suggested alternative solutions, such as expanding Medicaid or introducing new subsidy programs. As the deadline for the expiration of the subsidies approaches, individuals and families are advised to explore their options and prepare for potential changes to their health insurance coverage.

In conclusion, the expiration of the federal health care subsidies at the end of 2022 will have significant implications for individuals and families who have been relying on them to afford health insurance. With the potential for increased premiums, changes to eligibility, and uncertainty about future subsidies, it is essential for those affected to explore their options and plan for the future. By understanding the implications of the expiring subsidies, individuals and families can make informed decisions about their health insurance coverage and ensure that they have access to affordable, quality care.

Obamacare prices have been made public in a dozen states, revealing higher costs.

Higher Obamacare prices have become public in a dozen states, according to a recent report by The New York Times. The increased prices are a result of various factors, including rising healthcare costs, changes in the insurance market, and the ongoing COVID-19 pandemic. The price hikes are expected to affect millions of Americans who rely on the Affordable Care Act (ACA), also known as Obamacare, for their health insurance.

In the dozen states where the new prices have been made public, the average increase in premiums ranges from 5% to 15%. Some states, such as Illinois and Michigan, are seeing even higher increases, with premiums rising by as much as 25%. The increased prices are likely to be a burden for many consumers, particularly those who are already struggling to afford healthcare.

The main drivers of the price increases are rising healthcare costs, including higher hospital and doctor fees, as well as increased costs for prescription medications. Additionally, the ongoing COVID-19 pandemic has led to increased costs for insurance companies, which are being passed on to consumers in the form of higher premiums.

The price increases are also being driven by changes in the insurance market, including the departure of some insurance companies from the ACA market. This has reduced competition and given remaining insurers more power to raise prices. Furthermore, the Trump administration’s decision to expand the use of short-term health plans, which are not required to comply with ACA regulations, has also contributed to the price increases.

The increased prices are likely to have a significant impact on consumers, particularly those who are already struggling to afford healthcare. Many people may be forced to choose between paying higher premiums or opting for less comprehensive coverage. Others may be forced to go without health insurance altogether, which could have serious consequences for their health and well-being.

It is worth noting that the price increases are not uniform across all states, and some states are seeing smaller increases or even decreases in premiums. Additionally, many consumers will be eligible for subsidies to help offset the cost of their premiums, which could reduce the impact of the price increases. However, for many Americans, the higher Obamacare prices will be a significant burden, and could have serious consequences for their health and well-being.

Health Care Costs and Affordability

The United States has experienced a significant increase in health spending over the past few decades, driven by factors such as an aging population, rising rates of chronic conditions, advancements in medicine, and higher prices. While these factors are also present in other large and wealthy nations, the US has relatively high health spending compared to its peers. The US health system is fragmented, with multiple private and public payers, and a mainly fee-for-service payment system. Additionally, the US federal and state governments have generally done less to directly regulate or negotiate prices paid for medical services or prescription drugs, resulting in higher prices for the same brand-name prescription drugs, hospital procedures, and physician care.

Hospital and physician services account for approximately half of total health spending in the US, with hospital spending representing 31.2% of overall health spending in 2023, and physicians/clinics representing 20.1% of total spending. Prescription drugs are also a significant contributor to health spending, with retail prescription drugs experiencing the fastest growth in spending at 8.6% from 2020 to 2023. Private insurance spending has grown much faster than Medicare and Medicaid spending per enrollee, with private insurance often paying higher prices for health care compared to prices paid by Medicare and Medicaid.

The Bureau of Economic Analysis (BEA) has developed a Health Care Satellite Account, which estimates spending and price growth by disease category. This approach shows that the largest categories of medical services spending include the treatment of circulatory diseases, musculoskeletal conditions, and infectious diseases. Health spending is a function of prices and use, and people and health plans in the US often pay higher prices for the same prescription drugs or hospital procedures than people in other large and wealthy nations. The COVID-19 pandemic has led to fluctuations in health care use, with a sharp decrease in health utilization in 2020 followed by an increase in 2021.

The main drivers of health costs in the US are higher prices, rather than higher utilization. In fact, Americans generally have shorter average hospital stays and fewer physician visits per capita compared to other countries. The US health system’s unique features, such as its fragmented and fee-for-service payment system, contribute to its high health spending. To contain health costs, it is essential to understand the components of health spending and identify areas where cost containment efforts could be most effective. This can be achieved by examining trends in health spending by type of service, source of funds, and disease category, as well as analyzing prices and utilization. By addressing the underlying drivers of health costs, the US can work towards reducing its high health spending and improving health outcomes.

ManipalCigna Sarvah has been named the ‘Product of the Year 2025’ in the health insurance category, as reported by the Press Trust of India.

ManipalCigna Sarvah has been awarded the ‘Product of the Year 2025’ in the health insurance category. This prestigious award recognizes outstanding products that have made a significant impact in their respective industries. ManipalCigna Sarvah, a comprehensive health insurance product, has been acknowledged for its innovative features and benefits that cater to the evolving needs of customers.

The Product of the Year award is a prestigious recognition that is based on a robust research methodology, involving a survey of over 10,000 consumers across the country. The award is given to products that have demonstrated excellence in terms of innovation, quality, and customer satisfaction. ManipalCigna Sarvah’s win in the health insurance category is a testament to its commitment to providing customer-centric solutions that meet the changing needs of the market.

ManipalCigna Sarvah is a holistic health insurance product that offers a wide range of benefits, including comprehensive coverage, flexible plans, and personalized services. The product is designed to provide customers with financial protection against medical expenses, while also promoting healthy habits and preventive care. With its innovative features and benefits, ManipalCigna Sarvah has set a new benchmark in the health insurance industry.

The award is a significant milestone for ManipalCigna, a leading health insurance provider in India. The company has been at the forefront of innovation in the health insurance industry, introducing new products and services that cater to the diverse needs of customers. ManipalCigna’s commitment to excellence and customer satisfaction has earned it a reputation as a trusted and reliable health insurance provider.

The recognition of ManipalCigna Sarvah as the ‘Product of the Year 2025’ is a reflection of the company’s dedication to delivering high-quality products and services that meet the evolving needs of customers. With this award, ManipalCigna has reinforced its position as a leader in the health insurance industry, and is poised to continue its legacy of innovation and excellence in the years to come.

The award is also a testament to the growing importance of health insurance in India. As the country’s healthcare landscape continues to evolve, there is an increasing need for innovative and customer-centric health insurance products that cater to the diverse needs of customers. ManipalCigna Sarvah’s win in the health insurance category highlights the company’s commitment to addressing this need, and its dedication to providing high-quality health insurance solutions that promote healthy habits and financial protection.

AHPI revokes suspension of cashless services for Bajaj Allianz policyholders

The Academy of Hospital Administration (AHA) and the Insurance Provider, Bajaj Allianz, have come to a resolution regarding the suspension of cashless services for Bajaj Allianz policyholders. Recently, the AHA had revoked the suspension, allowing policyholders to once again avail of cashless services at empaneled hospitals.

The suspension was initially imposed due to certain disagreements between the AHA and Bajaj Allianz regarding the payment terms and reimbursement rates for medical services provided to policyholders. However, after a series of negotiations and discussions, the two parties have reached a mutually agreeable solution, paving the way for the reinstatement of cashless services.

As a result of this development, Bajaj Allianz policyholders can now avail of cashless treatment at empaneled hospitals, without having to pay out-of-pocket expenses. This move is expected to bring relief to policyholders who were earlier forced to bear the financial burden of medical expenses due to the suspension of cashless services.

The AHA and Bajaj Allianz have been working closely to iron out their differences and find a solution that benefits policyholders. The revocation of the suspension is a positive step towards ensuring that policyholders receive uninterrupted and hassle-free medical services.

In a statement, Bajaj Allianz expressed its commitment to providing seamless and efficient services to its policyholders. The company has assured that it will continue to work with the AHA to ensure that policyholders receive the best possible medical care at empaneled hospitals.

The development is also expected to have a positive impact on the healthcare sector, as it will enable policyholders to access quality medical services without financial constraints. The move is seen as a significant step towards promoting healthcare accessibility and affordability in the country.

Overall, the revocation of the suspension of cashless services for Bajaj Allianz policyholders is a welcome move that will benefit policyholders and the healthcare sector as a whole. The AHA and Bajaj Allianz have demonstrated their commitment to working together to ensure that policyholders receive the best possible medical services, and this development is expected to have a positive impact on the healthcare landscape in the country.

ACA healthcare plans are at the center of the shutdown fight: NPR

The US government shutdown has brought attention to the issue of extending Affordable Care Act (ACA) tax credits, which are set to expire in December. Democrats are pushing for an extension, citing the urgency of the situation, while Republicans argue that there is plenty of time to figure it out. The tax credits make ACA health care premiums affordable for many Americans, and their expiration could lead to a significant increase in premiums.

A recent poll found that over 78% of the public, including majorities of Democrats, independents, Republicans, and MAGA supporters, favor extending the enhanced ACA tax credits. Insurance commissioners, including North Dakota’s Jon Godfread, are also calling for an extension, citing the need to act before open enrollment begins on November 1.

If Congress fails to extend the subsidies, premiums are expected to double for many consumers next year, potentially driving people to go uninsured. The Congressional Budget Office estimates that 4 million people will become uninsured in the next few years if the enhanced tax credits expire. Most enrollees in the ACA marketplaces live in states that President Trump won, and they are often small business owners, farmers, ranchers, or gig workers.

The subsidies are expensive for the government, with the Congressional Budget Office estimating that extending them permanently would cost $350 billion over the next decade. Conservative groups oppose the enhanced subsidies, arguing that they were meant to be temporary during the COVID-19 pandemic and that extending them will exacerbate rising health care costs. However, some Republicans, such as Rep. Marjorie Taylor Greene and Sen. Josh Hawley, support extending the tax credits or coming up with a different plan to prevent dramatic rate hikes for consumers.

The debate over the ACA tax credits is complex, with different opinions on the urgency of the situation and the potential consequences of not extending the subsidies. However, with open enrollment approaching, the need for a solution is becoming increasingly pressing. As Godfread notes, the discussion about rising health care costs is separate from the need to extend the subsidies, which have helped provide access to consumers. Ultimately, the fate of the ACA tax credits will depend on the ability of lawmakers to come to an agreement, and the consequences of their decision will be felt by millions of Americans who rely on the ACA marketplaces for their health insurance.

Most employers offer mental health care benefits, but their effectiveness is often questionable.

Many employers offer mental health care benefits to their employees, but the effectiveness of these benefits is often questionable. While it’s commendable that companies are acknowledging the importance of mental health, simply offering benefits is not enough. The quality and accessibility of these benefits are crucial in determining their effectiveness.

Some common issues with employer-provided mental health benefits include limited coverage, long wait times, and lack of diversity in treatment options. For example, a company may offer counseling services, but only with a limited number of sessions or with a long waiting period. This can be frustruating for employees who need immediate help or have complex issues that require more intensive treatment.

Another issue is the lack of transparency and education about mental health benefits. Employees may not be aware of the benefits available to them or may not know how to access them. This can lead to underutilization of benefits and a lack of support for employees who need it.

Moreover, mental health benefits are often stigmatized, and employees may be hesitant to use them due to fear of judgment or repercussions. This stigma can be perpetuated by companies that don’t prioritize mental health or create a culture that supports openness and honesty about mental health issues.

To make mental health benefits more effective, employers should prioritize accessibility, diversity, and transparency. This can include offering a range of treatment options, such as therapy, meditation, and employee assistance programs. Companies should also educate employees about the benefits available to them and create a culture that supports mental health.

Additionally, employers should consider the specific needs of their workforce and tailor their benefits accordingly. For example, a company with a high-stress work environment may want to offer more intensive counseling services or stress management programs. By taking a proactive and supportive approach to mental health, employers can create a healthier and more productive work environment.

Ultimately, offering mental health care benefits is a good start, but it’s only the first step. Employers must prioritize the quality and accessibility of these benefits to ensure that they are effective in supporting the mental health and well-being of their employees. By doing so, companies can create a positive and supportive work environment that benefits both employees and the organization as a whole.

Denied, delayed, dismissed: Inside India’s broken health insurance system. The Indian health insurance system is plagued by a multitude of issues, leaving many without access to necessary medical care.Numerous individuals have experienced their claims being denied, delayed, or dismissed, resulting in financial hardship and decreased health outcomes. This broken system is characterized by inefficiencies, lack of transparency, and inadequate coverage. Many Indians struggle to navigate the complex and often frustrating process of filing claims, leading to delayed or foregone treatment. Furthermore, the dismissive attitude of some insurance providers and healthcare institutions exacerbates the problem, leaving patients feeling helpless and disenfranchised. The consequences of this broken system are far-reaching, affecting not only the individual but also their families and communities. It is imperative that the Indian government and healthcare stakeholders take immediate action to reform and improve the health insurance system, ensuring that all citizens have access to quality and affordable medical care.

The health insurance system in India is failing to deliver on its promise of providing a safety net for families in need of medical care. Despite the industry’s rapid expansion, with a growth rate of 9% in the full financial year FY25, and a gross premium collection of approximately Rs. 1.18 lakh crore, the system is plagued by bureaucracy, delayed responses, and claim denials. Insurers are rejecting claims at an alarming rate, with only 71.3% of claims being approved by value in FY24.

The cost of staying insured is also skyrocketing, with premium hikes of 20-25% each year, far outpacing wage growth. Medical inflation is running at 13-14% annually, and families are struggling to keep up with the rising costs. A LocalCircles survey found that nearly half of policyholders had faced partial or total claim rejections in the past three years.

The health insurance process is also overly complex, with multiple layers of approval and a lack of transparency. Third-Party Administrators (TPAs) are often incentivized to reject claims, and hospitals are frequently left waiting for reimbursement. Patients are being forced to foot the bill or chase updates, leading to a cycle of frustration and uncertainty.

The regulatory oversight is also patchy, with the Insurance Regulatory and Development Authority of India (IRDAI) failing to effectively enforce regulations. There is a need for a common regulator to cover hospitals, TPAs, and insurers under one umbrella to address the nexus between them.

To fix the system, bold and systemic reforms are needed. This includes digitization, automation, and healthcare exchanges to improve claim processing, as well as providing clear and simplified policy documents to consumers. Regulators must strengthen awareness campaigns and provide accessible channels for patients to escalate complaints.

Until reforms take hold, families are being forced to fight every step of the way to get their claims approved. The health insurance system in India has become a high-stakes test of patience, persistence, and luck, rather than a safety net. It is essential for consumers to be vigilant and keep meticulous records, push for escalation within insurers, and file complaints on the Bima Bharosa portal or approach the Insurance Ombudsman or a Consumer Court if necessary.

The stories of Sumit Kumar, Rahul Bansal, and Vipin Vishnu Ajayan, who have all faced claim rejections and delays, highlight the human impact of the failing health insurance system. It is crucial for the government and regulators to take immediate action to address the issues and ensure that health insurance in India becomes a reliable and trustworthy safety net for families in need.

Experts like Dr. Girdhar Gyani and Dr. KC Haridas are emphasizing the need for a common health regulator, digitization, and automation to improve the claim processing. Dr. Haridas also suggests that using a technically competent insurance broker can help in getting claims settled, and it does not increase premiums as the commission is already built in.

In conclusion, the health insurance system in India is in dire need of reform. The current system is failing to deliver on its promise, and families are suffering as a result. It is essential for the government, regulators, and insurers to work together to create a more efficient, transparent, and patient-centric system that provides a reliable safety net for those in need.

Tata AIA has launched ‘Health Buddy’, a virtual health and wellness companion.

Tata AIA has launched a new product called Tata AIA Health Buddy, which is India’s first 24×7 health and wellness companion offered by a life insurer. According to Sanjay Arora, Chief of Operations at Tata AIA, the launch of Health Buddy is driven by the company’s core value of consumer obsession. The goal is to provide customers with a comprehensive solution that combines health, wellness, and life insurance, setting a new standard in consumer care.

Tata AIA Health Buddy is designed to empower consumers by providing them with access to world-class health and wellness solutions. The product aims to not only protect customers’ health but also enable them to live healthier and more fulfilling lives. By offering a 24×7 health companion, Tata AIA is recognizing the importance of providing continuous support and guidance to customers in their health and wellness journey.

The launch of Tata AIA Health Buddy marks a significant innovation in the life insurance industry, where traditional products have primarily focused on providing financial protection in the event of unforeseen circumstances. By incorporating health and wellness features, Tata AIA is taking a more holistic approach to customer care, acknowledging that physical and mental well-being are essential aspects of overall quality of life.

With Tata AIA Health Buddy, customers can expect to have access to a range of health and wellness services, including preventive care, fitness tracking, and personalized advice from healthcare experts. The product is likely to appeal to health-conscious individuals who are looking for a more integrated approach to managing their health and wellness.

Overall, the launch of Tata AIA Health Buddy reflects Tata AIA’s commitment to putting customers at the forefront of its business. By offering a unique and innovative product that addresses the evolving needs of consumers, the company is demonstrating its dedication to delivering exceptional customer experiences and setting a new benchmark in the life insurance industry. As the healthcare landscape continues to evolve, products like Tata AIA Health Buddy are likely to play an increasingly important role in helping individuals manage their health and wellness.

Best Health Insurance Companies Of 2025 – Forbes Advisor

The Affordable Care Act (ACA), also known as Obamacare, has implemented a set of requirements for health insurance companies operating in the ACA marketplace at HealthCare.gov. These requirements ensure that individuals have access to a comprehensive range of healthcare services. Under the ACA, health insurance companies must cover various essential services, including ambulatory patient services, emergency services, hospitalizations, lab services, and mental health services.

In addition to these services, health insurance companies must also cover pediatric care, including vision and dental services, as well as pregnancy, maternity, and newborn care. Prescription drugs, preventive care, and chronic disease management are also mandatory services that must be covered. Furthermore, rehab and habilitative services, including devices, are also required to be covered by health insurance companies.

Beyond the ACA mandates, Congress has added additional requirements for health insurers. For example, birth control coverage and breastfeeding benefits are now mandatory services that must be provided by health insurance companies. However, it’s worth noting that health insurers are not required to offer dental or vision coverage for adults, nor are they required to provide medical management programs such as weight management. Nevertheless, some insurance companies may choose to offer these expanded services as part of their coverage.

Overall, the ACA has played a crucial role in ensuring that individuals have access to a wide range of healthcare services. By requiring health insurance companies to cover essential services, the ACA has helped to improve healthcare outcomes and reduce the financial burden of healthcare costs on individuals and families. While there may be some limitations to the services that are required to be covered, the ACA has helped to establish a foundation for comprehensive healthcare coverage in the United States. As a result, individuals can rest assured that they will have access to the healthcare services they need, from doctor visits and hospital stays to preventive care and prescription drugs.

Shoppers of Affordable Care Act Coverage Are Already Being Hit With Sticker Shock – Center for American Progress

The Center for American Progress has reported that individuals purchasing health insurance through the Affordable Care Act (ACA) marketplace are experiencing sticker shock due to increasing premiums. Many consumers are facing significant price hikes, making it challenging for them to afford coverage. This surge in costs is attributed to various factors, including the expiration of temporary subsidies and the rising cost of healthcare services.

The ACA, also known as Obamacare, was enacted to provide affordable health insurance to millions of Americans. However, the recent premium increases have raised concerns about the sustainability of the program. The Center for American Progress notes that the average premium for a benchmark silver plan has increased by over 10% in some states, with some consumers facing hikes of up to 20%.

One of the primary causes of the premium increases is the expiration of temporary subsidies provided by the American Rescue Plan Act (ARPA). These subsidies, which were enacted in 2021, helped reduce premium costs for millions of Americans. However, they were only temporary, and their expiration has led to a significant increase in costs for many consumers.

Another factor contributing to the rising premiums is the increasing cost of healthcare services. Medical inflation, driven by factors such as increased hospital and physician costs, has led to higher expenses for insurers, which are then passed on to consumers in the form of higher premiums.

The sticker shock experienced by ACA marketplace shoppers has significant implications for the affordability and accessibility of health insurance. Many individuals and families may struggle to afford coverage, potentially leading to a decline in enrollment and an increase in the number of uninsured Americans. The Center for American Progress emphasizes the need for policymakers to take action to address the rising costs and ensure that affordable health insurance remains available to those who need it.

To mitigate the effects of the premium increases, the Center for American Progress recommends that policymakers consider extending or making permanent the temporary subsidies provided by the ARPA. Additionally, they suggest implementing policies to reduce healthcare costs, such as increasing competition among insurers and promoting value-based care. By taking these steps, lawmakers can help ensure that the ACA remains a viable and affordable option for millions of Americans.

Federal and postal workers are expected to face double-digit health care premium increases for the upcoming year, according to Government Executive.

Federal and postal workers can expect to see significant increases in their health care premiums next year. According to the Federal Employees Health Benefits (FEHB) program, which covers over 8 million federal employees, retirees, and their families, premiums are projected to rise by an average of 10.6% in 2023. This marks the fifth consecutive year of double-digit premium increases for federal workers.

The FEHB program, which is the largest employer-sponsored health insurance program in the world, offers a range of health plans to federal employees and retirees. The program is self-funded, meaning that it is paid for by a combination of employee and employer contributions, as well as premiums paid by enrollees. The premium increases are necessary to keep pace with rising health care costs, including increased costs for prescription drugs, hospitalizations, and doctor visits.

The 10.6% average premium increase is higher than the 8.8% increase seen in 2022, and significantly higher than the 3.6% increase in 2020. The increases will vary depending on the specific health plan and enrollment type, with some plans seeing increases as high as 15%. The premium increases will be effective on January 1, 2023, and will apply to all FEHB enrollees, including federal employees, retirees, and their families.

The premium increases will be paid for by a combination of employee and employer contributions. Federal employees will see their biweekly premiums increase by an average of $25-$50, depending on their plan and enrollment type. The employer contribution, which is funded by federal agencies, will also increase to help cover the rising costs of health care.

The premium increases have been a source of concern for federal workers, who have seen their out-of-pocket health care costs rise significantly in recent years. The increases have also been criticized by federal employee unions, which argue that the rising costs of health care are unsustainable and will lead to decreased enrollment and increased retiree costs. Despite the challenges, the FEHB program remains one of the most popular and comprehensive health insurance programs in the country, offering federal employees and retirees access to a wide range of health plans and benefits.

MTG blows up GOP shutdown message with health-care rant

Marjorie Taylor Greene, a Republican congresswoman, has gone off-script by speaking out about the looming health insurance premium spike that will affect millions of Americans, including her own adult children. Despite the Republican party’s efforts to focus on the government shutdown and blame Democrats, Greene has emphasized the need to address the impending crisis. In a tweet, she expressed her discontent with the party’s lack of a plan to help Americans deal with the rising costs, calling their shutdown strategy “shameful, disgusting, and traitorous.”

Greene’s comments have put her at odds with her party’s leadership, including House Speaker Mike Johnson, who suggested that she didn’t know what she was talking about. However, Greene has refused to back down, stating that her party has no solution to the problem and that it’s something that cannot be ignored. Her remarks have likely rattled her GOP colleagues, as many Republicans running in competitive races in 2026 are privately concerned about the issue.

Interestingly, President Donald Trump briefly seemed to abandon the party line when he mentioned that he was negotiating with congressional Democrats on health care policy and was open to making a deal on expiring health insurance subsidies. However, he quickly walked back his comments after presumably receiving pressure from congressional Republicans.

The incident highlights the Republican party’s struggle to address the complex issues surrounding health care. While Democrats have made health care a key part of their midterm message, Republicans have been accused of being clueless on the issue. Greene’s comments have shed light on the party’s internal divisions and their lack of a coherent plan to address the rising health insurance costs.

Greene’s willingness to speak out against her party’s stance has sparked concerns among Republicans, who are trying to maintain a unified front during the government shutdown. Her actions have also raised questions about the party’s ability to address the real concerns of American voters, particularly when it comes to issues like health care. As the shutdown continues, it remains to be seen how the Republican party will respond to Greene’s comments and the growing concerns about health insurance costs.

Health care premiums are increasing by 100%

A significant change in budget at the state and federal levels is expected to impact families financially, particularly in regards to healthcare. Specifically, premiums on marketplace insurance plans are anticipated to rise starting in 2026, as key tax credits expire at the end of 2025. This expiration will lead to higher costs for health coverage, leaving many to wonder how they will afford it.

According to Gbenga Ajilore, Chief Economist for the Center on Budget and Policy, the expiration of tax credits will have a notable impact on families. For instance, in Colorado, a family of four with a household income of $80,000 will see their monthly premiums increase from $260 to $560. Similarly, a single adult earning $50,000 per year will experience a rise in monthly premiums from $270 to $420.

Ajilore highlights that individuals who rely on marketplace insurance plans are “at the mercy of the system,” with limited options for affordable health coverage. Unless they secure a job that offers employer-provided healthcare, they may be forced to choose between paying higher premiums or forgoing health coverage altogether. Furthermore, hospitals with higher uncompensated care costs will pass these expenses on to individuals with health coverage, resulting in increased insurance premiums.

The impending rise in healthcare costs is a pressing concern, as families will need to make difficult decisions about how to allocate their resources. With the tax credits set to expire, many will face significant financial burdens, potentially forcing them to sacrifice other essential expenses to maintain their health coverage. As the changes take effect, it is crucial for families to explore their options and plan accordingly to mitigate the impact of these increased costs.

UnitedHealth, AXA, CVS Health, and Ping An are driving global growth through expanded coverage and integrated care models.

The global health insurance market is expected to experience significant growth, driven by increasing demand for affordable healthcare access, regulatory support for private insurers, and digitalization. The market was valued at $1.58 trillion in 2024 and is anticipated to grow at a compound annual growth rate (CAGR) of 6.20% from 2025 to 2034, reaching $2.88 trillion by 2034.

Key opportunities in the market include the rising demand for affordable healthcare, growth of the private sector due to regulatory support, and digitalization enhancing claim processing. Preferred Provider Organization (PPO) plans, term insurance, and the adult demographic are expected to show strong potential. North America currently leads the market, while the Asia-Pacific region is expected to experience rapid expansion.

The increasing prevalence of chronic diseases is a significant driver of market growth, with six in ten adults affected by at least one chronic condition. The need for comprehensive and accessible health insurance coverage is growing rapidly, and this demand is expected to propel market growth over the forecast period.

Emerging trends in the market include the development of tailored solutions for small and medium-sized enterprises (SMEs) and the growing geriatric population. Customized SME solutions are expected to accelerate market expansion, while the rising geriatric population is anticipated to substantially enhance market growth.

The market is segmented into various demographics, including minors, adults, and senior citizens. Adults are expected to dominate the market due to growing health awareness, increasing employment-based coverage, and rising demand for private healthcare.

The key players in the health insurance market include UnitedHealth Group, AXA, CVS Health, Ping An Insurance Group, and others. These companies offer a range of health coverage solutions, including commercial, Medicaid, Medicare, vision, and dental plans.

The report provides an analysis of the market by region, with North America leading and Asia-Pacific experiencing exponential growth. The market is expected to be driven by PPO plans, private providers, term insurance, and the adult demographic. The report also provides insights into the market size, forecast, and compound annual growth rate, as well as the largest market in 2024 and the projected market size by 2034.

In terms of market segmentation, the report breaks down the market by type, provider, coverage, demographics, mode, end-user, distribution channel, and region. The report provides a comprehensive analysis of the market, including market size, forecast, and growth trends, as well as the key players and their strategic initiatives.

Overall, the global health insurance market is expected to experience significant growth, driven by increasing demand for affordable healthcare access, regulatory support for private insurers, and digitalization. The market is anticipated to be driven by PPO plans, private providers, term insurance, and the adult demographic, with North America leading and Asia-Pacific experiencing exponential growth.

Germany’s Day Hospitals Combine Medical Care, Home Support – 조선일보

Germany’s day hospitals have been gaining attention for their innovative approach to healthcare, combining medical care with home support. These facilities provide patients with the opportunity to receive medical treatment and therapy during the day, while still allowing them to return to the comfort of their own homes at night.

The concept of day hospitals originated in the 1980s, with the goal of reducing hospitalization rates and providing more efficient care. Today, there are over 1,000 day hospitals operating in Germany, with many more in development. These facilities offer a range of services, including diagnostic testing, therapy sessions, and medication management.

One of the primary benefits of day hospitals is their ability to provide patients with a more personalized and flexible care experience. Patients can receive treatment and therapy tailored to their specific needs, while also having the freedom to return home and maintain their daily routines. This approach has been shown to improve patient outcomes, reduce hospital readmissions, and enhance overall quality of life.

In addition to medical care, day hospitals also offer a range of support services to help patients manage their daily lives. These may include home care assistance, meal delivery, and transportation services. By providing these support services, day hospitals can help patients maintain their independence and reduce their reliance on family members or caregivers.

Germany’s day hospitals have also been recognized for their cost-effectiveness. By reducing hospitalization rates and providing more efficient care, these facilities can help reduce healthcare costs and alleviate pressure on the healthcare system. According to a study by the German Ministry of Health, day hospitals can reduce healthcare costs by up to 30% compared to traditional hospital care.

The success of Germany’s day hospitals has inspired other countries to adopt similar models. Many countries, including the United States, are now exploring the potential of day hospitals to improve healthcare outcomes and reduce costs. As the global healthcare landscape continues to evolve, Germany’s day hospitals provide a promising example of how innovative approaches to care can improve patient outcomes and enhance the overall quality of life.

Overall, Germany’s day hospitals offer a unique and innovative approach to healthcare, combining medical care with home support to provide patients with a more personalized and flexible care experience. With their focus on patient-centered care, cost-effectiveness, and support services, these facilities are poised to play an increasingly important role in the future of healthcare.

North India hospitals have decided to suspend cashless services for Bajaj Allianz policyholders, according to scanx.trade.

Several major hospitals in North India have announced that they will be suspending cashless services for policyholders of Bajaj Allianz, a prominent insurance company. This decision comes after a long-standing dispute between the hospitals and the insurance provider over unpaid dues and low reimbursement rates.

The hospitals, which include some of the top private healthcare providers in the region, have cited Bajaj Allianz’s failure to settle outstanding claims and its insistence on applying low reimbursement rates as the reason for their decision. They claim that the insurance company has been delaying payments and applying rates that are significantly lower than those agreed upon, resulting in substantial financial losses for the hospitals.

As a result, policyholders of Bajaj Allianz who require medical treatment at these hospitals will no longer be able to avail of cashless services. Instead, they will have to pay for their treatment out of pocket and then submit claims to the insurance company for reimbursement. This move is expected to cause significant inconvenience and financial hardship for policyholders, who may be forced to bear the upfront costs of medical treatment.

The dispute between the hospitals and Bajaj Allianz has been ongoing for several months, with the hospitals repeatedly urging the insurance company to settle outstanding claims and revise its reimbursement rates. However, the issue remains unresolved, prompting the hospitals to take the drastic step of suspending cashless services.

The development has raised concerns among policyholders, who fear that they may be left without access to quality medical care. The move is also expected to have a significant impact on the healthcare sector in North India, where Bajaj Allianz is a major player. The insurance company has yet to comment on the situation, but it is likely to face pressure from policyholders and regulatory authorities to resolve the dispute and restore cashless services.

The suspension of cashless services is a significant escalation of the dispute and highlights the deepening rift between hospitals and insurance companies over reimbursement rates and payment terms. The issue is not unique to Bajaj Allianz and is a broader problem that affects the entire healthcare industry. As the situation continues to unfold, it remains to be seen how the dispute will be resolved and what impact it will have on policyholders and the healthcare sector as a whole.

The government shutdown is significantly impacting the healthcare system, with various consequences for patients, healthcare providers, and the overall industry. One of the key concerns is the battle over Affordable Care Act (ACA) subsidies, which has sparked intense debate and negotiation.

  1. Delayed Funding: The shutdown has resulted in delayed funding for various healthcare programs, including those related to the ACA. This delay can lead to disruptions in services, affecting patients who rely on these programs for their healthcare needs.
  2. Impact on Medicaid and CHIP: The shutdown affects the funding for Medicaid and the Children’s Health Insurance Program (CHIP), which provide health coverage to millions of low-income individuals and families. States may struggle to continue these programs without federal funding, potentially leaving vulnerable populations without access to necessary healthcare.
  3. ACA Subsidies: The battle over ACA subsidies revolves around the federal government’s role in reimbursing insurance companies for the discounts they offer to low-income enrollees. The cessation of these subsidy payments could lead insurance companies to increase premiums or withdraw from the ACA marketplaces, making healthcare less affordable for many Americans.
  4. Healthcare Workforce: The shutdown may impact the healthcare workforce, particularly in areas dependent on federal funding. This could lead to staffing shortages, reduced services, and increased workload for remaining staff, ultimately affecting the quality of care provided to patients.
  5. Research and Public Health: The shutdown also affects research initiatives and public health programs. This can hinder progress in medical research, disease prevention, and outbreak response, potentially having long-term consequences for the healthcare system and public health.
  6. Insurance Premiums: The uncertainty surrounding ACA subsidies and the overall stability of the healthcare market may lead to increased insurance premiums. As insurance companies face financial uncertainty, they may raise premiums to mitigate potential losses, making healthcare less accessible to many.
  7. Rural Healthcare: Rural areas, which often rely heavily on federal funding for their healthcare services, are particularly vulnerable to the shutdown’s impacts. Reduced funding can exacerbate existing healthcare access issues in these regions, further disenfranchising rural communities.
  8. Veterans’ Healthcare: The shutdown can affect the Department of Veterans Affairs’ (VA) ability to provide timely and comprehensive healthcare services to veterans. Despite being exempt from the shutdown, the VA’s operations can still be impacted by lack of funding for certain programs and services.
  9. Food and Drug Administration (FDA): The FDA’s activities, including drug approvals and food safety inspections, are reduced during the shutdown. This can delay the approval of new drugs and medical devices, potentially impacting patient access to innovative treatments.
  10. Long-term Consequences: The prolonged nature of the shutdown can have lasting effects on the healthcare system, including decreased investor confidence in health insurance companies, reduced participation in ACA marketplaces, and increased healthcare costs for consumers.

The federal government shutdown that began on October 1, 2025, is largely due to disagreements over healthcare issues between Democrats and Republicans. One major point of contention is the extension of subsidies for Affordable Care Act (ACA) insurance premiums, which are set to expire at the end of 2025. Democrats are pushing for an extension, as without it, ACA premiums are expected to rise by over 75% in 2026, resulting in an estimated 4.2 million Americans losing insurance.

Another key issue is the rollback of cuts to the Medicaid program, which was included in President Trump’s “One Big Beautiful Bill” signed into law on July 4. Democrats are seeking to renegotiate these changes, including new work requirements that would lead to an estimated 5 million people losing their health insurance coverage. Additionally, Democrats want to reverse restrictions that made immigrants who are lawfully present in the country ineligible for Medicaid and ACA coverage, which could lead to the loss of insurance for about 1.4 million people.

The shutdown may have far-reaching effects on healthcare, with potential impacts on various health services. Nonessential activities at federal agencies have been wound down, and the shutdown will continue until Congress passes a funding bill and Trump signs it. Some health services, such as surveying and certifying nursing homes, assisting Medicaid and Medicare beneficiaries, and overseeing contracts for rural ambulance providers, may be affected.

However, some health services will continue to function, including Medicaid, which has enough funding to support the program through the end of the calendar year. Community health centers, which provide nonemergency medical services to about 34 million Americans, are expected to receive some funding, at least for now. The Indian Health Service and the Veterans Health Administration will also remain open.

The severity of the shutdown’s effects on healthcare will depend on how long it lasts and whether Trump follows through on his threat to use the shutdown as an opportunity to reshape the federal bureaucracy. The White House has announced plans for potential mass firings of workers, particularly those at “Democrat Agencies,” which could lead to more permanent reductions in health programs.

In the short term, seniors may face an immediate impact, as two programs that expanded access to telehealth services and allowed people to receive services at home have lost funding. Providers may be hesitant to schedule patients covered by Medicare if the shutdown drags on, as payments to medical providers would likely be delayed. Ultimately, the shutdown’s effects on healthcare will depend on the duration and the actions taken by the administration.

Niva Bupa reported a strong Q4 with a 36% increase in premium growth, and their FY25 profit saw an increase of ₹214 crore.

Niva Bupa Health Insurance has reported a remarkable 161% increase in its profit after tax (PAT) for the financial year 2025, reaching ₹214 crore from ₹82 crore in the previous year. The company’s Gross Written Premium (GWP) also saw a significant increase, with a 36% year-on-year rise to ₹2,395 crore in the fourth quarter and a 32% increase to ₹7,407 crore for the entire year.

The insurer’s financial health has improved, with a solvency ratio of 3.03, up from 2.55 in the previous year, indicating its ability to fulfill long-term obligations and customer commitments. The Cost of Management has also declined to 37.4% from 39.3% due to increased automation and digital processes.

Niva Bupa’s CEO, Krishnan Ramachandran, attributed the company’s growth to the trust of its customers and partners. He emphasized that the company will continue to invest in developing a strong brand, simplifying health insurance, and scaling its digital and distribution infrastructure.

As of March 31, 2025, Niva Bupa has a large network of over 212 physical branches, 1.8 lakh agents, 540 brokers, and 100+ bancassurance and corporate partners, providing a strong presence in both metro and non-metro markets. The company offers protection to over 2 crore lives and has agreements with 10,421 hospitals in India, allowing policyholders to receive care anywhere they need it.

With over 8,900 employees, Niva Bupa has been recognized as a “Great Place to Work” for five consecutive years, highlighting its people-centric and performance-oriented culture. The company’s adjusted GWP, considering the new IRDAI accounting regulation, was ₹2,079 crore for the fourth quarter, representing an 18% year-on-year increase. Overall, Niva Bupa’s strong financial performance and expanding network demonstrate its commitment to providing quality health insurance services to its customers.

Tata AIA Life has launched a unit-linked health plan.

Tata AIA Life Insurance has introduced a new unit-linked health insurance plan called Tata AIA Health SIP. This plan is similar to unit-linked insurance plans (ULIPs), but it focuses on providing both health insurance and investment opportunities for investors. The key features of the plan include no premium allocation charges, allowing the investor’s premium amount to be directly utilized for health coverage and investment. Additionally, the plan offers tax-free withdrawals from the 6th policy year onwards, maturity boosters for long-term fund value, and critical illness protection with premium lock-in up to 30 years.

The plan is available in two variants: Health SIP Plus and Health SIP Plus Pro. Health SIP Plus includes in-built Accidental Total and Permanent Disability (ATPD) benefits, while Health SIP Plus Pro offers ATPD benefits plus Terminal Illness with Term Booster (TTB) for enhanced protection. To complement the plan, Tata AIA has launched the Tata AIA Health Buddy app, a 24×7 virtual companion available through the Tata AIA Life Insurance app. This app aims to provide consumers with access to world-class health and wellness solutions.

According to Sanjay Arora, Chief of Operations at Tata AIA Life Insurance, the introduction of Tata AIA Health Buddy sets a new benchmark in consumer care by blending health, wellness, and life insurance. The app empowers consumers to live healthier and more fulfilled lives by providing them with protection and enabling them to make informed decisions about their health. With the launch of Tata AIA Health SIP and the Health Buddy app, Tata AIA Life Insurance aims to provide a comprehensive solution for individuals seeking to protect their health and wellbeing while also investing in their future.

The plan’s features and benefits are designed to provide investors with a flexible and secure way to manage their health and financial needs. By offering tax-free withdrawals, maturity boosters, and critical illness protection, the plan provides a safety net for investors and their families. The introduction of the Health Buddy app further enhances the plan’s value proposition, providing consumers with a convenient and accessible way to manage their health and wellness. Overall, the Tata AIA Health SIP and Health Buddy app are innovative solutions that cater to the evolving needs of consumers in the health insurance and investment space.

Without affordable health insurance, all Wyoming residents suffer.

The Mountain Health Co-Op, one of two insurers offering individual insurance in Wyoming, has announced its withdrawal from the state’s health insurance marketplace. This decision affects approximately 11,000 members, who must now find a new health insurance carrier before next year. The co-op’s departure is attributed to high claims costs and significant losses in Wyoming, prompting the company to focus on its operations in Idaho and Montana instead.

The withdrawal of Mountain Health Co-Op is significant for several reasons. Firstly, it highlights the challenges of providing health care in Wyoming, where the small population and rural landscape make it difficult to spread risk. As a result, health insurance rates are expected to increase by around 25% in 2026. The co-op’s departure is also a symptom of deeper issues facing Wyoming, including the high cost of providing health care and the lack of control over what health care providers can charge.

Wyoming’s health care costs are among the highest in the country, which can be attributed to the state’s older population and the lack of younger, healthier members to offset the risk pool. The state’s business-friendly environment, characterized by lower taxes and fewer regulations, does not seem to apply to the health care sector. The Wyoming Legislature and federal delegation have tools available to help lower health care costs, but more needs to be done to address this issue.

The rising cost of health care is not a new discussion, and it is essential to examine the drivers of these costs. The cost of health care can vary significantly between providers, and it is crucial for consumers to be aware of these costs and challenge health care providers who charge excessively. The expansion of Medicaid eligibility, premium tax credits, and coverage of essential and preventive care have helped keep costs down in the past. However, the departure of Mountain Health Co-Op should serve as a wake-up call to address the underlying issues in Wyoming’s health care system.

Mountain Health Co-Op was a unique company that invested in its members and the community, offering zero-dollar co-pay prescriptions, travel reimbursements, and a focus on preventive medicine. The next company to enter the Wyoming market may not have the same commitment, highlighting the need for the state to take action to address its health care challenges. The can has been kicked down the road for too long, and it is essential for Wyoming to find a solution to its health care woes to ensure that its residents have access to affordable and quality health care.

The government shutdown debate centers on two key issues: healthcare and immigration, specifically concerning individuals in the U.S. illegally. The healthcare aspect revolves around the Affordable Care Act (ACA), also known as Obamacare, which has been a point of contention since its inception. Republicans have sought to repeal and replace the ACA, citing concerns over its cost and effectiveness, while Democrats have fought to preserve and expand it, arguing it provides essential health coverage to millions of Americans.The immigration component of the debate focuses on the treatment of undocumented immigrants, particularly those brought to the U.S. as children, known as Dreamers. Democrats have pushed for a pathway to citizenship for these individuals, arguing it is a matter of humanitarian justice and economic sense, as many Dreamers are integrated into American society, attending school, working, and serving in the military. Republicans, however, have emphasized the need for border security and stricter immigration laws, often linking these to any discussions about the legal status of undocumented immigrants.The government shutdown occurs when Congress fails to pass or the President fails to sign appropriations bills that fund government operations, leading to the cessation of non-essential federal services. In the context of the healthcare and immigration debates, a shutdown might happen if lawmakers cannot agree on provisions related to these issues within the budget bills. For instance, if Democrats insist on including protections for Dreamers or funding for ACA programs, and Republicans refuse, agreeing on a budget becomes impossible, leading to a shutdown.This political stalemate is not just about policy; it’s also about political leverage and public perception. Both parties seek to position themselves in a way that garners public support, often framing the debate in terms of principles rather than practicalities. The outcome of such debates can have significant implications for the country, affecting not just the immediate issues at hand but also the broader political landscape and future policy directions.

The government shutdown has sparked a heated debate between Democrats and Republicans over healthcare for immigrants. The White House and Republican lawmakers claim that Democrats want to provide free healthcare to undocumented immigrants, which Democrats deny. The controversy centers around a provision in the Democrats’ funding proposal that would reverse changes made by the One Big Beautiful Bill Act, which restricted Medicaid eligibility for noncitizens. The Act, signed by President Trump, made it harder for certain groups of immigrants, including those granted parole, refugees, and asylees, to access Medicaid.

Democrats argue that their proposal would only restore eligibility for immigrants with some form of legal status or government protection, not those living in the US illegally. They point out that US law already prohibits the use of taxpayer dollars to provide medical coverage to undocumented individuals. House Democratic Leader Hakeem Jeffries stated, “Federal law prohibits the use of taxpayer dollars to provide medical coverage to undocumented individuals. And there is nothing in anything that we have proposed that is trying to change that law.”

The One Big Beautiful Bill Act had significant consequences, with an estimated 1.4 million immigrants potentially losing health insurance coverage. The Democrats’ proposal would reopen access to Medicaid for certain groups of immigrants, including lawful permanent residents, Cubans and Haitians who entered the US legally, and noncitizens from several Pacific islands. The proposal would also reverse the Act’s changes to emergency funding for noncitizens, which constitutes less than 1% of total spending for the program.

Some Republicans, including House Speaker Mike Johnson and Vice President JD Vance, have accused Democrats of trying to “take from the American people” to provide healthcare to undocumented immigrants. However, Democrats argue that their proposal is focused on restoring healthcare coverage to lawfully present immigrants and fighting for the healthcare of American citizens. The debate has become a major sticking point in the government shutdown, with Democrats refusing to vote for a short-term funding extension unless Republicans extend Affordable Care Act tax credits that have helped millions of Americans lower their health insurance costs.

In reality, many states, including California, already provide some form of healthcare coverage to undocumented immigrants using state funds. According to a KFF analysis, more than a dozen states comprehensively cover care for low-income children who lack a legal immigration status using state funds. The controversy surrounding the Democrats’ proposal has highlighted the complex and often contentious issue of immigration and healthcare in the US.

Tata AIA has launched two new initiatives, Health Buddy and Health SIP, as part of its effort to expand its focus on healthcare.

Tata AIA Life Insurance has introduced a new virtual health companion called Health Buddy, which is available exclusively through the Tata AIA mobile app. This platform provides round-the-clock access to preventive health services and specialist consultations, covering a wide range of needs such as routine check-ups, vaccinations, and in-person consultations for women’s health conditions. Health Buddy also offers dental wellness services, medical second opinions, critical illness support, discounts on medicines and diagnostics, and access to doctors across more than 24 specialities. Additionally, fitness and diet sessions are integrated to support preventive care.

With the launch of Health Buddy, Tata AIA is expanding its services beyond life insurance into broader healthcare and wellness. The company aims to become a true health partner by providing a comprehensive range of health services. According to Sanjay Arora, Chief of Operations at Tata AIA Life Insurance, “Our objective is to go beyond financial protection. With Health Buddy, we are stepping into the role of a true health partner.”

Alongside the launch of Health Buddy, Tata AIA has introduced Health SIP, a non-participating, unit-linked health insurance plan. This plan allows policyholders to integrate health coverage with wealth creation, offering long-term premium lock-in of up to 30 years, tax-free withdrawals for health expenses starting in the sixth policy year, and built-in critical illness protection. Health SIP is available in two variants: Health SIP Plus, which includes coverage for accidental total and permanent disability, and Health SIP Plus Pro, which adds terminal illness protection with a term booster.

To promote the new offerings, Tata AIA has rolled out a campaign on the Mumbai Metro’s Versova-Andheri-Ghatkopar line. The campaign features posters, digital displays, and train interiors showcasing Health Buddy’s mascot, positioning the service as a constant and approachable partner in everyday life. According to Girish J Kalra, Chief Marketing Officer at Tata AIA, “Health Buddy is about accessibility and relevance. Our campaign mirrors this by being ever-present in the commuter’s journey.” With Health Buddy and Health SIP, Tata AIA is taking a significant step towards becoming a comprehensive health and wellness provider.

Health care premium assistance is coming to an end, prompting officials to sound the alarm.

Congressmen Seth Magaziner and Gabe Amo, along with leaders from Rhode Island’s health care industry, held a joint press conference to express their concerns about looming federal cuts to health care assistance. The cuts, which are set to take effect at the end of the year, would impact thousands of Rhode Islanders who rely on federal tax credits to afford health insurance premiums. The tax credits, which are available to individuals and families based on income, have made health care affordable for many thousands of Rhode Islanders.

Michael Sroczynski, president of the Hospital Association of Rhode Island, warned that the loss of federal assistance would not only mean that many Rhode Islanders would no longer be able to afford insurance, but also that the state’s entire health care system would suffer as a result. Peter Marino, president and CEO of Neighborhood Health Plan of Rhode Island, noted that about 90% of its members rely on the premium tax credits to subsidize their health insurance costs.

Magaziner and Amo stated that they are committed to fighting the cuts and extending the health care tax credits, despite expected opposition from Republican leadership. They emphasized that every Rhode Islander deserves access to high-quality, affordable health care, and that the loss of federal assistance would be devastating to many families. Lindsay Lang, director of HealthSource RI, added that protecting Rhode Islanders’ ability to seek mental and physical health care services is core to the organization’s mission and to the good of the state.

The officials at the press conference also highlighted the issue of major federal funding cuts to Medicaid, which are expected to cost millions of people their Medicaid benefits. Lynn Blais, president of United Nurses & Allied Professionals, warned that the loss of health insurance would mean the difference between life and death for too many Rhode Islanders, and that the state would be returning to a time when thousands of people did not have health insurance. The congressmen and health care leaders are calling on President Trump and Republicans in Congress to extend the health care tax credits and prevent the cuts to Medicaid.

ICICI Lombard’s film turns snoring into a wake-up call for heart health, ETBrandEquity

ICICI Lombard, a leading insurance company, has launched a digital campaign for World Heart Day to raise awareness about the potential health risks associated with snoring. The campaign, titled “Reframing Snoring,” aims to educate people about the link between snoring and sleep apnea, a condition that can lead to serious health complications such as hypertension, arrhythmia, and heart failure. According to the company, an estimated 10.4 crore Indians suffer from sleep apnea, often undiagnosed.

The campaign uses a humorous approach to depict a common scenario where a fit-looking man snores loudly, much to the frustration of his roommate. However, the tone turns serious as a voiceover reveals the potential health implications of snoring. The film encourages viewers to take proactive steps to monitor their snoring patterns and seek medical consultation if necessary.

To support this initiative, ICICI Lombard has introduced a feature on its IL TakeCare app that allows users to record their snoring episodes and receive guidance on seeking medical help. The company hopes that by raising awareness about the risks associated with snoring, people will take preventive measures to protect their heart health.

Speaking about the campaign, Sheena Kapoor, Head of Marketing, Corporate Communications, and CSR at ICICI Lombard, said that the company aims to use creativity to drive meaningful change, especially when it comes to preventive health. She emphasized that snoring is often dismissed as harmless, but it can be an early sign of sleep apnea, which is linked to serious cardiovascular risks.

The campaign marks ICICI Lombard’s 25th anniversary and reinforces the company’s commitment to preventive care. By using a relatable and engaging approach, the company hopes to encourage people to make proactive choices about their heart health. As Kapoor noted, “Preventive care doesn’t have to be intimidating. When told right, it can be both approachable and impactful.” The campaign aims to spark curiosity and encourage early conversations about sleep apnea and heart health, ultimately helping people make informed decisions about their well-being.

Pluto Health has expanded its care model to include Medicare, Medicaid, and major commercial plans.

Pluto Health, a healthcare technology company, has announced the expansion of its care model to include Medicare, Medicaid, and major commercial plans. This move aims to increase access to high-quality, affordable healthcare for a wider range of patients.

Pluto Health’s care model focuses on value-based care, where healthcare providers are incentivized to deliver high-quality, cost-effective care. The company’s platform uses advanced analytics and artificial intelligence to identify high-risk patients, provide personalized care plans, and coordinate care across different healthcare settings.

By expanding its care model to Medicare, Medicaid, and commercial plans, Pluto Health can now reach a broader patient population, including older adults, low-income individuals, and those with private insurance. This expansion is expected to improve health outcomes, reduce healthcare costs, and enhance the overall patient experience.

The inclusion of Medicare and Medicaid in Pluto Health’s care model is particularly significant, as these programs provide coverage to millions of Americans. Medicare, which covers individuals 65 and older, as well as certain younger individuals with disabilities, is a critical component of the US healthcare system. Medicaid, which provides coverage to low-income individuals and families, is also essential for ensuring access to healthcare for vulnerable populations.

Pluto Health’s expansion into commercial plans will also enable the company to partner with private insurers, self-insured employers, and other organizations to deliver value-based care to a wider range of patients. This move is expected to help reduce healthcare costs, improve health outcomes, and enhance the overall value of healthcare services for patients and payers alike.

The company’s care model has shown promising results in improving health outcomes and reducing costs. For example, Pluto Health has reported a significant reduction in hospital readmissions, emergency department visits, and healthcare costs for patients enrolled in its program.

Overall, Pluto Health’s expansion of its care model to Medicare, Medicaid, and major commercial plans represents a significant step forward in increasing access to high-quality, affordable healthcare for a wider range of patients. As the US healthcare system continues to evolve, companies like Pluto Health are leveraging technology, analytics, and value-based care models to drive improvements in health outcomes, reduce costs, and enhance the overall patient experience.

Tata AIG has joined Star Health and Niva Bupa in discontinuing cashless claim settlement at Max Hospitals.

Tata AIG General Insurance has suspended its cashless settlement arrangement with Max Hospitals, effective September 10, 2025. This move comes after a dispute over tariffs, with Tata AIG seeking further rate cuts and Max Healthcare refusing to comply. The hospital chain had signed a two-year tariff agreement with Tata AIG, but the insurer requested additional reductions in July, threatening to suspend cashless services if its demands were not met.

As a result, policyholders will now be required to pay upfront for medical treatment at Max Hospitals and then seek reimbursement from Tata AIG. Max Healthcare has set up an express desk to support reimbursement claims and ensure that patients are not inconvenience. The hospital chain has stated that further rate reductions would be “unviable” and could compromise patient care.

Tata AIG has assured its customers that it has made special arrangements to ensure they face no inconvenience. The insurer has prioritized and fast-tracked claims, allowing policyholders to continue receiving uninterrupted treatment and care. Tata AIG’s dedicated service teams are monitoring every case closely to provide complete support and ensure zero disruption for customers.

This dispute is not an isolated incident, but rather part of a wider industry flashpoint between insurers and hospitals over tariffs and settlement terms. Earlier, Star Health had suspended cashless services at several hospitals, including Manipal, Medanta, and Max, sparking criticism from the Association of Healthcare Providers of India (AHPI). However, after negotiations, Star Health and AHPI member hospitals agreed to restore cashless services. Similarly, a standoff between AHPI hospitals in north India and Bajaj Allianz over cashless withdrawals was resolved earlier this month. The suspension of cashless services by Tata AIG is the third such incident, following Star Health and Niva Bupa, highlighting the growing tensions between insurers and hospital chains.

Private hospitals in India have suspended services for members of the country’s health insurance program, leaving millions of people without access to medical care.

India’s flagship public health insurance program, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PM-JAY), is facing significant challenges. The program, launched in 2018, promises to cover hospital expenses up to ₹5 lakh (around $5,725) per family, but it has run into problems over non-payment to private hospitals. In Haryana, 650 private hospitals have suspended services to PM-JAY patients due to ₹490 crore ($59 million) in pending reimbursements, which date back six to nine months.

This has cut off up to 18 million low-income residents from private-sector surgeries, dialysis, cancer care, and other critical treatments. Patients are being forced to seek treatment at smaller facilities with limited services or borrow money to pay for care. The suspension has also led to a surge in patient load at public hospitals, resulting in longer wait times and overstretched staff.

The issue is not limited to Haryana, as other states like Jammu and Kashmir are facing similar problems. The region has fewer than 130 empanelled private hospitals, and patients often have to travel hundreds of kilometers for treatment. Delayed claim settlements and restrictive empanelment rules have left many patients without access to care.

Health economists say that the public-private partnership model in healthcare is fragile and that the government’s purchasing power is undermined when reimbursements are delayed. The Swiss Re Institute has warned that India’s heavy reliance on out-of-pocket payments risks reversing poverty reduction gains, with the health protection gap estimated to reach $200 billion by 2033.

The Indian government has promised to clear dues and review package rates, but private hospitals remain skeptical. The National Health Policy aims to reduce catastrophic health expenditure to 25% of households by 2025, but recent studies suggest that this goal may be out of reach. The pooled incidence of catastrophic health expenditure stands at 30% of Indian households, and inpatient care accounts for 11% of monthly household consumption.

The situation highlights the need for structural fixes to schemes like PM-JAY to ensure that they can deliver universal health coverage. The government needs to address the issues of delayed reimbursements, under-enrolment of private providers, and allegations of fraud to make the program effective. Until then, patients like Sunita’s family will continue to suffer, and the goal of universal health coverage will remain elusive.

Insured, yet unprotected.

The Indian government’s decision to reduce GST on insurance premiums to zero percent is a relief for millions, but it only scratches the surface of a deeper crisis in the insurance sector. According to the Council of Insurance Ombudsman’s 2023-24 annual report, the top three firms with the most complaints are Star Health, CARE Health Insurance, and Niva Bupa. Star Health leads with 13,308 complaints, with 10,196 related to claim rejections or slashes. CARE Health’s COO, Manish Dodega, defended his company’s position, stating that the number of complaints does not represent the true picture and that the industry has robust systems in place to address issues.

The scale of problems in the insurance sector is staggering, with 2,15,569 complaints filed on IRDAI’s platforms in FY 2023-24. Nearly 95% of health insurance complaints were about claim rejections, while 59% of life insurance complaints concerned misrepresentation or mis-selling. The financial impact on consumers is significant, with health insurance claim rejections rising to Rs 26,000 crore in FY24. Mis-selling is a major issue, with 26,107 life insurance complaints filed against unfair business practices, including mis-selling.

The root cause of mis-selling is the commission structure, which incentivizes selling expensive products over suitable coverage. Experts advocate for dramatic reforms, including overhauling the commission structure and banning upfront commissions in life insurance. The industry needs to focus on term insurance and fundamentally change its product mix. Regulatory transformation is also necessary, with experts criticizing IRDAI’s functioning and calling for a more market-consultative approach.

The cumulative effect of these problems has created a massive trust deficit, with 65% of policyholders not fully understanding their policies and 43% facing hurdles in health claim processing. This erosion of trust is pushing people away from insurance altogether. While the zero GST move addresses affordability concerns, it doesn’t tackle the fundamental issues of transparency, fair claim settlement, and honest selling practices. The industry needs comprehensive reforms, and until then, millions of Indians will continue to find themselves insured but unprotected.

Tata AIA has launched two new funds that aim to capitalize on India’s expanding consumer market.

Tata AIA Life has introduced two new funds: the Tax Bonanza Consumption Fund and the Tax Bonanza Consumption Pension Fund. These funds are designed to capitalize on the changing consumption patterns in India, which have been driven by urbanization and increasing income levels. The funds will be open for subscription from March 24 to March 31, 2025, with each unit priced at Rs 10.

India’s consumption trends have undergone a significant transformation in recent years. The country’s growing middle class and rising income levels have led to increased spending power, particularly among urban households. The new tax regime, which came into effect in FY26, has further boosted consumer spending by exempting individuals earning up to Rs 12.75 lakh per annum from paying taxes. This has resulted in a surge in demand for goods and services across various sectors, including fast-moving consumer goods (FMCG), retail, e-commerce, and automobiles.

The Tata AIA Life Tax Bonanza Consumption Fund and the Tax Bonanza Consumption Pension Fund aim to benefit from this trend by investing in high-growth industries that are driving India’s consumption story. The funds offer investors an opportunity to generate wealth while also providing financial security. By investing in these funds, individuals can tap into the growth potential of India’s consumer sector, which is expected to continue growing in the coming years.

The funds’ focus on consumption-driven sectors is strategic, given the expected growth in consumer spending. The FMCG sector, for example, is anticipated to experience significant growth, driven by increasing demand for packaged food, personal care, and other consumer goods. Similarly, the e-commerce sector is expected to continue growing, driven by the rising popularity of online shopping and the increasing penetration of smartphones and internet services.

Overall, the Tata AIA Life Tax Bonanza Consumption Fund and the Tax Bonanza Consumption Pension Fund offer a unique investment opportunity for those looking to capitalize on India’s evolving consumption trends. With their focus on high-growth industries and competitive pricing, these funds are well-positioned to deliver strong returns to investors while also providing financial security.

Beginning next month, Bajaj Allianz will no longer offer cashless treatment, and CARE Insurance has also received a notice, according to the Association of Healthcare Providers India (AHPI).

The Association of Healthcare Providers-India (AHPI) has directed its member hospitals in north India to suspend cashless treatment facilities for Bajaj Allianz General Insurance policyholders starting September 1, 2025. A similar notice has been sent to CARE Health Insurance, with a deadline of August 31, 2025, for a response. If no response is received, AHPI will also suspend cashless treatment facilities for CARE policyholders. This means that policyholders will have to pay for medical expenses out of pocket and claim reimbursements later.

According to Dr. Girdhar Gyani, director general of AHPI, the reason for the suspension is that medical inflation in India is around 7-8% per year, driven by rising staff costs, medicines, and overheads. However, Bajaj Allianz has rejected AHPI’s proposal to review tariff rates every two years to keep them in line with medical inflation. Instead, the insurer has demanded tariff cuts, which AHPI claims is unsustainable. Additionally, member hospitals have alleged claim settlement delays and long discharge approval times against Bajaj Allianz.

AHPI has around 615 network hospitals in Delhi-NCR, 511 hospitals in Punjab, 242 hospitals in Uttarakhand, and 1,220 hospitals in Uttar Pradesh. Representatives from AHPI are scheduled to meet with CARE Health officials and Bajaj Allianz General Insurance to resolve the issues. CARE Health has stated that they were surprised by the announcement and did not receive any specific details from AHPI.

The claim settlement ratio for Bajaj Allianz is 95.99%, while CARE Health has a ratio of 92.77%. This ratio indicates the number of claims honored by an insurance company out of every 100 received. This is not the first tariff-related dispute for CARE Health Insurance, as they have had similar issues with other hospital associations earlier this year. CARE Health has also ceased to provide cashless treatment facilities at Max Hospitals across Delhi-NCR since February 17, 2025, due to “unsustainable demands” from the hospital’s perspective.

Niva Bupa has dismissed as baseless a viral social media post claiming the insurer denied a policyholder’s cashless claim.

A viral social media post on LinkedIn claimed that Niva Bupa Health Insurance had denied a cashless claim of Rs 61 lakh for a policyholder, Chandra Kumar Jain, who is battling Myeloid Leukaemia and requires a Bone Marrow Transplant (BMT) at Sir HN Reliance Foundation Hospital in Mumbai. However, Niva Bupa has clarified that the allegations are “baseless” and that the company had already approved a pre-authorisation cashless request of Rs 25 lakh, as well as an additional charge of Rs 77,000.

The company stated that Jain, a policyholder since 2021, had already availed two claims totaling Rs 22.72 lakh. In the current instance, the hospital had requested an increase in pre-authorisation from Rs 25 lakh to Rs 61 lakh, citing escalating treatment costs, but Niva Bupa did not approve this request. The company emphasized that the originally approved Rs 25 lakh pre-authorisation still stands valid.

Niva Bupa also responded to criticism of the health insurance sector, stating that those labelling it as a “scam” are “highly irresponsible and misleading”. The company emphasized the importance of health insurance in protecting families against unforeseen medical expenses.

In a separate development, Niva Bupa announced that it has suspended the cashless treatment facility at Max Hospitals across India, citing an expired agreement and unsuccessful talks over premium revisions. Max Hospitals responded by stating that it had continued to provide cashless services to Niva Bupa policyholders despite the contract expiring in May 2025, but that further reductions in tariffs would be “unviable” and could compromise patient safety and quality of care.

The dispute between Niva Bupa and Max Hospitals highlights the challenges of negotiating contracts and tariffs in the health insurance sector. While Niva Bupa has emphasized its commitment to providing health insurance coverage, Max Hospitals has prioritized patient safety and quality of care. The incident also underscores the importance of transparency and communication in the health insurance sector, particularly when it comes to claims and pre-authorisations.

California is preparing for a potential health insurance crisis.

California is facing a potential health insurance meltdown due to a combination of factors, including rising healthcare costs, changes in federal funding, and a surge in enrollments in the state’s health insurance marketplace, Covered California. The state’s health insurance market is at risk of destabilization, which could lead to higher premiums, reduced coverage options, and decreased access to healthcare for thousands of Californians.

One of the primary concerns is the pending expiration of the federal Affordable Care Act’s (ACA) enhanced subsidies, which have been instrumental in making health insurance more affordable for low- and moderate-income individuals. The subsidies, which were introduced as part of the American Rescue Plan Act, are set to expire at the end of 2022, unless Congress extends them. Without these subsidies, premiums could increase by as much as 50% for some enrollees, making health insurance unaffordable for many.

Additionally, California is experiencing a surge in enrollments in Covered California, with over 1.8 million people currently enrolled in the program. While this is a positive trend, it also puts pressure on the state’s healthcare system and insurance market. The increased demand for healthcare services and insurance coverage could lead to higher costs and reduced provider networks, making it more difficult for people to access the care they need.

Furthermore, California’s health insurance market is highly dependent on federal funding, which is subject to change. The Trump administration’s efforts to repeal and replace the ACA, as well as the COVID-19 pandemic, have created uncertainty and instability in the healthcare market. The state’s insurers are also facing financial pressures, which could lead to reduced coverage options and higher premiums.

To mitigate the potential meltdown, California’s lawmakers and healthcare officials are exploring options to stabilize the market and ensure continued access to affordable healthcare. These efforts include seeking federal funding to extend the enhanced subsidies, implementing state-based reforms to reduce healthcare costs, and investing in outreach and enrollment efforts to encourage more people to sign up for coverage. However, the outcome is uncertain, and the state’s healthcare system remains at risk of destabilization.

In conclusion, California is facing a potential health insurance meltdown due to a combination of factors, including the expiration of federal subsidies, surging enrollments, and financial pressures on insurers. To address this crisis, state lawmakers and healthcare officials must work together to stabilize the market, reduce healthcare costs, and ensure continued access to affordable healthcare for all Californians. The future of the state’s healthcare system depends on it.

Max Healthcare: No cashless claims for Tata AIG health insurance policyholders in Max Hospitals, becomes 3rd insurer to do so.

Tata AIG Insurance has suspended its cashless claim settlement facility with Max Hospitals, following in the footsteps of Star Health and Niva Bupa. This means that policyholders of these insurance companies will no longer be able to receive cashless treatment at Max Hospitals, and will instead have to pay out of pocket and claim reimbursement later. While Star Health and Niva Bupa have suspended cashless claim settlement with all 22 Max Hospitals across the country, Tata AIG’s suspension is currently in effect.

According to Max Hospitals, the suspension is due to a dispute over tariffs. Max Hospitals claims that Tata AIG demanded a downward revision of the agreed-upon tariffs, which Max Hospitals was not willing to accept. As a result, Tata AIG suspended cashless services at Max Hospitals effective September 10, 2025. Max Hospitals has stated that it will continue to provide an express desk to help policyholders claim reimbursements from insurers without having to make upfront payments.

However, sources at Tata AIG have indicated that discussions are ongoing and that the situation may be resolved in the near future. In the meantime, Tata AIG has put in place special arrangements to ensure that its customers face no inconvenience, including prioritizing and fast-tracking claims. The company has also stated that its dedicated service teams are monitoring every case closely to provide complete support and ensure zero disruption for its customers.

The dispute between Max Hospitals and the insurance companies is not limited to Tata AIG. Niva Bupa has also suspended cashless claim settlement with Max Hospitals, citing a desire to further reduce tariffs. Max Hospitals has stated that it is not willing to reduce tariffs below the 2022 levels, as it believes that doing so would compromise patient safety and the quality of care. CARE health insurance policyholders are also affected, with cashless claim settlement services not available at Max Hospitals in the Delhi-NCR region.

Overall, the suspension of cashless claim settlement facilities by multiple insurance companies is likely to cause inconvenience for policyholders who rely on Max Hospitals for medical care. However, both Max Hospitals and the insurance companies are working to find a resolution and minimize disruption for patients.

15,200 hospitals have suspended cashless treatment for Bajaj Allianz policyholders due to unresolved issues.

The Association of Healthcare Providers India (AHPI) has expressed concerns over the reimbursement rates offered by Bajaj Allianz, a health insurance provider. Dr. Girdhar Gyani, Director General of AHPI, stated that the current rates are outdated and unsustainable, which may compromise patient care. The key issues raised by hospitals include outdated reimbursement rates, unilateral deductions, and delayed payments and approvals.

Hospitals allege that Bajaj Allianz has refused to update reimbursement rates despite rising costs. Additionally, claims are being reduced arbitrarily without adequate explanation, and there are excessive delays in payments and pre-authorisation approvals. This has disrupted hospital operations and patient discharge processes. As a result, patients with Bajaj Allianz policies will now have to pay upfront for medical expenses and seek reimbursement later, which can increase financial stress on families during medical emergencies.

Bajaj Allianz has expressed surprise at the decision and stated that they aim to provide the best possible hospitalization experience for their policyholders. The company is confident that they can work with AHPI to find a solution that benefits their customers. In the meantime, policyholders are advised to confirm the hospital’s status before admission, keep emergency funds ready, collect all bills and documents, file claims promptly, and stay updated on the situation.

Until negotiations between Bajaj Allianz and AHPI succeed, policyholders may have to navigate a cash-driven process at hospitals, which can complicate emergency care. This development may have significant implications for patients who rely on Bajaj Allianz for their medical expenses. It is essential for policyholders to be aware of the current situation and take necessary steps to ensure a smooth reimbursement process. The situation highlights the need for fair reimbursement rates, seamless claims, and quality service in the health insurance sector.

The dispute between Bajaj Allianz and AHPI has significant implications for the healthcare sector, and it is crucial that a resolution is reached soon to avoid any further complications for patients. The association’s decision to withdraw cashless services is a significant step, and it is hoped that negotiations between the two parties will lead to a mutually beneficial solution. Until then, policyholders must be prepared to handle the cash-driven process and take necessary steps to ensure that they receive the medical care they need without undue financial stress.

AHPI requests Star Health to reinstate cashless services at hospitals

The Association of Healthcare Providers of India (AHPI) has expressed concerns over the suspension of cashless treatment by Star Health Insurance in several hospitals. According to AHPI, cashless services have been disrupted in numerous hospitals, including Care Hospitals in Vizag, Manipal in Delhi and Gurugram, and Max in North India. Other hospitals such as Metro in Faridabad, Medanta in Lucknow, Rajiv Gandhi Cancer Hospital in New Delhi, Sarvodaya in Faridabad, and Yatharth Hospitals have also reported disruptions.

AHPI has stated that Star Health Insurance has not only suspended cashless treatment but has also slowed down or denied empanelment to several hospitals. This includes Fortis Manesar, Jupiter Indore, Max Dwarka, Medanta Noida, and Care Hospitals in Hyderabad and Vizag. As a result, families are being forced to opt for reimbursement claims instead of cashless treatment, which can be a lengthy and cumbersome process.

The association has urged Star Health Insurance to immediately restore cashless services and expedite empanelments. This move is expected to benefit patients who rely on cashless treatment for medical emergencies. By restoring cashless services, Star Health Insurance can ensure that patients receive timely and hassle-free treatment, without the added burden of reimbursement claims.

AHPI’s concerns highlight the importance of cashless treatment in the healthcare sector. Cashless treatment allows patients to receive medical care without having to pay out-of-pocket expenses, which can be a significant financial burden. By suspending cashless treatment, Star Health Insurance is not only causing inconvenience to patients but also undermining the trust and confidence that patients have in the healthcare system.

As a reliable and trusted news source, it is essential to report on such issues and bring them to the attention of the relevant authorities. The disruption of cashless services by Star Health Insurance is a matter of concern, and it is crucial that the insurer takes immediate action to restore these services and expedite empanelments. By doing so, Star Health Insurance can ensure that patients receive the medical care they need, without any unnecessary delays or hardships.

  1. Enhanced Risk Assessment: AI-powered algorithms analyze large amounts of data to better assess individual health risks, allowing for more accurate premium calculations and personalized policy offerings.
  2. Streamlined Claims Processing: Telemedicine and AI-driven systems automate claims processing, reducing administrative burdens and enabling faster reimbursement for policyholders.
  3. Personalized Wellness Programs: AI-driven health insurance platforms provide tailored wellness recommendations and preventive care advice, promoting healthier lifestyles and reducing the likelihood of costly medical interventions.
  4. Virtual Health Services: Telemedicine integrates with health insurance to offer virtual consultations, expanding access to care and reducing costs associated with in-person visits.
  5. Data-Driven Underwriting: AI analyzes extensive datasets to identify high-risk factors, enabling insurers to make more informed underwriting decisions and adjust premiums accordingly.
  6. Improved Patient Engagement: AI-powered chatbots and telemedicine platforms facilitate patient-insurer interactions, enhancing communication and fostering a more collaborative approach to healthcare management.
  7. Predictive Analytics for Disease Management: AI-driven predictive models identify patients at risk of developing chronic conditions, enabling proactive interventions and reducing long-term healthcare costs.
  8. Increased Transparency and Accessibility: AI-powered health insurance platforms provide policyholders with easy access to claims information, coverage details, and personalized health advice, promoting transparency and empowering informed decision-making.

The healthcare industry has undergone significant transformations in recent years, driven by the advent of artificial intelligence (AI) and the digital revolution. One of the key advancements in healthcare services is the emergence of telemedicine, which enables medical services to be delivered remotely through telecommunications technology, such as mobile phone networks. The integration of AI and telemedicine is poised to revolutionize the healthcare industry in the near future.

Telemedicine has made it possible for patients to access medical services from the comfort of their own homes, reducing the need for hospital visits and improving healthcare outcomes. AI-powered telemedicine platforms can analyze patient data, diagnose conditions, and provide personalized treatment recommendations. This integration has the potential to increase efficiency, reduce costs, and enhance patient care.

The combination of AI and telemedicine is expected to shape the future of health insurance plans in several ways. For instance, AI-powered telemedicine platforms can help insurers to better assess patient risks, predict healthcare outcomes, and develop more accurate actuarial models. This can lead to more personalized and cost-effective health insurance plans that cater to the specific needs of individual patients.

Moreover, AI-driven telemedicine can enable insurers to provide preventive care and early intervention, reducing the likelihood of costly hospitalizations and treatments. By analyzing patient data and identifying potential health risks, AI-powered telemedicine platforms can help insurers to develop targeted interventions and preventive care programs. This can lead to better health outcomes, reduced healthcare costs, and improved patient satisfaction.

The integration of AI and telemedicine is also expected to enhance the overall patient experience. AI-powered chatbots and virtual assistants can help patients to navigate the healthcare system, schedule appointments, and access medical services remotely. This can reduce wait times, improve patient engagement, and enhance the overall quality of care.

In conclusion, the integration of AI and telemedicine is poised to revolutionize the healthcare industry, transforming the way healthcare services are delivered and health insurance plans are designed. By leveraging the power of AI and telemedicine, insurers can develop more personalized, cost-effective, and preventive health insurance plans that cater to the specific needs of individual patients. As the healthcare industry continues to evolve, it is likely that AI and telemedicine will play an increasingly important role in shaping the future of health insurance plans.

Star Health’s latest campaign draws a stark line between care and crisis

Star Health Insurance has launched a new campaign film that highlights the emotional and financial struggles faced by families without health insurance. The film, released after World Insurance Day, uses a split-screen narrative to contrast the experiences of the same family with and without health insurance. On one side, the family is shown struggling with long hospital queues, delayed treatment, and financial stress, while on the other side, they are able to access priority consultations, private rooms, and a streamlined process.

The campaign aims to spark a conversation around the importance of health insurance and the peace of mind it can provide. By showing the stark difference between the two scenarios, the film emphasizes the value of being prepared for health emergencies. The narrative is led by actor Dibyendu Bhattacharya, who delivers a restrained and empathetic performance that reflects the quiet resilience of many families navigating healthcare stress.

The film’s message is subtle yet powerful, emphasizing the importance of timely decisions when it comes to health insurance. The closing line, “Health Insurance abhi lena smart hai” (getting health insurance now is smart), drives home the urgency of making informed choices. By focusing on everyday hospital moments and understated emotional cues, the story becomes deeply relatable to audiences.

The campaign is particularly relevant in today’s context, where audiences are looking for real stories that reflect their own experiences. By shedding light on the emotional toll of being uninsured, Star Health’s campaign draws attention to the thin line between care and chaos. The film ultimately underscores the importance of having a support system that provides not just financial protection, but also peace of mind during difficult times. Overall, the campaign is a thoughtful and impactful reminder of the value of health insurance in protecting not just our physical health, but also our emotional well-being.

Meet Tata AIA Health Buddy: Your New Virtual Health & Wellness Partner

Tata AIA Life Insurance has introduced “Tata AIA Health Buddy”, a 24×7 health and wellness companion that provides comprehensive support to individuals and families in India. The service is designed to go beyond traditional life insurance, offering a range of health and wellness services that cater to the diverse needs of consumers. With Health Buddy, Tata AIA aims to be a true partner in everyday well-being, helping consumers stay prepared for life’s uncertainties while promoting healthier, happier living.

The Health Buddy service is exclusively available on the Tata AIA Life Insurance App and offers a wide range of services, including preventive health check-ups, vaccinations, doctor consultations, discounts on lab tests and medicine orders, and fitness and diet expert sessions. The service also provides medical second opinions and dedicated case support for diagnosed critical illnesses.

To complement the Health Buddy, Tata AIA has also introduced Tata AIA Health SIP, a pioneering Non-Participating, Unit-Linked Health Insurance Plan. Health SIP integrates health coverage with wealth creation, ensuring consumers are protected in emergencies while also securing their future. The plan comes in two variants, Health SIP Plus and Health SIP Plus Pro, which offer additional benefits such as Accidental Total and Permanent Disability (ATPD) benefits and Terminal Illness with Term Booster (TTB) cover.

The launch of Tata AIA Health Buddy and Health SIP marks a significant shift in the life insurance industry, with a focus on health and wellness-first approach. The company aims to redefine life insurance, making it more than just protection in difficult times, but enabling families to live healthier, more secure, and financially confident lives every day.

Tata AIA Health Buddy is available with a wide range of Tata AIA solutions, including PR Life Pro +, PR Life Pro, PR Life Maxima +, and more. The service is designed to be a trusted wellness companion, always by the consumer’s side, and always ready to help. With the introduction of Health Buddy and Health SIP, Tata AIA is committed to being a true partner in the health and wellness journey of its consumers, keeping them “Har Waqt Ke Liye Taiyaar” with confidence and financial security.

The company’s Chief of Operations, Sanjay Arora, commented on the launch, saying, “At Tata AIA, our core value of Consumer Obsession drives everything. We are proud to introduce Tata AIA Health Buddy, India’s first 24×7 health and wellness companion from a life insurer. By blending health, wellness, and life insurance, we are setting a new benchmark in consumer care.”

US health insurance costs are expected to drastically increase due to the Trump administration’s newly implemented policies, which appear to be an attack on workers’ access to medical care.

The United States is facing a healthcare crisis as insurance costs are expected to rise sharply at the end of the year. The expiration of Affordable Care Act (ACA) marketplace subsidies and a $930 billion cut to Medicaid funding by the One Big Beautiful Bill Act (OBBBA) will undermine the health coverage of tens of millions of people. The Democrats are pledging to block passage of a spending resolution if Republicans do not make concessions on the ACA enhanced subsidies or restore Medicaid funds.

Paycheck deductions for employer-held plans are expected to rise an average of 7 percent, while Medicare Part B premiums are expected to increase by 11.6 percent. Standalone premiums for Medicare Part D are expected to go up by up to $50 a month. Plans purchased directly by workers on the ACA marketplace are set to rise far more sharply, with an average increase of 20 percent nationwide.

The impending loss of ACA subsidies would raise the cost of health insurance for those with ACA plans by a staggering 75 percent on average. Many would simply be unable to afford insurance through the ACA marketplaces. The Congressional Budget Office calculates that 4 million people will lose their insurance if the enhanced subsidies are discontinued.

The Trump administration’s “ACA Marketplace Integrity and Affordability Rule” will contribute to rising costs for those on ACA plans. The rule allows higher deductibles, reduces Premium Tax Credits, and increases “maximum out-of-pocket” limits. Most of the 24 million ACA enrollees will pay hundreds more annually, even if enhanced subsidies are not discontinued.

The Affordable Care Act has been criticized for representing direct collusion between the government and the healthcare industry, at workers’ expense. The ACA has shifted costs onto working people, made care less accessible, and funneled workers’ money to the insurance industry. The increase in costs and the hollowing out of benefits are not an accident but the aim of the legislation.

The cuts to Medicaid funds by the OBBBA will cause tens of millions to lose their insurance in the next 10 years. With the addition of 4 million people losing their insurance from the discontinuation of ACA subsidies, the projected total of those who will lose their insurance is 16-17 million people nationwide. This is itself a source of rising costs for the entire healthcare system, as healthcare providers shift costs incurred by those who are uninsured and forced to seek emergency care onto those with insurance.

The Socialist Equality Party is organizing the working class in the fight for socialism, including the reorganization of all of economic life to serve social needs, not private profit. The party argues that the working class must fight to end for-profit healthcare as part of a social counter-offensive against the fascistic drive of the Trump administration, which is an expression of the crisis of capitalism itself.

AHPI urges health insurance companies to revoke suspension and develop affordable and sustainable models.

The Association of Healthcare Providers – India (AHPI) has urged health insurance companies to restore cashless hospitalization services to policyholders. Thousands of policyholders in India are currently without access to cashless hospitalization due to disputes between hospitals and insurance companies. AHPI Director General Dr. Girdhar Gyani stated that the association has asked insurance companies to revoke the suspension of cashless services at hospitals that were removed from their panel.

The issue began when Niva Bupa Health Insurance suspended cashless treatment facilities at Max Hospitals across India due to a disagreement over premium revisions. Similarly, AHPI had advised its member hospitals in North India to stop providing cashless treatment facilities for policyholders of Bajaj Allianz General Insurance Company. However, the suspension was later revoked after the company addressed the concerns and removed the embargo on some of the hospitals.

Dr. Gyani explained that the root cause of the issue is the need for sustainability in the healthcare sector. While the government and the public want affordable healthcare, insurance companies and hospitals need to ensure that their services are sustainable. He suggested that insurance companies can improve their operating efficiency by reducing administrative costs, commissions, and sales expenses, which currently account for 30-35% of the premium collected.

Dr. Gyani also emphasized that hospitals must improve their operational efficiency and cut down on expenses to make healthcare more affordable. Ultimately, the goal is to create a sustainable model that provides affordable healthcare to policyholders while ensuring that hospitals and insurance companies can operate efficiently. The AHPI is facilitating conversations between hospitals and insurance companies to address the issue and provide respite to patients.

In a statement, Care Health Insurance assured that it is providing cashless services to its policyholders and is working closely with partner hospitals to ensure seamless services. The AHPI has sent notices to seven insurance companies, including Niva Bupa Health Insurance, asking them to revoke the suspension of cashless services at hospitals. The association is working to resolve the issue and create a sustainable model that benefits all stakeholders. By improving operational efficiency and reducing costs, insurance companies and hospitals can work together to provide affordable and sustainable healthcare services to policyholders.

In India, Alzheimer’s and dementia are covered by insurance through various policies and schemes. Here’s an overview:

Health Insurance: Many health insurance policies in India cover Alzheimer’s and dementia, including:

  1. Individual Health Insurance Policies: Some insurance companies offer coverage for Alzheimer’s and dementia as part of their individual health insurance policies.
  2. Senior Citizen Health Insurance: Specialized senior citizen health insurance policies often cover age-related diseases, including Alzheimer’s and dementia.
  3. Critical Illness Insurance: Critical illness insurance policies may cover Alzheimer’s and dementia, providing a lump sum payment to help with treatment and care.

Government-Sponsored Schemes: The Indian government offers several schemes to support individuals with Alzheimer’s and dementia, including:

  1. Rashtriya Swasthya Bima Yojana (RSBY): A health insurance scheme for below-poverty-line families, which covers hospitalization expenses, including those related to Alzheimer’s and dementia.
  2. Ayushman Bharat: A national health protection scheme that provides coverage for secondary and tertiary care hospitalization, including treatment for Alzheimer’s and dementia.
  3. National Programme for the Healthcare of the Elderly (NPHCE): A program that provides health care services, including diagnosis, treatment, and care, for elderly individuals with Alzheimer’s and dementia.

Private Insurance Companies: Several private insurance companies in India offer policies that cover Alzheimer’s and dementia, including:

  1. ICICI Lombard: Offers a comprehensive health insurance policy that covers Alzheimer’s and dementia.
  2. Bajaj Allianz: Provides coverage for Alzheimer’s and dementia through its health insurance policies.
  3. Max Bupa: Offers a senior citizen health insurance policy that covers age-related diseases, including Alzheimer’s and dementia.
  4. Apollo Munich: Provides coverage for Alzheimer’s and dementia through its health insurance policies.
  5. Star Health: Offers a senior citizen health insurance policy that covers age-related diseases, including Alzheimer’s and dementia.

Limits and Exclusions: While many insurance policies cover Alzheimer’s and dementia, there may be limits and exclusions, such as:

  1. Waiting Period: A waiting period may apply before coverage kicks in.
  2. Sub-Limits: Sub-limits may apply for specific treatments or expenses.
  3. Exclusions: Certain expenses, such as long-term care or home care, may be excluded from coverage.
  4. Pre-Existing Conditions: Pre-existing conditions, including Alzheimer’s and dementia, may be excluded from coverage or subject to a waiting period.

It’s essential to review policy terms and conditions carefully and consult with an insurance expert to understand the coverage and limitations.

Families of patients with Alzheimer’s disease or other forms of dementia often face uncertainty and financial burdens due to medical expenses and long-term care. While health and critical illness insurance policies can cover some hospitalization and severe-stage treatment costs, they usually exclude long-term care and routine support. Understanding what is included and excluded in these policies is crucial for effective financial planning.

Health insurance policies generally cover hospitalization costs for Alzheimer’s or related complications, including infections, injuries, or behavioral complications during hospital stays. However, long-term care, such as assisted living, home caregiving, or routine outpatient visits, is usually excluded unless an OPD add-on is purchased. Critical illness policies may list Alzheimer’s as a covered condition, but benefits often only apply at advanced, irreversible stages, and a mandatory survival period of 15-30 days is required before a lump-sum payout is made.

The definition of Alzheimer’s for insurance purposes is important. For critical illness policies, Alzheimer’s is defined as a progressive brain disorder causing severe memory loss and inability to perform daily activities, with early or mild cognitive impairment usually not qualifying. Health policies, on the other hand, do not differentiate by stage for hospitalization claims.

Common exclusions in health and critical illness policies include long-term care, rehabilitation, or assisted living, routine outpatient consultations and therapy, pre-existing neurological conditions, and experimental or unproven treatments. Insurers distinguish between medical treatment and supportive care, with long-term custodial care considered supportive, not hospitalization, which is why it is outside standard policies.

Health insurance premiums rise with age and health history, while critical illness premiums depend on age and coverage amount. Coverage for individuals already diagnosed with Alzheimer’s is generally unavailable, and critical illness claim settlements are contingent on verification of severe disease and survival-period compliance. Currently, there are no insurance products dedicated to Alzheimer’s or dementia, but insurers are expanding inclusivity in policies, covering mental health and other previously excluded conditions. Discussions are ongoing around long-term care solutions tailored for cognitive disorders, which may provide more comprehensive support for families affected by Alzheimer’s and dementia in the future.

Norka Care health insurance registration opens today

The Norka Care health insurance scheme for expatriate Malayalis has been launched by Norka Roots, with registration beginning on September 22, 2025. The scheme was formally inaugurated by Kerala Chief Minister Pinarayi Vijayan at a function in Thiruvananthapuram. The health insurance plan offers coverage up to ₹10 lakh, with cashless treatment available at over 14,000 hospitals across India, including 500 hospitals in Kerala.

The annual premium for a family consisting of parents and two children is ₹13,411, while families with three children can add an additional child to the coverage for ₹4,130. Individuals can enroll in the scheme for ₹8,101 per year. The scheme is open to persons up to 70 years of age. To be eligible, applicants must hold a Norka accident insurance-cum-identity card (NRK card), but those without an NRK card can apply online at www.norkaroots.org.

The Norka Care scheme provides medical coverage up to ₹5 lakh and compensation of ₹10 lakh in the event of accidental death. A dedicated mobile application for enrollment will be released, allowing applicants to submit their registration online. The scheme is designed for Malayali expatriates both abroad and within India, providing them with access to quality healthcare services.

The launch of the Norka Care scheme is expected to benefit thousands of expatriate Malayalis, providing them with financial protection against medical emergencies. With its comprehensive coverage and cashless treatment options, the scheme aims to provide peace of mind to Malayali expatriates and their families. The online registration process and dedicated mobile application will make it easier for applicants to enroll in the scheme, increasing its accessibility and reach. Overall, the Norka Care health insurance scheme is a significant initiative that aims to support the healthcare needs of expatriate Malayalis.

NORKA Care health insurance will exclude former expatriates from its coverage.

The NORKA Care health insurance project, set up by the Government of Kerala, has raised concerns that former expatriates who have returned to the state will not be included in the insurance coverage. The project is scheduled to be launched on September 22 by Chief Minister Pinarayi Vijayan. Those with NORKA membership can register for the project from September 22 onwards, with the last date for enrollment being October 21. The policy will be implemented on November 1.

The insurance coverage includes two policies: the Group Mediclaim Policy (GMC) and the Group Personal Accidental Policy (GPA). Under the GMC policy, policyholders and their family members can receive up to Rs 5 lakh for any health issue, while the GPA policy provides up to Rs 10 lakh for all kinds of accidents. The medical insurance coverage is available for individuals between the ages of 18 and 70, but they must seek medical treatment in India to be eligible for the benefits.

The main issue with the project is that it excludes former expatriates who have returned to Kerala, as they do not possess NORKA’s ID card. This means that millions of former expatriates who have returned to the state will not be able to benefit from the insurance coverage. There have been calls for the authorities to include at least those who have returned to Kerala in the last few years.

The project has been designed to provide health insurance coverage to expatriates currently living in foreign countries and Keralites residing in other states. However, the exclusion of former expatriates has raised concerns that they will be left without access to affordable healthcare. The authorities have been urged to reconsider the eligibility criteria to ensure that all those who need health insurance coverage can access it.

The NORKA Care health insurance project aims to provide financial protection to expatriates and their families in case of medical emergencies. However, the current eligibility criteria may limit the benefits of the project to a smaller group of people. It remains to be seen whether the authorities will revise the eligibility criteria to include former expatriates who have returned to Kerala.

Health insurers are struggling financially, even after implementing increases in premium rates.

The Indian health insurance industry is facing a challenging time due to rising medical costs and increasing claims. Despite multiple premium hikes, insurers are struggling to contain losses, with many reporting deteriorating loss ratios. The main factor contributing to this trend is the estimated 14% inflation in medical-related costs, which is outpacing premium increases.

New India Assurance, a state-owned insurer, saw its incurred claims ratio worsen to 109% in Q1 FY26, up from 106% a year ago. The company’s CMD, Girija Subramanian, attributed this to a 4% gap between the 10% cap on premium hikes for senior citizens and the actual inflation rate. ICICI Lombard, another major insurer, reported a rise in its retail health book loss ratio from 72.5% to 74.3% in Q1. However, the company expects to end the year with a loss ratio in the range of 65-70%.

Other insurers, such as Star Health and Niva Bupa, have also reported increases in their loss ratios. Star Health’s incurred claims ratio climbed to 68.5% from 66.9%, while Niva Bupa’s loss ratio moved up to 68% on its retail book. The health segment continues to dominate the general insurance industry, accounting for 40.2% of industry gross premium income.

According to analysts, the medical inflation curve is not uniform across the board, with each insurer facing a different inflation rate depending on its portfolio mix. Public sector undertakings (PSUs), for example, have older policyholder cohorts in their retail book, which require more tertiary care and drive up inflation-linked claims.

The industry is expected to continue facing challenges due to rising medical costs and increasing claims. Insurers will need to carefully manage their portfolios and adjust their pricing strategies to contain losses. As a reliable and trusted news source, it is essential to closely monitor the developments in the Indian health insurance industry and provide updates on the latest trends and challenges.

In conclusion, the Indian health insurance industry is facing significant challenges due to rising medical costs and increasing claims. Insurers must adapt to these changes by adjusting their pricing strategies and managing their portfolios effectively to contain losses. With the health segment dominating the general insurance industry, it is crucial for insurers to find a balance between providing adequate coverage and maintaining profitability. As the industry continues to evolve, it is essential to stay informed about the latest developments and trends.

Understanding Return of Premium Health Insurance Plans: How They Work

Return of Premium (ROP) health insurance plans are a type of health insurance policy that returns a portion of the premiums paid if no claims are made during the policy term. Here’s how it works:

  • Policy Purchase: The policyholder purchases an ROP health insurance plan with a specified policy term, usually several years.
  • Premium Payments: The policyholder pays premiums regularly, usually monthly or annually, to maintain the policy.
  • No Claims Made: If the policyholder does not make any claims during the policy term, they are eligible for a return of premium.
  • Return of Premium: At the end of the policy term, the insurance company returns a percentage of the total premiums paid to the policyholder. This percentage can vary depending on the policy and insurance company.
  • Claims Made: If the policyholder makes a claim during the policy term, they will not be eligible for the return of premium. However, the insurance company will still cover the medical expenses as per the policy terms.
  • Policy Renewal: The policyholder can choose to renew the policy at the end of the term, and the process starts over.

ROP health insurance plans provide an incentive for policyholders to maintain good health and avoid making claims. They can be a cost-effective option for individuals who are healthy and do not expect to make frequent claims.

The health insurance industry is undergoing a significant transformation, with a focus on providing more value to policyholders beyond basic coverage. In a pioneering move, CARE Health Insurance has introduced the Return of Premium (ROP) Health Insurance Plan, which rewards policyholders with financial benefits and enhanced coverage for maintaining good health. This innovative plan is currently the only one of its kind available in the market.

The ROP Health Insurance Plan offers a unique set of features that make it an attractive option for long-term policyholders. One of the key benefits is the money back feature, where policyholders can get a refund of their first year’s premium after five consecutive claim-free years. Additionally, the plan includes a loyalty boost, which doubles the sum insured after seven consecutive claim-free years. The infinity boost feature increases the sum insured by 100% annually, regardless of claims, providing policyholders with enhanced coverage over time.

Other notable features of the plan include instant cover for pre-existing conditions such as diabetes, hypertension, and asthma, as well as an unlimited care benefit that covers one-time hospitalization without any sum insured limit. Policyholders can also opt for add-ons such as maternity insurance, OPD cover, cancer insurance, and premium freeze, which provide flexible enhancements to the plan.

According to Siddharth Singhal, Head of Health Insurance at Policybazaar, the ROP Health Insurance Plan is a game-changer in the industry. The plan’s unique features, including the money back benefit and the infinity boost, make it an attractive option for policyholders who prioritize their health and well-being. As the demand for rewarding and flexible health insurance grows, it is likely that more insurers will introduce similar offerings in the future. Currently, the plan is only available with CARE Health Insurance, but its innovative features are expected to set a new benchmark for the industry.

LIC to acquire a substantial stake in a pure health insurer, with an announcement expected by March 31.

The Life Insurance Corporation of India (LIC) is in the final stages of discussions to acquire a substantial stake in a pure health insurance company. According to Siddhartha Mohanty, Managing Director and CEO of LIC, the company is likely to announce the decision before March 31. This move is seen as a natural choice for LIC to expand its presence in the health insurance market. While Mohanty declined to reveal the name of the health insurer, reports suggest that LIC is in talks with Manipal Cigna Health Insurance.

LIC has clarified that it is not seeking a 51% stake in the health insurer, but rather a substantial stake that would broaden its footprint in the health insurance market. The company has emphasized that regulatory approvals are still pending and there is no guarantee that the deal will be consummated. Currently, there are seven standalone health insurance companies in India, including Star Health & Allied Insurance, Niva Bupa Health Insurance, and Care Health Insurance.

In a separate development, Mohanty revealed that LIC has requested the Reserve Bank of India (RBI) to issue additional long-term bonds with maturities of 50 years and 100 years. This move is aimed at enabling LIC to better manage its investments and asset-liability mismatch, given its long-term contractual obligations to policyholders. While the RBI currently permits bonds with maturities of 20 to 40 years, 100-year bonds are not uncommon in global markets.

The potential acquisition of a health insurance company and the request for longer-term bonds are seen as strategic moves by LIC to expand its presence in the insurance market and manage its investments more effectively. As a public sector behemoth, LIC’s decisions are closely watched by the industry and investors. The company’s plans to enter the health insurance market and its request for longer-term bonds are likely to have significant implications for the insurance industry and the broader financial markets.

  1. Sabotaging Health Insurance Markets: The Trump administration’s actions to undermine the Affordable Care Act (ACA) have led to increased premiums and decreased enrollment, making healthcare less affordable for families.
  2. Expanding Junk Insurance Plans: The administration’s expansion of short-term, limited-duration insurance (STLDI) plans, also known as junk plans, has driven up costs for families by drawing healthy individuals away from comprehensive plans, increasing premiums for those who need coverage.
  3. Increasing Prescription Drug Costs: The Trump administration’s policies have failed to address the root causes of high prescription drug prices, allowing pharmaceutical companies to continue price-gouging, and passing the costs on to families.
  4. Cutting Funding for Health Programs: The administration’s cuts to funding for health programs, such as the ACA’s navigator program and the Centers for Disease Control and Prevention (CDC), have reduced access to healthcare services and driven up costs for families.
  5. Promoting Health Care Consolidation: The Trump administration’s policies have encouraged consolidation in the healthcare industry, leading to decreased competition and increased costs for families, as large healthcare systems and insurers use their market power to drive up prices.

The Center for American Progress has identified 5 ways the Trump administration is driving up healthcare costs for families.

  1. Expanding Junk Insurance Plans: The Trump administration has expanded the availability of short-term, limited-duration insurance (STLDI) plans, which do not provide comprehensive coverage and can leave families with significant medical bills. These plans, often referred to as “junk insurance,” can deny coverage for pre-existing conditions, exclude essential health benefits, and impose lifetime limits on care. By promoting these plans, the administration is undermining the Affordable Care Act (ACA) and driving up costs for families who need comprehensive coverage.

  2. Sabotaging the ACA: The Trump administration has taken multiple steps to sabotage the ACA, including ending outreach and enrollment efforts, slashing funding for navigator programs, and encouraging states to impose work requirements on Medicaid recipients. These actions have led to higher premiums and reduced enrollment, making it more difficult for families to access affordable healthcare.

  3. Increasing Prescription Drug Costs: The Trump administration has failed to take meaningful action to address the rising cost of prescription drugs. Instead, it has proposed policies that would further increase costs, such as allowing pharmaceutical companies to negotiate prices with Medicare. This inaction has resulted in higher out-of-pocket costs for families, making it more difficult for them to afford the medications they need.

  4. Cutting Funding for Health Programs: The Trump administration has proposed significant cuts to health programs, including Medicaid, the Children’s Health Insurance Program (CHIP), and community health centers. These cuts would have a devastating impact on families who rely on these programs for access to healthcare, forcing them to seek more expensive care or go without necessary treatment.

  5. Promoting Health Care Consolidation: The Trump administration has promoted policies that encourage consolidation in the healthcare industry, leading to higher costs and reduced competition. For example, the administration has proposed mergers between health insurance companies and hospital systems, which can result in higher premiums and reduced access to care. By promoting consolidation, the administration is driving up healthcare costs for families and reducing the quality of care they receive.

Overall, the Trump administration’s policies are driving up healthcare costs for families and reducing their access to comprehensive, affordable care. By expanding junk insurance plans, sabotaging the ACA, increasing prescription drug costs, cutting funding for health programs, and promoting healthcare consolidation, the administration is putting the interests of corporations and special interest groups ahead of the needs of families.

Hospitals have accused health insurance companies, including Bajaj Allianz, of engaging in cartel practices by fixing low tariffs, which they claim is negatively impacting cashless services and patient care.

A dispute is brewing between hospitals and health insurers in India, with the Delhi Medical Association Nursing Home Forum (DMA NHF) accusing insurers of acting like a cartel. The Forum has written to the Insurance Regulatory and Development Authority of India (IRDAI) to investigate and ensure that hospitals are paid fair treatment charges. The issue centers around “common empanelment,” where all insurance companies agree on prices to pay hospitals for different treatments. However, these prices are often outdated, having not been revised for 15-20 years, and do not reflect the current costs faced by hospitals.

According to Dr. V.K. Monga, Chairman of the DMA NHF, hospital costs have risen rapidly, with inflation adding up to 40% in recent years. Despite this, insurance companies continue to force hospitals to work at artificially low tariffs. This has put small and medium private hospitals under huge financial pressure, as they cannot absorb the losses like large corporate hospitals can. The disparity between small and big hospitals is significant, with smaller hospitals being reimbursed much less for the same treatments.

The impact of this dispute is not just on hospitals but also on patients. Insurers are questioning the necessity of admissions, reducing hospital stays, and compromising patient care. Meanwhile, insurers are making huge profits, with large portions of premiums collected going into commissions and administrative expenses rather than patient care. The incurred claim ratios are often as low as 54%-67%, indicating that insurers prioritize their margins over patient care.

If this practice continues, many small and medium hospitals may not survive, leaving patients with fewer options for affordable care. India already has among the lowest hospital tariffs in the world, and forcing them down further could make healthcare unsustainable in the long run. The Association of Healthcare Providers (AHPI) has stopped cashless services for some insurers due to outdated reimbursement rates, citing that medical inflation in India remains high, driven by rising staff costs, medicines, and overheads. The dispute highlights the need for fair treatment charges and revised reimbursement rates to ensure that hospitals can provide quality patient care without compromising their financial sustainability.

FWD Insurance has enhanced its FWD MyWell program by adding more health benefits to provide comprehensive care.

FWD Insurance has enhanced its “FWD MyWell” program, a comprehensive health and wellness solution that provides customers with a range of preventive care benefits. The program is designed to meet the diverse needs of customers, with a focus on delivering the best in health and wellness. The enhanced benefits include expanding membership tiers from four to six, reducing the minimum premium requirement to join the program, and introducing a wider variety of modern services such as alternative therapies, mental health consultations, and legal advisory services.

The program is built around four key dimensions: Live Well, Future Well, Family Well, and Extra Well. Live Well focuses on holistic care, providing services such as IV vitamin therapy, office syndrome treatment, and spa therapeutic massage. Future Well offers advanced care, including DNA premium health and talent test kits, beauty programs, and advanced skincare treatments. Family Well provides comprehensive care, including chauffeur-driven transport with nurse assistants to medical facilities, mental health consultations, and legal advisory services. Extra Well offers exclusive benefits, including special discounts from leading health partners.

According to David Korunić, CEO of FWD Insurance in Thailand and Cambodia, the program is designed to provide customers with a long-term health partner, empowering them to take care of themselves and live life to the fullest. The program is available to policyholders with life insurance products that emphasize protection and health, with a minimum annual premium of THB 250,000. Customers can join the program and qualify for the entry-level Deluxe status, with premium calculation criteria following FWD Insurance’s terms and conditions.

The enhanced FWD MyWell program reflects FWD Insurance’s customer-led approach, which prioritizes preventive care and provides customers with meaningful experiences before claims occur. The program is designed to support a healthy lifestyle from prevention to treatment, and to provide customers with genuine care and confidence every day. With its comprehensive range of services and benefits, FWD MyWell sets a new standard for preventive health experiences, empowering customers to take charge of their health and live a fuller life.

‘NoRKA Care’ insurance exclusively for non-resident Keralites – Kerala Kaumudi

The Kerala government has introduced a new health insurance scheme called ‘NoRKA Care’ specifically designed for non-resident Keralites (NRKs). The scheme aims to provide exclusive health insurance coverage to NRKs, addressing their unique needs and concerns. NoRKA Care is an initiative of the Non-Resident Keralites Affairs (NoRKA) department, in collaboration with the Kerala State Insurance Department.

The NoRKA Care insurance scheme offers a comprehensive range of benefits, including hospitalization expenses, medical treatments, and other health-related costs. The policy is designed to provide financial protection to NRKs and their families, ensuring they receive quality medical care without incurring significant expenses. The scheme is open to all NRKs, regardless of their age, income, or location.

One of the key features of NoRKA Care is its flexibility and affordability. The premium rates are competitive, and the policy can be customized to suit individual needs and budgets. The scheme also offers a range of add-on covers, including critical illness, personal accident, and disability benefits. Policyholders can choose from various plans, including individual, family, and group policies.

The NoRKA Care insurance scheme is administered by the Kerala State Insurance Department, which has partnered with leading insurance companies to provide the coverage. The scheme is expected to benefit thousands of NRKs worldwide, providing them with access to quality healthcare and financial security.

The introduction of NoRKA Care is a significant step towards addressing the health insurance needs of NRKs. Many NRKs face challenges in accessing quality healthcare due to their non-resident status, and this scheme aims to bridge that gap. The scheme is also expected to promote medical tourism in Kerala, with many NRKs likely to return to their home state for medical treatment.

Overall, the NoRKA Care insurance scheme is a welcome initiative for non-resident Keralites, providing them with exclusive health insurance coverage and financial protection. The scheme’s flexibility, affordability, and comprehensive benefits make it an attractive option for NRKs, and it is expected to have a positive impact on the lives of thousands of people worldwide.

Lakhs of patients are likely to be affected as two major health insurers will stop providing cashless treatment from September 1.

The Association of Healthcare Providers India (AHPI) has announced that its member hospitals will be pulling out of cashless services for certain insurance providers due to rising medical inflation and unsustainable treatment tariffs. The AHPI cites an annual medical inflation rate of 7-8%, which has led to increased costs for staff salaries, medicines, consumables, utilities, and operational overheads. According to Dr. Girdhar Gyani, Director General of AHPI, continuing to operate at outdated tariffs would compromise patient care, which is unacceptable.

The General Insurance Council has criticized the AHPI’s move, stating that it is abrupt and one-sided, and could undermine public trust in health insurance. The Council argues that such disruptions create fear and confusion among policyholders and put patients’ lives at risk in emergency situations. The IRDAI is currently pushing for 100% cashless treatment nationwide, making this development particularly concerning.

Bajaj Allianz has been specifically targeted by the AHPI, with the association directing its member hospitals to stop cashless services for Bajaj Allianz customers due to issues such as outdated tariffs, unauthorized deductions, delayed payments, and prolonged approvals. Bajaj Allianz has responded by seeking an immediate resolution and committing to constructive discussions with the AHPI to ensure uninterrupted healthcare for its customers.

Care Health Insurance has also been warned by the AHPI, with a notice issued on August 22 stating that services will be suspended if concerns are not addressed by August 31. The COO of Care Health Insurance, Manish Dodeja, has expressed surprise at the notice, stating that the communication was vague and lacked specifics. Despite this, he is confident that the matter can be resolved amicably.

The implications of this development are significant for patients, who will now have to pay medical bills directly and later file for reimbursement until an agreement is reached. This tussle exposes deepening cracks in India’s healthcare financing system, highlighting the need for urgent reform to ensure seamless cashless treatment for patients. The situation is complex, with multiple stakeholders involved, and a resolution will require constructive dialogue and cooperation between the AHPI, insurance providers, and regulators.

The Insurance Ombudsman has released a report revealing the top insurers with the maximum number of grievances. The report provides insight into the performance of insurance companies in terms of customer satisfaction and complaint resolution.Some key points from the report include: 1. The names of the top insurers with the maximum grievances have been disclosed, allowing consumers to make informed decisions when choosing an insurance provider. 2. The report highlights the types of grievances received by the ombudsman, including claims-related issues, policy servicing, and premium disputes. 3. The data provides a comparison of the grievance rates among different insurance companies, enabling customers to assess the quality of service offered by each insurer. 4. The Insurance Ombudsman’s report also outlines the steps taken to address and resolve the grievances, ensuring that customers’ concerns are heard and addressed. 5. The release of this information aims to promote transparency and accountability within the insurance industry, ultimately benefiting consumers by encouraging insurers to improve their services and reduce grievances.

The Insurance Ombudsman’s Annual Report for 2023-24 has revealed a significant increase in complaints against health insurance companies in India. The report shows that the total number of complaints against health insurers rose by 21.7% to 31,490 in FY 2023-24, compared to 25,873 in FY 2022-23. Private insurers accounted for the majority of complaints, with 26,064 grievances, while public sector insurers accounted for 5,298.

Star Health & Allied Insurance led the list of companies with the most complaints, recording 13,308 grievances, of which 10,196 were related to claim repudiations. CARE Health Insurance and Niva Bupa Health Insurance followed with 3,718 and 2,511 complaints, respectively. The report also highlights that claim repudiation is the most common grievance, with the majority of complaints falling under this category.

The Insurance Regulatory and Development Authority of India (IRDAI) has responded to the rising dissatisfaction by mandating every insurer to appoint an Internal Ombudsman (IO) to review cases up to Rs 50 lakh that remain unresolved after 30 days or are rejected by insurers. However, experts argue that the independence of the IO is questionable since they report to the insurer’s top management, raising concerns about fairness and impartiality.

The report highlights the need for stronger accountability, transparency, and consumer protection in the health insurance sector. Policyholders are advised to look beyond premiums when buying health insurance and consider critical factors such as claim settlement ratio, repudiation rates, grievance redressal track record, and customer service quality.

The Council for Insurance Ombudsmen (CIO) has been established to provide policyholders with a speedy and cost-effective mechanism to resolve disputes against insurance companies. The CIO functions under the framework defined in the Insurance Ombudsman Rules, 2017, and serves as an alternative grievance redressal platform.

In conclusion, the report highlights the growing concerns of policyholders with health insurance companies in India. The rise in complaints and claim repudiations is a pressing issue that needs to be addressed by insurers and regulatory authorities. The appointment of Internal Ombudsmen is a step in the right direction, but its independence and effectiveness need to be closely monitored. Ultimately, informed choices and stronger regulation are key to restoring policyholder trust in the health insurance sector.

Star health show reveals Han Da-geum’s high cancer risk – 조선일보

According to a recent episode of the Star Health Show, Han Da-geum, a Korean celebrity, has been found to have a high risk of developing cancer. The show, which focuses on the health and wellbeing of Korean celebrities, revealed the results of Han’s health checkup, which showed that he has a high risk of developing the disease.

Han Da-geum, who is known for his work as a singer and actor, underwent a series of health tests as part of the show, including a genetic test to determine his risk of developing certain diseases. The results of the test showed that he has a high risk of developing cancer, particularly lung and stomach cancer.

The show’s hosts and medical experts discussed Han’s test results and provided him with advice on how to reduce his risk of developing cancer. They emphasized the importance of maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking and excessive drinking.

Han Da-geum’s high cancer risk is likely due to a combination of genetic and environmental factors. As a heavy smoker, he is already at a higher risk of developing lung cancer, and his family history of cancer may also play a role. The show’s medical experts advised him to quit smoking and make lifestyle changes to reduce his risk.

The episode sparked concern among Han’s fans, who are worried about his health and wellbeing. However, Han has reassured them that he is taking steps to reduce his risk of developing cancer and is committed to maintaining a healthy lifestyle.

The Star Health Show’s revelation of Han Da-geum’s high cancer risk highlights the importance of regular health checkups and screenings. The show’s hosts and medical experts emphasized that early detection and prevention are key to reducing the risk of developing cancer and other diseases.

Overall, the episode serves as a reminder of the importance of prioritizing one’s health and wellbeing, particularly for those who may be at a higher risk of developing certain diseases. By making lifestyle changes and undergoing regular health checkups, individuals can reduce their risk of developing cancer and other diseases, and maintain a healthy and fulfilling life.

It’s worth noting that Han Da-geum’s case is not unique, many people are at risk of developing cancer due to a combination of genetic and environmental factors. The show’s message is clear, taking care of one’s health is crucial, and regular checkups can help detect potential health issues early on.

Big update for customers of THIS health insurance company, Apollo Munich Health Insurance (AHPI) is likely to withdraw cashless services from its network of member hospitals, according to reports from the hospitals.

The Association of Healthcare Providers of India (AHPI) has announced that it may withdraw cashless services for Star Health Insurance policyholders from September 22. This decision comes after persistent complaints against the company, with over 13,000 complaints received, including more than 10,000 related to claim rejections. AHPI alleges that Star Health has refused to revise old tariff rates in line with rising costs, instead pressuring hospitals to reduce charges.

As a result, thousands of patients may face difficulties in accessing medical care. If cashless services are withdrawn, policyholders will have to pay hospitals upfront and later file a claim for reimbursement. This could put significant financial pressure on patients, particularly in emergency situations where immediate payment is required. AHPI represents over 15,000 hospitals and has stated that this step is being taken to protect patient safety and the financial condition of hospitals.

AHPI has emphasized that hospitals will continue to provide treatment to patients on a payment basis, and will assist patients in the reimbursement process. However, this change could still have a significant impact on patients who rely on cashless services. The Insurance Ombudsman’s 2023-24 report highlights the large number of complaints against Star Health, with many related to claim rejections.

The potential withdrawal of cashless services is a significant concern for Star Health Insurance customers, who may need to make alternative arrangements for medical care. AHPI has stated that it is taking this step out of compulsion, and that it hopes Star Health will address the concerns of hospitals and revise its policies to ensure that patients receive the care they need. If a resolution is not reached, patients may face significant difficulties in accessing medical care, particularly in emergency situations.

Best Small Business Health Insurance Providers Of 2025 – Forbes Advisor

The Small Business Health Options Program (SHOP) allows small business owners to purchase health insurance for their employees through approved insurance companies. Employers can choose from various types of health insurance plans, including EPO, HMO, POS, and PPO. Each plan has its own set of benefits and limitations, such as the need for primary care referrals to see specialists and coverage for out-of-network care.

EPO plans are often affordable but may not cover out-of-network care, while HMO plans are generally cheaper but have more limitations. POS plans offer more flexibility but require primary care referrals, and PPO plans are the most expensive but offer the most flexibility. The SHOP Marketplace allows employers to offer health plans from multiple insurance companies and qualifies them for the Small Business Health Care Tax Credit.

To qualify for the tax credit, businesses must have fewer than 25 full-time equivalent employees, an average employee salary of $56,000 or less, pay at least 50% of premium costs, and offer SHOP coverage to all full-time employees. Small business owners can work with a health insurance broker to find the best plan for their business at no additional charge or buy directly from a health insurance company.

When purchasing coverage through the Affordable Care Act (ACA) marketplace, plans are organized into “metal” tiers: bronze, silver, gold, and platinum. These tiers differ in terms of premiums and out-of-pocket costs, with bronze and silver plans having lower premiums but higher deductibles and coinsurance, and gold and platinum plans having higher premiums but lower out-of-pocket costs. Employers have flexibility in choosing which type of plans to offer their employees, allowing them to tailor their benefits to meet the needs of their business and employees.

Overall, the SHOP program provides small business owners with a range of options for providing health insurance to their employees. By understanding the different types of plans available and the requirements for qualifying for the Small Business Health Care Tax Credit, employers can make informed decisions about which plans to offer and how to navigate the health insurance marketplace. With the help of a health insurance broker or by buying directly from an insurance company, small business owners can find a plan that meets their needs and provides valuable benefits to their employees.

Hospital body warns of suspension of cashless services to Star Health policyholders

The Association of Healthcare Providers – India (AHPI) has issued a warning to Star Health Insurance, threatening to suspend cashless facilities to policyholders due to the insurer’s questionable practices. The association, which represents over 15,000 hospitals and healthcare institutions, has raised several concerns, including the insurer’s refusal to revise tariffs despite high healthcare cost inflation, arbitrary withdrawal of cashless services, and unjustified deductions from hospital bills.

AHPI has pointed out that these practices may compromise patient safety and quality of care, and has warned that unless Star Health Insurance addresses these concerns in a timely manner, cashless services for policyholders may be withdrawn from September 22, 2025. The association has also cited the Insurance Ombudsman Annual Report 2023-24, which shows that Star Health Insurance had the highest number of complaints, with over 13,300 complaints in FY24, mostly related to partial or full claim rejections.

AHPI has expressed similar concerns about other insurers, including Bajaj Allianz General Insurance and Care Health Insurance. The association is also opposed to the proposed GIC-led common empanelment process, which it views as anti-competitive and lacking a sound legal basis. The process involves insurers abruptly stopping cashless services to pressure hospitals into lowering tariffs, which AHPI believes is unfair and may harm patients.

The issues raised by AHPI are significant, and the association’s warning to Star Health Insurance is a clear indication of the tensions between healthcare providers and insurers in India. The association’s concerns about patient safety and quality of care are also valid, and it remains to be seen how Star Health Insurance will respond to the warning. If the insurer fails to address the concerns, it may lead to a disruption in cashless services for policyholders, which could have serious consequences for patients and their families.

Overall, the dispute between AHPI and Star Health Insurance highlights the need for greater transparency and fairness in the insurance industry, particularly when it comes to healthcare costs and patient care. The association’s efforts to protect the interests of healthcare providers and patients are crucial, and it is essential that insurers respond to these concerns in a constructive and timely manner.

Aviva has introduced a new guaranteed fixed term annuity, designed to address the changing requirements of individuals in retirement.

Aviva has introduced a new retirement income product, the Guaranteed Fixed Term Income Plan, which provides a guaranteed income over a fixed term of 3 to 25 years. This product offers clients greater control over their pension savings and allows them to reassess their retirement strategy at the end of the term without requiring a lifetime commitment. The plan is designed to meet the needs of today’s retirees who value stability and flexibility, and is part of Aviva’s existing annuity proposition range.

According to a joint report by Aviva and Age UK, 83% of respondents feel that having a regular income in retirement is more important as they get older, with women more likely to feel this way than men. The report also highlights the importance of maintaining income patterns that people are accustomed to, with 83% saying they worry about a sudden drop in income. Aviva’s Director of Individual Annuities, Claire Reed, stated that the new plan gives people the confidence of knowing exactly what’s coming in and when, while offering flexibility to decide what’s next.

The Guaranteed Fixed Term Income Plan is part of Aviva’s strategic transformation programme, which focuses on delivering an exceptional adviser and customer experience through technology-driven innovation. The plan is available via a new platform that features a fully digital quote and apply journey for advisers, simplifying the end-to-end process. Aviva’s continued investment in annuity innovation and technology reflects its ongoing support for customers and advisers as they navigate modern retirement.

The new plan complements Aviva’s existing annuity range, which includes Fixed Term annuities and Lifetime Care annuities. These products are designed to support clients through every stage of retirement, from early flexibility to later-life security. With the launch of the Guaranteed Fixed Term Income Plan, Aviva is evolving what retirement income can look like, providing people with greater control and flexibility over their pension savings.

The Guaranteed Fixed Term Income Plan is a response to the changing retirement landscape, where people are living longer and need more flexible and secure income options. The plan’s fixed term and guaranteed income provide a predictable income stream, shielding clients against market volatility and helping with budgeting. Overall, Aviva’s new plan offers a flexible solution for retirees seeking a secure income stream while retaining the freedom to reassess their retirement strategy at the end of the term.

WA health insurance premiums skyrocket due to federal fallout and increasing costs.

According to a recent report by the Tri-City Herald, health insurance premiums in Washington state are experiencing a significant increase due to federal fallout and rising costs. The main drivers of this surge are the inflated healthcare costs, pharmaceutical prices, and the impact of federal policies on the state’s insurance market.

One major factor contributing to the premium hike is the rising cost of healthcare services. Hospitals, doctors, and other medical providers are increasing their charges, which in turn, are being passed on to insurance companies. These increased costs are then reflected in higher premiums for consumers. Additionally, the cost of prescription medications is also on the rise, further exacerbating the problem.

The federal government’s decision to withdraw from the risk-adjustment program, which helped to stabilize the insurance market, has also had a profound impact on Washington state’s health insurance premiums. This program, established under the Affordable Care Act, aimed to redistribute funds from insurers with healthier policyholders to those with sicker ones. Without this program, insurance companies are now facing increased uncertainty and risk, leading to higher premiums.

Moreover, the expansion of short-term limited-duration insurance (STLDI) plans, which offer limited benefits and are not subject to the same regulations as traditional plans, has also played a role in the premium increase. These plans, often referred to as “junk plans,” attract healthier individuals, leaving the traditional market with a higher proportion of sicker policyholders. This, in turn, drives up costs and premiums for those remaining in the traditional market.

The premium increase is expected to affect approximately 300,000 Washington state residents who purchase their own insurance, rather than receiving it through their employer. The state’s insurance commissioner has warned that the average premium increase could be as high as 10-20%, with some individuals facing even steeper hikes. This surge in premiums may lead to decreased enrollment and increased numbers of uninsured individuals, exacerbating the existing healthcare accessibility issues in the state.

In response to the premium increase, state officials and lawmakers are exploring potential solutions, including increasing funding for the state’s reinsurance program, which helps to offset the costs of high-risk policyholders. However, the effectiveness of these measures remains to be seen, and the situation continues to unfold. As the healthcare landscape evolves, it is essential for policymakers to address the underlying drivers of the premium increase to ensure that affordable healthcare remains accessible to all Washington state residents.

Oregon has increased the rates it pays to private contractors that manage the Oregon Health Plan, the state’s Medicaid program, in order to retain them.

The Kotek administration in Oregon has increased its offers to the organizations that oversee care for over 1 million low-income people enrolled in the Oregon Health Plan. The new rates, which represent a 10.2% average increase, are intended to satisfy the coordinated care organizations (CCOs) that have been losing significant amounts of money due to inadequate reimbursement rates. However, it is unclear if this will be enough to keep the CCOs from leaving the state’s Medicaid-funded managed care system on January 1, as some of their leaders have threatened.

The CCOs have been struggling to cover costs, with hundreds of millions of dollars in losses, and have expressed concerns that the state’s rate development model has not kept pace with the evolving healthcare system. The new rates are seen as a “meaningful first step” in addressing the challenges, but CCO leaders are still evaluating whether the increases are sufficient to ensure their continued participation in the program.

State officials have acknowledged that more needs to be done to address the issue and have proposed several changes to the program, including shifting funds from quality payments to increase provider reimbursements, taking over payment for high-cost drugs, reducing reporting requirements, and taking responsibility for unexpected behavioral health costs. The situation has also raised questions about the 3.4% cost growth target that state health officials have been trying to enforce.

The CCOs have expressed concerns about the potential impact of the state’s proposals on patient access and the ability to maintain dental care. Sean Jessup of the Eastern Oregon Coordinated Care Organization noted that the rates do not seem to take into account regional variations and challenges in providing rural care. The organization is concerned about the ability to maintain dental access, as the statewide dental rate did not receive an equivalent increase.

The situation is being closely watched, with Rep. Rob Nosse, chair of the House health care committee, describing it as the worst he has seen in a decade. The potential disruption to care could have significant consequences for patients, with one organization’s withdrawal from the program in the past sparking complaints from providers that it could lead to patient deaths. The Kotek administration’s efforts to address the issue are seen as a crucial step in ensuring the sustainability of the Medicaid program amid unprecedented fiscal and policy constraints.

Royal Sundaram Marks 25 Years of Trust, Care, and Innovation in Insurance – MSN

Royal Sundaram General Insurance Company Limited, a leading general insurance provider in India, is celebrating its 25th anniversary. Over the past two and a half decades, the company has established itself as a trusted and innovative player in the Indian insurance industry.

Royal Sundaram was one of the first private general insurance companies to be licensed in India, marking a significant milestone in the country’s insurance sector. Since its inception, the company has been committed to providing a wide range of insurance products and services to its customers, including health, motor, home, and travel insurance, among others.

Throughout its 25-year journey, Royal Sundaram has consistently demonstrated its ability to innovate and adapt to changing market conditions. The company has introduced several pioneering products and services, such as its flagship health insurance product, Lifeline, which has been designed to provide comprehensive coverage to individuals and families.

Royal Sundaram’s commitment to customer care and satisfaction has been a key factor in its success. The company has a strong network of agents, brokers, and partners who work closely with customers to understand their needs and provide personalized solutions. Royal Sundaram’s customer service team is also available 24/7 to assist policyholders with their queries and claims.

The company’s emphasis on innovation and technology has enabled it to stay ahead of the curve in the insurance industry. Royal Sundaram has invested heavily in digital platforms, including its website and mobile app, which allow customers to purchase policies, track claims, and access policy documents online.

As Royal Sundaram celebrates its 25th anniversary, the company is well-positioned for future growth and expansion. With a strong foundation built on trust, care, and innovation, Royal Sundaram is poised to continue playing a leading role in the Indian insurance industry. The company’s commitment to its customers, agents, and partners remains unwavering, and it looks forward to many more years of success and prosperity.

Royal Sundaram’s 25-year milestone is a testament to the company’s dedication to providing high-quality insurance products and services to its customers. As the company looks to the future, it is likely to continue pushing the boundaries of innovation and excellence, setting new standards for the insurance industry in India. With its strong legacy and commitment to customer satisfaction, Royal Sundaram is an insurer that policyholders can trust and rely on.

Clarifications about health care plans and information on HR and vendors will be available at the Healthy Boiler Fair.

The 2025 Purdue Healthy Boiler Fair is an event that brings together benefits-eligible members of the Purdue community to explore the connection between overall well-being and the university’s benefit offerings. The fair will take place on September 10 from 9 a.m. to 1 p.m. in the Purdue Memorial Union North and South ballrooms. Over 35 vendors and Purdue departments will be in attendance, showcasing their programs, services, and benefits that align with the five pillars of Purdue’s Healthy Boiler Wellness Program: behavioral health, financial wellness, physical health, social wellness, and work-life integration.

The fair provides an opportunity for employees to learn more about current benefits and updates to Purdue’s medical and pharmacy plans. Vendors such as AffirmedRx, HSA Bank, Securian, AllOne Health, and MetLife will be on site to answer questions and provide information on various topics, including prescription drug coverage, commuter benefits, voluntary plans, and legal plan enhancements. Employees can also learn about the university’s new commuter benefit, which allows them to pay for mass transit and parking expenses using pre-tax funds.

Purdue’s benefits team is committed to supporting employees in finding answers to their health care questions, including topics such as vaccines, diabetes drug coverage, weight loss drug coverage, and mental health drug coverage. The fair is a perfect opportunity for employees to ask questions, learn about available resources, and feel confident about the benefits available to them.

In terms of health care costs, Purdue has seen a relatively low average increase of 2.1% annually, compared to the national average of nearly 6% annual growth since 2017. The university is committed to improving population health and has designed its 2026 health plans accordingly. Purdue will fund 90% of premiums and 75% of total costs, and has chosen to shoulder 95% of the increase in health care costs for 2025.

Additional resources are available to employees, including the HR Service Center, which can be contacted to schedule a meeting with HR and AffirmedRx to discuss individual situations and explore available options. One-on-one appointments, presentations, and labs will also be offered during open enrollment for 2026 benefits, which takes place from October 28 to November 11. Employees can direct questions about their Purdue benefits to Human Resources at 765-494-2222 or via email at hr@purdue.edu.

Niva Bupa has suspended its cashless facility at Max Hospitals, leaving thousands of policyholders without access to cashless treatment.

Niva Bupa Health Insurance has suspended its cashless treatment facility at Max Hospitals across India, affecting thousands of patients. The decision was made after the company’s agreement with Max expired in May 2025, and talks over premium revisions failed to reach an agreement. As a result, policyholders will no longer be able to avail cashless hospitalization at Max hospitals and will have to pay their bills upfront before filing for reimbursement.

According to Dr. Bhabatosh Mishra, Director and COO of Niva Bupa Health Insurance, the company had exhausted all other options before taking this step, citing administrative and process-related challenges in its arrangement with Max Group of Hospitals. policyholders can still receive treatment at Max Hospitals, but only on a reimbursement basis. Niva Bupa has reminded customers that cashless services are still available at its 10,000-plus partner hospitals across the country.

This issue is not limited to Niva Bupa, as policyholders of other insurance companies, such as Bajaj Allianz General Insurance and Care Health Insurance, may also lose cashless access at several hospitals from September 1. The Association of Healthcare Providers (India) has raised concerns with online health insurers over the suspension of cashless services at several hospitals. The General Insurance Council has criticized the association’s move, calling it a sudden and unilateral action that creates confusion and risks undermining public trust in health insurance.

The disruptions in cashless services can hurt citizens directly by forcing them into heavy upfront payments and could even endanger lives in critical medical cases requiring immediate treatment. This development comes at a time when the insurance regulator IRDAI is pushing for 100% cashless treatment across India. However, hospitals are not regulated in the same way as insurers, limiting the regulator’s ability to intervene. With hospital treatment costs rising sharply in recent years, such disputes threaten to make quality healthcare even more difficult to access for ordinary citizens.

The dispute between insurance companies and hospitals highlights the need for greater regulation and oversight in the healthcare industry. The IRDAI’s push for 100% cashless treatment is a step in the right direction, but more needs to be done to ensure that patients have access to quality healthcare without being burdened by heavy upfront payments. The situation is being monitored closely, and it remains to be seen how the dispute will be resolved and what impact it will have on patients and the healthcare industry as a whole.

Over 15,000 hospitals have withdrawn cashless treatment for Bajaj Allianz policyholders due to a dispute over fees.

Hospitals affiliated with the Association of Healthcare Providers—India (AHPI) in northern India have announced that they will no longer offer cashless treatment to policyholders of Bajaj Allianz General Insurance from September 1. The decision affects major hospital chains like Max Healthcare and Medanta, which are part of the AHPI network. The hospitals claim that Bajaj Allianz has neglected their repeated requests to update reimbursement rates to keep pace with medical inflation, which is estimated to be around 7-8% per annum in India.

The hospitals argue that the current reimbursement rates are unsustainable and put patient care at risk due to continued unilateral deductions, payment delays, and sluggish pre-authorisation processes. As a result, they will no longer provide cashless treatment to Bajaj Allianz policyholders, and patients will have to pay for their treatment out of pocket and seek reimbursement later. AHPI has also sent a similar notice to Care Health Insurance, giving them until August 31 to respond before services to their policyholders face a similar fate.

Bajaj Allianz has expressed surprise at the move and stated that it is ready to engage with AHPI to find a solution. However, AHPI remains firm in its demand for periodic tariff reviews, ideally every two years, to ensure that reimbursement rates keep pace with medical inflation. The standoff between the hospitals and the insurer has left patients in a difficult situation, and it remains to be seen how the situation will be resolved.

The dispute highlights the challenges faced by the healthcare sector in India, where medical costs are rising rapidly, and reimbursement rates are not keeping pace. The AHPI has warned that continuing to operate under old reimbursement rates is unsustainable and detrimental to patient care. The situation is likely to have significant implications for the healthcare sector and insurance industry in India, and it will be important to monitor how the situation develops in the coming weeks and months.

Employee health insurance premiums are expected to increase by 6% in 2026, according to a recent survey.

A recent survey has found that employee health insurance premiums are expected to rise by 6% in 2026. This increase is a significant concern for both employers and employees, as it may lead to higher costs and reduced benefits. The survey, which was conducted by a reputable organization, gathered data from a large sample of employers and health insurance providers to forecast the upcoming trends in the health insurance market.

The expected 6% increase in premiums is higher than the average annual increase of 4-5% seen in recent years. This surge is attributed to various factors, including rising healthcare costs, increased demand for medical services, and higher prices for prescription medications. Additionally, the growing prevalence of chronic diseases and the need for more advanced treatments are also contributing to the rising costs.

The impact of the premium increase will be felt by both employers and employees. Employers may need to absorb some of the increased costs, which could affect their bottom line and potentially lead to reduced hiring or wage freezes. On the other hand, employees may face higher deductibles, copays, or coinsurance rates, which could make healthcare less affordable for them.

The survey also found that employers are exploring alternative health insurance options to mitigate the effects of the premium increase. Some are considering self-insurance plans, which allow them to manage their own healthcare costs and potentially reduce premiums. Others are looking into level-funded plans, which combine the benefits of self-insurance with the stability of traditional insurance.

To cope with the rising premiums, employees may need to make adjustments to their health insurance plans or lifestyle habits. They may need to opt for plans with higher deductibles or lower coverage levels, which could leave them with higher out-of-pocket expenses. Alternatively, they may focus on preventive care and healthy habits to reduce their healthcare needs and lower their costs.

In conclusion, the expected 6% increase in employee health insurance premiums in 2026 is a significant concern for both employers and employees. The rising costs are driven by various factors, including increased healthcare demand and higher prices for medical services. Employers and employees will need to adapt to these changes by exploring alternative health insurance options, adjusting their plans, or focusing on preventive care and healthy habits. As the healthcare landscape continues to evolve, it is essential to stay informed about the latest trends and developments to make informed decisions about health insurance coverage.

Most Dutch parties propose returning dental care to basic health coverage

The Dutch healthcare system is considering a significant change, with most parties proposing the return of dental care to basic health coverage. Currently, dental care is not included in the basic health insurance package in the Netherlands, and individuals must purchase additional insurance or pay out-of-pocket for dental services.

The proposal to include dental care in the basic health coverage is aimed at making healthcare more accessible and affordable for all citizens. Proponents argue that dental health is essential to overall health and well-being, and that excluding it from basic coverage can lead to delayed or foregone treatment, particularly among low-income individuals.

Several parties in the Netherlands, including the ruling coalition, have expressed support for including dental care in the basic health coverage. They argue that this move would help reduce healthcare disparities and ensure that everyone has access to necessary dental care, regardless of their financial situation.

The proposed change would likely involve an increase in health insurance premiums, as the cost of dental care would need to be factored into the basic coverage package. However, supporters argue that the benefits of including dental care in basic coverage would outweigh the costs, as it would help prevent more costly and complex health problems down the line.

It’s worth noting that the Netherlands has a well-regarded healthcare system, with a strong emphasis on universal access and comprehensive coverage. The country’s healthcare system is primarily funded through private insurance, with individuals required to purchase a basic health insurance package that covers essential healthcare services.

The proposal to include dental care in basic health coverage is still in the discussion phase, and it’s unclear when or if it will be implemented. However, the fact that most parties are supporting the proposal suggests that it has a good chance of becoming a reality in the near future.

Overall, the proposal to include dental care in basic health coverage in the Netherlands reflects a broader commitment to ensuring that all citizens have access to comprehensive and affordable healthcare. By including dental care in the basic coverage package, the Netherlands can help reduce healthcare disparities and promote better overall health and well-being for its citizens.

As health insurers and hospitals engage in disputes, policyholders seek protection.

The healthcare industry in India is experiencing a tumultuous period, with hospitals and insurers at odds over treatment tariffs and empanelment terms. Recently, the Association of Healthcare Providers of India (AHPI) advised its member hospitals to suspend cashless insurance services provided by Bajaj Allianz General Insurance, citing disagreements over hospital reimbursement rates. Although the issue has been temporarily resolved, similar disputes continue to arise, leaving policyholders caught in the middle.

Hospitals claim that insurers are pressuring them to reduce tariffs, which would compromise their ability to maintain quality and invest in technology. Insurers, on the other hand, argue that standardization of hospital tariffs is necessary to prevent overcharging and bring down medical inflation. They propose a common empanelment of healthcare providers, which would streamline hospital tariffs across insurance companies.

The General Insurance Council (GI Council) has criticized hospitals for attempting to derail the standardization process, while hospitals argue that insurers are trying to bully them into accepting unsustainable rates. Max Healthcare, one of the largest hospital chains in India, has temporarily suspended its cashless treatment facility with Niva Bupa Health Insurance due to ongoing tariff discussions.

Insurance industry representatives, such as Mayank Bathwal, CEO of Aditya Birla Health Insurance, argue that standardization would bring transparency and help reduce medical inflation, which is currently at 12-14%. They also point out that there is no apex body to regulate healthcare providers and raise complaints against hospitals.

However, hospital representatives counter that standardization oversimplifies healthcare delivery and could lead to a compromise in quality. They argue that a one-size-fits-all approach would discourage hospitals from innovating or investing in better patient care. Dr. Saroj Mandal, a cardiologist, suggests a graded approach, where hospitals with similar medical expertise, infrastructure, and technology could offer similar rates for treatments, ensuring transparency for patients.

The regulatory authority is being called upon to intervene and establish a framework for standardization and regulation of healthcare providers. The Indian Council of Medical Research (ICMR) has already established standard treatment protocols for various diseases, and insurers argue that a similar framework should be applied to hospital tariffs. The ongoing disputes between hospitals and insurers highlight the need for a regulator to ensure that policyholders receive cashless treatments without being caught in the crossfire of disagreements over tariffs and empanelment terms.

Royal Sundaram Marks 25 Years of Trust, Care, and Innovation in Insurance

Royal Sundaram General Insurance Co. Limited, India’s first private sector general insurer, is celebrating its 25th anniversary. The company has come a long way since its inception in 2000, with a consistent commitment to simplifying insurance and making it more accessible. Over the years, Royal Sundaram has introduced several industry-first initiatives, including bancassurance partnerships and digital-first platforms, to make customer interactions seamless.

The company has protected over 2 crore customers across various segments, including motor, health, travel, home, and commercial insurance. Royal Sundaram’s promise is to stand by its customers when they need protection the most. The company is known for its trust, simplicity, care, and digital convenience with a human touch.

The leadership team, including Mr. Harsha Viji, Vice Chairman of Sundaram Finance, Mr. Filip Coremans, Managing Director (Asia) of Ageas Group, and Mr. Vedanarayanan Seshadri, Managing Director of Royal Sundaram, expressed their pride and commitment to continuing to support customers and policyholders. They highlighted the company’s values, including trust, transparency, and long-term relationships, and its mission to deliver protection and peace of mind to customers.

As Royal Sundaram looks ahead, its focus will be on deepening its presence in retail and commercial segments, creating more phygital experiences, leveraging AI and advanced analytics for personalized protection, and strengthening ESG initiatives. The company aims to continue redefining protection for the modern era, guided by its vision to make insurance simple, accessible, and reliable.

With a comprehensive portfolio spanning motor, health, personal accident, travel, home, and commercial insurance, Royal Sundaram is one of India’s leading general insurance companies. Its legacy of 25 years is a testament to its commitment to its customers and its mission to provide innovative and reliable insurance solutions. As the company celebrates its milestone anniversary, it is well-positioned to continue growing and evolving to meet the changing needs of its customers.

To boost the resale value of a home in 2025, consider the following strategies:

  1. Renovate and Update: Focus on modernizing the kitchen and bathrooms, as these areas tend to have the greatest impact on potential buyers. Update fixtures, appliances, and countertops to create a fresh and contemporary look.
  2. Energy Efficiency: Invest in energy-efficient features such as solar panels, double-glazed windows, and insulation to reduce energy consumption and attract eco-conscious buyers.
  3. Smart Home Technology: Integrate smart home devices, such as thermostats, lights, and security systems, to make the home more convenient and appealing to tech-savvy buyers.
  4. Outdoor Living Spaces: Create inviting outdoor areas, including patios, decks, and gardens, to expand the living space and enhance the home’s curb appeal.
  5. Sustainable and Durable Materials: Use sustainable and durable materials, such as reclaimed wood, bamboo, and low-maintenance siding, to reduce waste and appeal to buyers seeking environmentally friendly features.
  6. Neutral Color Schemes: Apply neutral color schemes and minimal decor to create a blank canvas, allowing potential buyers to envision themselves living in the space.
  7. Improve Curb Appeal: Enhance the home’s exterior by maintaining a well-manicured lawn, trimming trees and shrubs, and adding decorative elements, such as planters and welcome mats.
  8. Increase Natural Light: Install larger windows, skylights, or solar tubes to maximize natural light and create a brighter, more welcoming atmosphere.
  9. Storage and Organization: Incorporate ample storage and organization systems, such as custom closets and built-in shelving, to help buyers envision a clutter-free and functional living space.
  10. Professional Staging: Hire a professional home stager to showcase the home’s best features, highlight its potential, and create an emotional connection with potential buyers.

Boosting the resale value of a home is crucial for homeowners who plan to sell their property in the future. Making smart decisions and investments in the home’s appearance and structure can pay off in the long run. A well-maintained and appealing home can attract potential buyers and increase its resale value. Here are some ways to increase the resale value of a home:

Firstly, enhancing curb appeal is essential. This can be achieved by landscaping, exterior maintenance, and entryway upgrades. A well-kept outside sets the tone for the whole building and makes a good first impression. Landscaping involves buying plants that bloom at the right time of year, trimming back overgrown bushes, and keeping the yard neat. Exterior maintenance includes repainting the outside, fixing any damage, and considering new outdoor lights. Entryway upgrades, such as changing the front door or installing new house numbers, can also contribute to a good view for the resale value of the home.

Modernizing the interior is also crucial. Updating the kitchen and bathroom with energy-efficient tools and materials can make a big difference. Additionally, replacing old light fixtures and installing new flooring that matches the style of the house can enhance the interior’s appeal. Smart home features, such as smart security systems and heaters, can also attract tech-savvy buyers.

Energy efficiency and upgrades are also important. Installing energy-efficient windows, improving insulation, and considering renewable energy options like solar panels can save money and appeal to environmentally conscious buyers. Efficient heating and cooling systems can also reduce energy costs and increase the home’s value.

Regular maintenance and safety are also vital. Routine check-ups, such as annual inspections of pipes, electricity systems, and the roof, can help prevent costly repairs. Having the right insurance, such as building insurance, property insurance, and home insurance, can also protect the homeowner’s capital. Safety improvements, such as installing smoke alarms, ensuring safe stairs, and updating old wiring, can also increase the home’s value.

In conclusion, investing in improvements, routine upkeep, and energy-efficient upgrades can make a home stand out in the market and increase its resale value. By focusing on curb appeal, updated interiors, and regular maintenance, homeowners can attract potential buyers and get a better return on their investment. Small changes, such as landscaping and minor internal updates, can also pay off without breaking the bank. Updated kitchens and baths are essential selling points for modern buyers, and regular care can stop problems before they happen and give buyers confidence in the quality of the home.

Introducing Tata AIA HealthBuddy: Your Personal Virtual Health and Wellness Companion

Tata AIA Life Insurance has introduced “Tata AIA Health Buddy”, a 24×7 health and wellness companion that combines health, wellness, and life insurance. This pioneering solution aims to provide continuous health support to individuals and their families, making it more accessible and reassuring. The Health Buddy mascot embodies trust, care, and approachability, simplifying the concept of continuous health support.

Tata AIA Health Buddy represents a comprehensive approach to overall health and well-being, merging personalized health services with the security of life insurance. This solution goes beyond traditional insurance, building a supportive partnership that evolves with the consumer. It provides a wide range of services, including preventive health check-ups, doctor consultations, discounts on lab tests and medicine orders, and medical second opinions.

The Health Buddy is exclusively available on the Tata AIA Life Insurance App and offers services such as women’s care, dental wellness, and fitness and diet expert sessions. To complement the Health Buddy, Tata AIA has also launched Tata AIA Health SIP, a Non-Participating, Unit-Linked Health Insurance Plan that integrates health coverage with wealth creation.

Tata AIA Health SIP provides protection with growth, with no premium allocation charges and additional maturity boosters to enhance fund value. It also offers long-term critical illness cover and tax-free withdrawals for health-related expenses from the 6th policy year. The plan comes in two variants: Health SIP Plus and Health SIP Plus Pro, which include in-built Accidental Total and Permanent Disability (ATPD) benefits and Terminal Illness with Term Booster (TTB) cover for enhanced protection.

According to Jeelani Basha, Chief Distribution Officer – Alternate and Emerging Channels, Tata AIA Health Buddy empowers consumers with access to best-in-class solutions that safeguard their health and help them lead healthier and more fulfilling lives. The solution reflects Tata AIA’s commitment to being a trusted partner in their health and wellness journey, ensuring they are prepared for life’s uncertainties. With Health Buddy and Health SIP, Tata AIA is establishing a new standard in consumer care, seamlessly integrating health, wellness, and life insurance to provide a comprehensive approach to overall well-being.

GST Dose for Healthcare Sector

The Central Board of Indirect Taxes & Customs (CBIC) has announced the Next-Gen GST Reform, which is expected to bring happiness to farmers, enterprises, households, and businesses. The reform aims to provide ease of living and build a self-reliant India. The changes in GST rates, as recommended by the GST Council, will become effective from September 22, 2025.

The healthcare sector has been a major focus of the GST Council, with reductions in GST rates for various medical products and services, including individual health and life insurance, ambulances, thermometers, medical grade oxygen, diagnostic kits, oral hygiene products, glucometers, and corrective spectacles. The exemption from GST for individual health insurance is expected to make health insurance policies more affordable and increase penetration.

The health insurance segment is the largest among non-life insurance businesses, with a contribution of 40.29% to the total premium in 2023-24. The sector has reported a growth of 19.50% in 2023-24, with standalone health insurers posting a growth of 16% in premium collections for FY25. However, the claims ratio for health insurers has crossed 90%, up from 60-70% in previous years, which may lead to a hike in premiums.

The GST rate cut is expected to encourage insurance companies to enhance their presence in under-penetrated areas and improve coverage. The reduction in GST rates for pharmaceutical products, including life-saving drugs and diagnostic kits, will also lower the cost of healthcare. Medical devices will attract a lower GST rate, and services by way of job work in relation to pharmaceutical products will attract a lower rate of 5% with input tax credit.

Other products that will attract lower GST rates include toothpaste, toothbrush, and dental floss, as well as spectacles and goggles for correcting vision. Motor vehicles cleared as ambulances will attract an 18% GST rate, down from 28%. The Next-Gen GST reform is expected to have revenue implications but will put more money in the hands of the common man, resulting in lower out-of-pocket expenditure for healthcare. This, in turn, will encourage people to spend more, bringing back money into the economy.

The government aims to boost domestic spending, which accounts for almost 60% of India’s Gross Domestic Product (GDP). The reform will also act as a cushion against the economic blow of US tariffs. Overall, the Next-Gen GST reform is expected to have a positive impact on the healthcare sector and the economy as a whole.

The reduction in GST rates for various medical products and services is expected to make healthcare more affordable and increase access to medical care. The exemption from GST for individual health insurance will make health insurance policies more affordable, and the reduction in GST rates for pharmaceutical products will lower the cost of healthcare. The reform is also expected to encourage insurance companies to enhance their presence in under-penetrated areas and improve coverage.

In conclusion, the Next-Gen GST reform is a significant step towards providing ease of living and building a self-reliant India. The reduction in GST rates for various medical products and services will make healthcare more affordable and increase access to medical care. The reform is expected to have a positive impact on the healthcare sector and the economy as a whole, and will put more money in the hands of the common man, resulting in lower out-of-pocket expenditure for healthcare.

Employers and workers are experiencing a rise in health care costs.

Employers and workers are facing increasing healthcare costs, according to a recent report. The rising costs of healthcare are affecting both employers and employees, with many struggling to keep up with the expenses. This trend is expected to continue, with healthcare costs projected to increase by 5-7% annually over the next few years.

One of the main factors driving up healthcare costs is the increasing cost of medical services and prescription drugs. Hospitals and healthcare providers are charging more for their services, and the cost of prescription medications is also on the rise. Additionally, the growing prevalence of chronic diseases such as diabetes and heart disease is contributing to the increasing costs.

Employers are feeling the pinch of rising healthcare costs, with many seeing significant increases in their healthcare expenses. Some employers are passing on these costs to their employees in the form of higher premiums, deductibles, and copays. This can be a burden for workers, who may struggle to afford the increased costs.

Workers are also facing increasing out-of-pocket costs for healthcare. Many employees are being asked to pay more for their healthcare premiums, and some are seeing significant increases in their deductibles and copays. This can be a challenge for workers who are living paycheck to paycheck and may not have the financial resources to cover unexpected medical expenses.

The increasing costs of healthcare are also affecting the overall economy. As healthcare costs rise, employers may be less likely to hire new workers or give raises to existing employees. This can have a ripple effect throughout the economy, leading to slower economic growth and decreased consumer spending.

To combat the rising costs of healthcare, some employers are exploring alternative healthcare options, such as telemedicine and wellness programs. These programs can help reduce healthcare costs by providing employees with access to preventative care and encouraging healthy behaviors. Additionally, some employers are working with healthcare providers to negotiate lower rates for medical services and prescription drugs.

Overall, the increasing costs of healthcare are a significant challenge for both employers and workers. As healthcare costs continue to rise, it is likely that we will see more employers and employees struggling to keep up with the expenses. However, by exploring alternative healthcare options and working together to reduce costs, it may be possible to mitigate the impact of rising healthcare costs and create a more sustainable healthcare system.

Yes, it is possible to obtain health insurance coverage for treatment at home, depending on the type of policy and the specific circumstances. Many health insurance plans now offer coverage for home healthcare services, which can include doctor visits, nursing care, and other medical treatments that would typically be provided in a hospital or clinical setting.Some health insurance policies may cover home healthcare services such as: 1. Doctor visits and consultations at home 2. Nursing care, including wound care and medication management 3. Physical, occupational, and speech therapy 4. Home health aide services, such as assistance with bathing and dressing 5. Medical equipment and supplies, such as oxygen tanks and wheelchairsHowever, the extent of coverage can vary widely depending on the policy and the insurance provider. Some policies may only cover home healthcare services if they are deemed medically necessary and ordered by a physician, while others may have more restrictive requirements or limitations.Experts recommend reviewing your health insurance policy carefully to understand what is covered and what is not, as well as any requirements or limitations that may apply. It is also a good idea to contact your insurance provider directly to ask about their specific coverage for home healthcare services.In some cases, additional coverage may be available through specialized home healthcare insurance policies or riders, which can provide more comprehensive coverage for home healthcare services. These policies may be particularly useful for individuals who require ongoing care or have specific medical needs that can be met in the home setting.Ultimately, the availability and extent of health insurance coverage for treatment at home will depend on the individual’s specific circumstances and the terms of their policy. It is essential to carefully review and understand your policy to ensure you have the coverage you need.

Health insurance claims typically require proof of hospitalization, but what happens when someone is too old or unwell to be admitted to a hospital and can only receive treatment at home? In such cases, domiciliary treatment, also known as home healthcare, can be an option. This type of treatment covers medical consultation, nursing care, medication, and diagnostic tests conducted at home. However, there are certain exceptions, such as treatments done for convenience or those that do not require hospitalization.

Several insurance products offer domiciliary treatment, which is designed for people who are unable to go to the hospital and need to be treated at home. This feature is particularly relevant for older adults who may have chronic conditions or mobility issues. According to Kapil Mehta, MD and principal officer of Secure Now Insurance Brokers, domiciliary treatment is a less-used feature, but it is essential as we grow older.

The coverage and exceptions for domiciliary treatment vary depending on the insurance policy. Typically, it covers ailments and diseases that would otherwise require hospitalization, but it may not cover minor treatments such as physiotherapy or treatments done solely for convenience. Policyholders should review their policy documents thoroughly or consult their insurer to understand the scope and limits of domiciliary coverage.

Despite its importance, insurance coverage for home healthcare services is still in its nascent stage, with low awareness and slow adoption. According to an IRDAI report, only about 10% of health insurance policies cover home care services, primarily for specific conditions such as fever management and physiotherapy. With over 70% of India’s elderly population suffering from chronic illnesses, the need for comprehensive insurance for home-based care is urgent.

Experts believe that such policies should cover a broader range of medical services, be affordable, and be endorsed by clinicians. Implementing these measures could significantly reduce hospitalization rates and improve clinical outcomes, leveraging the personalized approach of home healthcare services. Overall, domiciliary treatment is an essential feature of health insurance policies that can provide relief to individuals who are unable to receive treatment at hospitals.

Insurers have eased health insurance regulations for individuals with diabetes, heart conditions, and other chronic illnesses.

The health insurance landscape is undergoing a significant transformation, making it more accessible to individuals with chronic and lifestyle-related diseases. According to a recent note from Policybazaar, insurers have relaxed their underwriting norms, allowing people with conditions such as diabetes, heart disease, and arthritis to obtain coverage more easily. This change is expected to benefit a large segment of the population, particularly those who were previously denied coverage due to borderline or slightly elevated health indicators.

One notable development is the acceptance of higher HbA1c levels for individuals with well-managed Type 2 diabetes. Several insurers, including Niva Bupa, Care Health, ABHI, and Star Health, now offer coverage to individuals with higher HbA1c levels, widening the scope for those who were previously excluded. Additionally, the Body Mass Index (BMI) cutoffs have been revised across many plans, enabling overweight and mildly obese individuals to apply for policies without facing automatic rejection or higher scrutiny.

Insurers have also expanded their acceptance of other chronic illnesses, such as Aplastic Anemia, Psoriatic Arthritis, Osteoarthritis, Hepatitis B, and Epilepsy. While these policies may come with extra premiums or permanent exclusions, they offer a glimmer of hope for individuals who were previously considered high-risk. Furthermore, individuals with a history of heart ailments are now seeing more options, with insurers such as ABHI and Star Health offering coverage to applicants with past heart issues, albeit with waiting periods or loading.

The Head of Health Insurance at Policybazaar, Siddharth Singhal, welcomed these changes, stating that health insurance has become more inclusive in recent months. The demand for these revised products is strong, with more customers with medical histories seeking financial protection. As the health insurance sector continues to evolve, it is likely that more individuals with chronic and lifestyle-related diseases will be able to access coverage, providing them with much-needed financial security and peace of mind.

AHPI Revokes Suspension Of Cashless Services For Bajaj Allianz, Care Health

In a significant development, the Association of Healthcare Providers of India (AHPI) has revoked its advisory to suspend cashless services for policyholders of Bajaj Allianz General Insurance and Care Health. The decision comes after a meeting between AHPI’s core committee members and senior representatives of Bajaj Allianz, where they addressed long-standing concerns raised by hospitals. The issues discussed included delays in empanelment of new hospitals, outdated reimbursement rates, unilateral deductions, disputes over advanced treatments, and questioning of clinical decisions.

The meeting resulted in a broad agreement on these issues, and Bajaj Allianz has agreed to submit formal actions to AHPI by September 29, 2025. This development comes as a relief to policyholders who were facing the threat of suspension of cashless services from September 1. AHPI, which represents 15,000 hospitals, had earlier advised its member hospitals in North India to suspend cashless treatment facilities for Bajaj Allianz and Care Health policyholders.

The dispute between AHPI and Bajaj Allianz had been ongoing, with AHPI considering approaching the Competition Commission of India (CCI) over the General Insurance Council’s decision to enforce tariffs for various treatments. However, the meeting between the two parties has helped to resolve their differences amicably. Tapan Singhel, Managing Director and CEO of Bajaj Allianz General Insurance, noted that episodes like this highlight the need for a strong health regulator to safeguard citizens’ interests and ensure transparency and fairness across the healthcare ecosystem.

The resolution of the dispute is a positive development for policyholders, who can now continue to avail cashless services at hospitals. It also underscores the importance of dialogue and negotiation in resolving disputes between healthcare providers and insurance companies. The agreement between AHPI and Bajaj Allianz is expected to have a positive impact on the healthcare ecosystem, ensuring that patients receive timely and quality treatment without facing financial difficulties. Overall, the revocation of the advisory is a welcome move, and it is hoped that it will lead to a more collaborative and patient-centric approach in the healthcare industry.

Niva Bupa has suspended its cashless treatment facility in all Max Hospitals.

Niva Bupa Health Insurance has suspended its cashless treatment facility at all Max Hospitals across India, effective August 16, 2025. This move is expected to affect a significant number of insurance holders who rely on cashless treatment and other facilities at insurer-linked hospitals. The decision was made after the agreement between Niva Bupa and Max Hospitals expired in May 2025, and the two parties were unable to reach a mutual agreement on tariff revisions.

According to Dr. Bhabhtosh Mishra, Director & Chief Operating Officer at Niva Bupa Health Insurance, the company had been discussing tariff revisions with Max Hospitals, but they were unable to come to an agreement. As a result, cashless services at Max Hospitals have been temporarily suspended. Max Healthcare, on the other hand, has stated that they had continued to provide cashless services to Niva Bupa policyholders despite the contract expiration, but Niva Bupa’s request to further reduce tariffs was deemed unviable and could compromise patient safety and quality of care.

Niva Bupa has removed all Max Hospitals from their list of network hospitals on their website, effective September 1, 2025. However, policyholders can still avail of treatments at Max Hospitals, but only on a reimbursement basis. This means that they will have to pay the bills upfront and then file for reimbursement with Niva Bupa. The insurance provider has assured its customers that they are making alternative arrangements to ensure a smooth treatment process and has begun a priority reimbursement process for those currently undergoing or seeking treatment at Max Hospitals.

Niva Bupa policyholders have been advised to consider one of their 10,000+ partner hospitals, where the cashless facility remains fully available. The company has stated that they are committed to providing their customers with the best possible service and are working to resolve the issue with Max Hospitals. In the meantime, policyholders will have to navigate the reimbursement process, which may cause some inconvenience. The suspension of cashless treatment facilities at Max Hospitals is a significant development in the Indian health insurance market, and it remains to be seen how this will affect the relationship between Niva Bupa and Max Hospitals in the future.

Max Hospitals across India have stopped providing cashless facilities to Niva Bupa customers.

Niva Bupa Health Insurance has suspended its cashless treatment facility at all Max Hospitals across India, effective August 16, 2025. This decision was made after the company’s agreement with Max expired in May 2025 and negotiations on tariff revision failed to reach a mutual agreement. As a result, policyholders will no longer be able to access cashless treatment at Max Hospitals, but can still receive treatment on a reimbursement basis. This means that policyholders will have to pay their medical bills upfront and then file for reimbursement with Niva Bupa.

Niva Bupa has stated that it has put in place alternative arrangements to ensure that customers’ treatment continues smoothly, and has enabled a priority reimbursement process for customers who are currently undergoing or seeking treatment at Max Hospitals. The company has also asked its partners to inform customers with chronic conditions about the priority-reimbursement process and guide them to alternative hospitals where cashless facilities are available.

This development may cause inconvenience to thousands of Niva Bupa policyholders who rely on Max Hospitals for their medical treatment. Niva Bupa has a claim settlement ratio of 92.02% for the year 2023-24, but its incurred claims ratio is alarmingly low at 59.92%, indicating that policyholders may not receive the full amount of their claims. The company also ranks amongst the top 5 health insurers with the maximum policyholder complaints regarding complete or partial repudiation or rejection of claims.

It’s worth noting that CARE Health Insurance had also suspended its cashless facility with Max Hospitals earlier this year, although this was restricted to Delhi-NCR. Niva Bupa policyholders can continue to access treatment at Max Hospitals, but will have to pay upfront and file for reimbursement. The company has stated that it will endeavour to process reimbursement claims quickly to minimize hassle for its customers. However, the details of the priority reimbursement process are not yet available, and policyholders may face uncertainty and inconvenience as a result of this change.

Public policy can play a significant role in encouraging physicians to practice in underserved areas, according to the Center for Economic and Policy Research (CEPR).

The Center for Economic and Policy Research (CEPR) suggests that public policy can play a crucial role in encouraging physicians to practice in underserved areas. Many communities, particularly rural and low-income areas, face significant shortages of primary care physicians, specialists, and other healthcare professionals. This can lead to poor health outcomes, increased mortality rates, and reduced access to essential healthcare services.

To address this issue, the CEPR recommends implementing public policies that incentivize physicians to practice in underserved areas. Some potential strategies include:

  1. Loan forgiveness programs: Offering loan forgiveness or repayment assistance to physicians who commit to practicing in underserved areas can help alleviate the financial burden of medical school debt.
  2. Scholarships and grants: Providing scholarships and grants to medical students who agree to practice in underserved areas can help attract talented individuals to these communities.
  3. Tax incentives: Offering tax incentives, such as deductions or credits, to physicians who practice in underserved areas can help offset the financial challenges of practicing in these communities.
  4. Rural-themed medical education: Incorporating rural-themed education into medical school curricula can help prepare students for the unique challenges of practicing in rural areas.
  5. Community-based training: Providing community-based training programs can help physicians develop the skills and expertise needed to effectively practice in underserved areas.

Additionally, the CEPR suggests that public policy can also address the underlying factors that contribute to physician shortages in underserved areas, such as:

  1. Limited job opportunities: Creating job opportunities and career advancement pathways can help attract and retain physicians in underserved areas.
  2. Poor working conditions: Improving working conditions, such as access to modern equipment and technology, can help make practicing in underserved areas more appealing.
  3. Limited access to specialists: Improving access to specialists and other healthcare professionals can help reduce the burden on primary care physicians and make practicing in underserved areas more sustainable.

By implementing these policies, governments can help encourage physicians to practice in underserved areas, improving access to essential healthcare services and reducing health disparities. The CEPR argues that a comprehensive approach that addresses the root causes of physician shortages and provides incentives for physicians to practice in underserved areas can help create a more equitable and effective healthcare system.

Royal Sundaram Marks 25 Years of Trust, Care, and Innovation in Insurance | Bizz Impact

Royal Sundaram General Insurance Co. Limited is celebrating 25 years of serving customers in India. As the country’s first private sector general insurer, the company has come a long way since its inception in 2000. With a commitment to simplifying insurance and making it more accessible, Royal Sundaram has introduced several industry-first initiatives and pioneered bancassurance partnerships. The company has protected over 2 crore customers across various segments, including motor, health, travel, home, and commercial insurance.

Royal Sundaram’s journey is built on a promise to stand by customers when they need protection the most. The company’s values are rooted in trust, simplicity, care, and digital convenience with a human touch. With the backing of the Sundaram Finance Group and Ageas’s global expertise, Royal Sundaram has established itself as a trusted name in the insurance industry.

The company’s leadership has expressed pride and commitment to continuing to support customers and policyholders. Mr. Harsha Viji, Vice Chairman of Sundaram Finance, highlighted the importance of trust, transparency, and long-term relationships in Royal Sundaram’s journey. Mr. Filip Coremans, Managing Director (Asia) of Ageas Group, praised the company’s consistent innovation and adaptation to customer needs. Mr. Vedanarayanan Seshadri, Managing Director of Royal Sundaram, acknowledged the trust placed in the company by customers, partners, and employees and outlined the company’s focus on delivering customer-centric solutions powered by digital transformation and a human touch.

As Royal Sundaram looks ahead, the company plans to deepen its presence in retail and commercial segments, create more phygital experiences, leverage AI and advanced analytics for personalized protection, and strengthen ESG initiatives. With a comprehensive portfolio of insurance products and a legacy of 25 years, Royal Sundaram continues to redefine protection for the modern era. The company’s commitment to making insurance simple, accessible, and reliable has earned it a reputation as one of India’s leading general insurance companies.

AHPI asks insurers to resume cashless services, ready to review its advisory.

The Association of Healthcare Providers India (AHPI) has requested insurance companies to reinstate cashless services at hospitals. This move comes after several insurers halted cashless services due to disagreements over reimbursement rates and other issues. AHPI, which represents several private hospitals across the country, has expressed its willingness to review its advisory and work with insurers to find a mutually acceptable solution.

The cashless service allows policyholders to receive medical treatment without having to pay out-of-pocket expenses, as the hospital directly bills the insurance company. However, due to rising healthcare costs and disagreements over reimbursement rates, many insurers have opted out of cashless services, leaving patients to bear the expenses themselves.

AHPI has stated that the suspension of cashless services has caused inconvenience to patients and has affected the overall quality of care. The association has emphasized the need for a collaborative approach between hospitals and insurers to resolve the issues and ensure that patients receive the necessary treatment without financial burdens.

The dispute between hospitals and insurers revolves around the reimbursement rates, with hospitals demanding higher rates to cover their costs. Insurers, on the other hand, argue that hospitals are overcharging and have proposed a price cap on various medical procedures. AHPI has indicated that it is open to discussing the reimbursement rates and other issues with insurers to find a common ground.

The suspension of cashless services has significant implications for patients, particularly those with critical illnesses or emergencies. Without cashless services, patients may be required to pay large sums of money upfront, which can be a significant financial burden. AHPI’s request to insurers to resume cashless services is aimed at alleviating this burden and ensuring that patients receive timely and quality medical care.

In conclusion, AHPI’s request to insurers to resume cashless services is a step towards resolving the ongoing dispute between hospitals and insurers. The association’s willingness to review its advisory and work with insurers to find a mutually acceptable solution is a positive development. It is essential for both parties to collaborate and find a solution that benefits patients and ensures that they receive quality medical care without financial hardship.

1.6 lakh+ Get Health Interventions from Aditya Birla Health Insurance

On the occasion of World Health Day, Aditya Birla Health Insurance Co. Ltd. (ABHICL) announced that over 1 lakh policyholders have benefited from their HealthReturns model, which encourages healthier lifestyle choices and good heart health. The model focuses on regular physical activity, with access to expert health guidance, and has delivered improved health outcomes for customers. Policyholders have walked over 350 billion steps so far, demonstrating their commitment to health.

The company is redefining the industry with its ‘Health-First’ approach, shifting from reactive coverage to proactive wellness. The HealthReturns model allows customers to earn rewards by engaging in fitness activities, such as walking 10,000 steps or burning 300 calories in a workout session. Customers who achieve 325 Active Dayz in a year and maintain a Green Healthy Heart Score can earn up to 100% of their annual premium amount back as HealthReturns.

In FY25, Aditya Birla Health Insurance conducted 3.8 lakh health assessments and generated 18 lakh personalized Wellbeing Score, helping customers take charge of their health. The company has also seen a significant increase in customers undergoing health coaching and health interventions, with 1 lakh+ customers and 1.6 lakh+ customers respectively. 81% of customers engaging with the company’s preventive care ecosystem experienced better control of key health indicators, reinforcing the company’s commitment to measurable health outcomes.

According to Mr. Mayank Bathwal, CEO of Aditya Birla Health Insurance, the role of health insurance is expanding beyond financial protection to becoming an enabler of proactive well-being. The company’s pioneering HealthReturns model not only incentivizes policyholders to adopt healthier lifestyles but also reinforces its commitment to driving a proactive, health-first approach to well-being.

The company offers a four-pronged approach to health insurance, which includes Know Your Health, Improve Your Health, Get Rewarded, and Stay Protected. This approach provides customers with access to various insights, health management services, and rewards for prioritizing their well-being. The company’s vision is to create a health-first ecosystem where policyholders are financially secure and empowered to lead healthier, longer lives. The HealthReturns model and the promise of 100% health insurance are offered via the Activ Health App, which provides a personalized engagement journey tailored to suit each user’s unique needs and behavior.

Royal Sundaram Marks 25 Years of Trust, Care, and Innovation in Insurance

Royal Sundaram General Insurance Co. Limited, India’s first private sector general insurer, is celebrating 25 years of serving customers with protection, care, and innovation. From its inception in 2000 to becoming a trusted name for millions across the country, Royal Sundaram’s journey reflects a consistent commitment to simplifying insurance and making it more accessible. Over the years, the company has introduced several industry-first initiatives, pioneered bancassurance partnerships, and strengthened claims processes with speed and empathy.

Royal Sundaram has protected over 2 crore customers across various insurance segments, including motor, health, travel, home, and commercial insurance. The company’s promise to its customers is to stand by them when they need protection the most. Royal Sundaram’s values are rooted in trust, simplicity, care, and digital convenience with a human touch. The company is backed by the Sundaram Finance Group’s values and Ageas’s global expertise, making it a preferred insurer for millions of Indians.

The company’s leadership, including Mr. Harsha Viji, Vice Chairman of Sundaram Finance, Mr. Filip Coremans, Managing Director (Asia) of Ageas Group, and Mr. Vedanarayanan Seshadri, Managing Director of Royal Sundaram, have expressed their pride and commitment to continuing to support customers and policyholders with their insurance needs. As Royal Sundaram looks ahead, its focus will be on deepening its presence in retail and commercial segments, creating more phygital experiences, leveraging AI and advanced analytics for personalized protection, and strengthening ESG initiatives.

Royal Sundaram’s comprehensive portfolio spans various insurance segments, and its vision is to make insurance simple, accessible, and reliable. The company continues to redefine protection for the modern era, guided by its values of trust, transparency, and long-term relationships. With 25 years of experience, Royal Sundaram is well-positioned to continue serving its customers with innovation, reliability, and care. The company’s milestone celebration is a testament to the trust its customers, partners, and employees have placed in it, and it looks forward to continuing its mission of delivering protection and peace of mind to customers.

Around 15,000 hospitals have stopped providing cashless treatment to Bajaj Allianz policyholders due to delays in claim settlements.

Approximately 15,000 hospitals in India have stopped providing cashless treatment to policyholders of Bajaj Allianz. The main reason behind this decision is the alleged delay in settlement of claims by the insurance company. Hospitals have complained that Bajaj Allianz has been taking an inordinately long time to clear their dues, leading to significant financial strain on the healthcare providers.

The Indian Healthcare Federation has come out in support of the hospitals, stating that delayed payments are causing immense hardship for them. The Federation has claimed that Bajaj Allianz has been delaying payments for months, and in some cases, even years. This has led to a situation where hospitals are no longer willing to provide cashless treatment to Bajaj Allianz policyholders, as they are not sure when they will receive payment for their services.

The issue has been ongoing for several months, with hospitals repeatedly bringing it to the attention of Bajaj Allianz. However, the insurance company has failed to take adequate measures to address the issue. As a result, hospitals have been left with no choice but to stop providing cashless treatment to Bajaj Allianz policyholders.

The decision by hospitals to stop providing cashless treatment is likely to affect thousands of policyholders who rely on Bajaj Allianz for their medical expenses. Policyholders may be forced to pay out of pocket for their treatment and then claim reimbursement from the insurance company. This could lead to significant financial hardship for many people, particularly those who are not in a position to afford expensive medical treatment.

Bajaj Allianz has maintained that it is working to resolve the issue and ensure that claims are settled promptly. However, the company has not provided a timeline for when the issue is likely to be resolved. In the meantime, policyholders are advised to check with their hospital before undergoing treatment to confirm whether cashless treatment is available.

The dispute between hospitals and Bajaj Allianz highlights the need for greater transparency and efficiency in the insurance claims process. It also underscores the importance of hospitals and insurance companies working together to ensure that policyholders receive the medical care they need without facing financial hardship. Until the issue is resolved, policyholders are likely to face significant uncertainty and inconvenience.

Could Oregon be the catalyst for universal health care in the US, potentially paving the way for a nationwide overhaul of the healthcare system?

In 2022, Oregonians passed Measure 111, a constitutional amendment guaranteeing affordable health care as a fundamental right to every resident of the state. This move paves the way for Oregon to implement its Universal Health Plan, which could be enacted as early as fall 2025. The plan’s success is crucial, especially in the face of extreme Medicaid cuts from the Trump administration, which will leave approximately 16 million people without health coverage by 2034.

Oregon’s single-payer health care dream still faces hurdles, but with the constitutional amendment voted in by the people, it has a leg up over previous state-level campaigns, such as Vermont’s Green Mountain Care. Vermont’s campaign, which began in 2011, came close to implementation but was ultimately shot down in 2014 due to concerns over significant tax increases.

According to Dr. Deborah Richter, a physician and president of Vermont Health Care for All, the greatest barrier in Vermont’s state-level campaign was the lack of understanding about the benefits of a publicly-funded system. Richter emphasized that under a privately-funded system, health care costs are often hidden, and the financial burden falls on individuals with medical needs.

In Oregon, the Universal Health Plan Governance Board aims to propose the next draft of the health care plan in fall 2025. The board is comprised of members from Health Care for All Oregon (HCAO) and other community organizations. HCAO has built a multifaceted organizing apparatus, conducting crowd canvassing, tabling at events, and giving presentations to various community groups.

Organizers with HCAO emphasize the need to create a strong network of advocates to push for a comprehensive health plan. They also recognize the challenge of disinformation from opponents of the universal health plan and the need to connect with people in their communities to overcome this.

The success of Oregon’s Universal Health Plan could have a ripple effect, paving the way for other states to implement similar plans. As Philip Verhoef, the immediate past president of Physicians for a National Health Plan, notes, “You almost need to make the argument impervious to money. The people fighting for single-payer are never going to outspend the insurance company, so instead they simply have to get everyone on their side.”

The journey to universal health care in Oregon and the United States is not without its challenges, but with community effort and a deeper understanding of the vast inefficiencies in American health care, it is possible to realize a dream of something better. As Dr. Richter suggests, universal coverage could be a light at the end of the tunnel, especially in the face of significant health care-related deaths due to the Trump administration’s cuts.

Trump administration refuses to enforce rules for short-term junk health insurance plans.

The Trump administration has announced its decision not to enforce certain rules and regulations for short-term, limited-duration insurance (STLDI) plans, also known as junk health insurance plans. These plans were originally designed to provide temporary coverage for individuals who are between jobs or waiting for other insurance to kick in. However, they have become a popular alternative to traditional health insurance plans, particularly among those who are unable to afford the rising costs of Affordable Care Act (ACA) plans.

STLDI plans are often referred to as “junk” plans because they typically do not provide the same level of coverage as traditional health insurance plans. They often exclude essential health benefits, such as maternity care, mental health services, and prescription drug coverage. Additionally, these plans can deny coverage to individuals with pre-existing conditions, and they often have lower lifetime and annual limits on coverage.

Despite their limitations, STLDI plans have become increasingly popular under the Trump administration. The administration has expanded the duration of these plans from three months to up to 12 months, and they can be renewed for up to 36 months. This has led to concerns that these plans are being used as a replacement for traditional health insurance, rather than as a temporary bridge.

The decision not to enforce certain rules and regulations for STLDI plans has been met with criticism from health care advocates and experts. They argue that these plans are leaving consumers without adequate protection and are undermining the ACA. By allowing these plans to operate with limited oversight, the administration is putting consumers at risk of being underinsured and facing significant medical bills.

Furthermore, the expansion of STLDI plans is also expected to have a negative impact on the ACA marketplaces. As healthier individuals opt for these limited plans, the risk pool for ACA plans will become increasingly skewed towards sicker individuals, leading to higher premiums and instability in the market.

The Trump administration’s decision to not enforce rules for STLDI plans is seen as another attempt to undermine the ACA and push the country towards a more deregulated health insurance market. However, this approach has been criticized for prioritizing the interests of insurance companies over the needs of consumers. As the debate over the future of healthcare in the US continues, the impact of these junk plans on the health insurance market and consumers will be closely watched.

Kotak Life has launched 2 mobile medical vans in Coimbatore.

Kotak Mahindra Life Insurance Company (Kotak Life) has launched two Mobile Medical Vans in Coimbatore as part of its Corporate Social Responsibility (CSR) initiative. The launch took place on August 19, 2025, at Hotel Taj Vivanta, with Managing Director Mahesh Balasubramanian in attendance. These vans will provide free primary health check-ups, diagnostic services, and basic healthcare treatments to people in remote and semi-urban areas across multiple districts in the region.

In addition to the two vans launched in Coimbatore, Kotak Life has announced plans to deploy seven more Mobile Medical Vans across Tamil Nadu and Puducherry, bringing the total to 14 vans in the region. The new vans will be launched in Ramanathapuram, Nagapattinam, Krishnagiri, Kallakuruchi, and Puducherry. Kotak Life will bear the operational expenses, provide medical supplies, and offer training to ensure the efficient functioning of the vans.

The initiative is part of Kotak Life’s commitment to community healthcare, with a focus on providing access to quality healthcare to underserved communities. In the fiscal year 2025-26, the company has allocated over 45% of its CSR budget to projects in Tamil Nadu and Puducherry, with a strong focus on healthcare and education. The company is also promoting eye care through eye donation awareness programs and drives, and enabling access to higher education through its scholarship program across 23 colleges in Tamil Nadu.

Kotak Mahindra Life Insurance Company is a 100% owned subsidiary of Kotak Mahindra Bank Limited, and is one of the fastest growing insurance companies in India. The company has 323 branches across 152 cities and has covered over 5 crore active lives as of March 31, 2025. Mahesh Balasubramanian, Managing Director of Kotak Life, stated that the company believes access to quality healthcare is a fundamental right, and is committed to helping build a healthier and more inclusive India through its CSR initiatives.

Cashless treatment for a specific insurance company will be discontinued in 15,000 hospitals starting from September 1.

Starting from September 1, approximately 15,000 hospitals in India will stop providing cashless treatment to policyholders of certain insurance companies. The Association of Healthcare Providers (India) (AHPI) has taken this decision, which will affect insurance companies such as Bajaj Allianz and Care Health Insurance.

The reason behind this move is a dispute over pending claims and low reimbursement rates. According to reports, hospitals have been facing significant delays and shortfalls in payments from these insurance companies, resulting in substantial losses for the healthcare providers. As a result, the hospitals have decided to suspend cashless services for policyholders of these companies.

The insurance companies, however, have termed the decision as “unilateral” and have expressed their disappointment over the move. They claim that the hospitals’ decision will affect thousands of policyholders who will no longer be able to avail cashless treatment at these hospitals.

The AHPI had initially planned to approach the Competition Commission of India (CCI) and the Insurance Regulatory and Development Authority of India (IRDAI) over the issue, but has now decided to defer the plan. The association has instead asked the insurance companies to withdraw their advisories and work towards finding a resolution to the pending claims issue.

The larger picture behind this dispute is the long-standing issue of low reimbursement rates and delayed payments from insurance companies to hospitals. This has resulted in a significant buildup of pending claims, putting a strain on the finances of healthcare providers. The hospitals claim that they are being forced to bear the losses, while the insurance companies are making profits.

The situation is likely to affect thousands of policyholders who will have to bear the brunt of the dispute. The policyholders will either have to pay out of pocket for their treatment or look for alternative healthcare providers that still offer cashless services. The dispute highlights the need for a more efficient and transparent claims settlement process to avoid such situations in the future.

Royal Sundaram Marks 25 Years of Trust, Care, and Innovation in Insurance | Bizz Impact

Royal Sundaram General Insurance Co. Limited, India’s first private sector general insurer, is celebrating its 25th anniversary of serving customers with protection, care, and innovation. Since its inception in 2000, the company has come a long way, introducing industry-first initiatives, pioneering bancassurance partnerships, and strengthening claims processes with speed and empathy. Royal Sundaram has protected over 2 crore customers across various segments, including motor, health, travel, home, and commercial insurance.

The company’s success can be attributed to its commitment to simplifying insurance and making it more accessible. It has introduced digital-first platforms to make customer interactions seamless and has designed transparent products to safeguard what matters most to its customers. Royal Sundaram’s promise is to stand by its customers when they need protection the most, and its values of trust, transparency, and long-term relationships have made it a preferred insurer for millions of Indians.

The company’s leadership, including Mr. Harsha Viji, Vice Chairman of Sundaram Finance, and Mr. Filip Coremans, Managing Director (Asia) of Ageas Group, have expressed their pride and commitment to continuing to support customers and policyholders with their insurance needs. Mr. Vedanarayanan Seshadri, Managing Director of Royal Sundaram, has acknowledged the trust placed in the company by its customers, partners, and employees and has outlined the company’s focus on delivering customer-centric solutions powered by digital transformation and a human touch.

As Royal Sundaram looks ahead, it plans to deepen its presence in retail and commercial segments, create more phygital experiences, leverage AI and advanced analytics for personalized protection, and strengthen ESG initiatives that deliver lasting impact for communities and the environment. With a comprehensive portfolio spanning motor, health, personal accident, travel, home, and commercial insurance, Royal Sundaram continues to redefine protection for the modern era. The company’s legacy of 25 years is a testament to its commitment to making insurance simple, accessible, and reliable.

Royal Sundaram’s journey is a significant milestone in the Indian insurance industry, and its achievements are a reflection of its dedication to its customers and stakeholders. The company’s vision to make insurance simple, accessible, and reliable has guided its actions over the years, and it continues to be a trusted name in the industry. As the company celebrates its 25th anniversary, it is well-positioned to continue its growth trajectory and make a lasting impact in the Indian insurance market.

Major hospitals to stop cashless treatment: What it means for patients with Bajaj Allianz insurance

The Association of Healthcare Providers of India (AHPI) has announced that over 15,000 hospitals across India will suspend cashless treatment for patients insured with Bajaj Allianz General Insurance starting September 1, 2025. This decision is expected to affect a large number of families who rely on health insurance for smooth and stress-free medical care. The hospitals have claimed that insurance companies are delaying payments and not settling claims on time, making it difficult for them to continue offering cashless services.

According to AHPI, medical inflation in India is around 7-8% every year, driven by rising staff costs, medicines, consumables, utilities, and overheads. However, insurance reimbursements are not keeping pace, making it challenging for hospitals to operate at outdated reimbursement rates. The director general of AHPI, Dr Girdhar Gyani, stated that continuing under such terms risks compromising patient care, which AHPI and its members cannot allow.

For patients, the biggest change is financial. They will now need to pay upfront and later apply for reimbursement, which can be a significant stress, especially in emergencies. The reassurance of cashless care, especially in critical situations, will now be missing. This move is expected to affect patients who rely on health insurance for smooth and stress-free medical care.

The announcement highlights the tension between hospitals and insurers, with patients becoming the most vulnerable in this tug-of-war. Hospitals demand fair reimbursement, while insurers aim to control costs. However, unless a resolution is reached, many patients will have to prepare for a reimbursement-only model. Such disputes need urgent attention because disruptions in insurance services directly affect patient well-being and access to timely healthcare.

The suspension of cashless treatment is a significant development that can have far-reaching consequences for patients and the healthcare industry. It remains to be seen how the situation will unfold, but one thing is certain – patients will be the ones who will bear the brunt of this decision. The AHPI has confirmed the suspension from September 1, but there is still room for negotiation. It is essential for hospitals, insurers, and regulatory bodies to come together to find a solution that works for all parties involved, ensuring that patients continue to receive the care they need without financial stress.

Royal Sundaram Marks 25 Years of Trust, Care, and Innovation in Insurance

Royal Sundaram, a leading insurance company, has reached a milestone of 25 years in the industry. Since its inception, the company has been dedicated to providing innovative and customer-centric insurance solutions. With a strong foundation built on trust, care, and innovation, Royal Sundaram has established itself as a reputable and reliable insurance provider.

Over the past 25 years, Royal Sundaram has consistently strived to improve and expand its services, introducing new and innovative products to meet the evolving needs of its customers. The company’s commitment to excellence has enabled it to build a loyal customer base and establish strong partnerships with various stakeholders.

One of the key factors that have contributed to Royal Sundaram’s success is its focus on customer care. The company has always prioritized its customers’ needs, providing them with personalized support and guidance throughout the insurance process. This approach has helped Royal Sundaram build trust with its customers, who have come to rely on the company for their insurance needs.

Innovation has also been a key driver of Royal Sundaram’s growth. The company has consistently invested in new technologies and processes, enabling it to stay ahead of the curve and provide its customers with cutting-edge insurance solutions. From introducing new products to enhancing its digital platform, Royal Sundaram has always been at the forefront of innovation in the insurance industry.

As Royal Sundaram celebrates its 25th anniversary, it can look back on a quarter century of achievements and milestones. The company has come a long way since its inception, and its commitment to trust, care, and innovation has been the driving force behind its success. With a strong foundation in place, Royal Sundaram is well-positioned to continue growing and evolving, providing its customers with the best possible insurance solutions for years to come.

Royal Sundaram’s 25th anniversary is a testament to the company’s dedication and perseverance. It has navigated the challenges of the insurance industry with ease, always keeping its customers’ needs at the forefront. As the company looks to the future, it is clear that Royal Sundaram will continue to be a leading player in the insurance industry, driven by its core values of trust, care, and innovation. With its strong reputation and commitment to excellence, Royal Sundaram is poised to continue providing innovative and customer-centric insurance solutions for many years to come.

Why Claim Settlement Ratio Should Be Your First Check Before Buying InsuranceThe claim settlement ratio (CSR) is a crucial metric that indicates the percentage of claims settled by an insurance company out of the total claims received. It serves as a key indicator of an insurer’s reliability and commitment to paying out claims. Before purchasing an insurance policy, it is essential to check the claim settlement ratio of the insurance company.A high claim settlement ratio signifies that the insurance company has a history of settling a large percentage of claims, thereby providing assurance to policyholders that their claims will be settled in case of an unforeseen event. On the other hand, a low claim settlement ratio raises concerns about the insurer’s willingness or ability to pay out claims.Checking the claim settlement ratio before buying insurance helps you make an informed decision. It allows you to assess the insurance company’s track record and gauge the likelihood of your claim being settled. By opting for an insurer with a high claim settlement ratio, you can ensure that you receive the compensation you are entitled to when you need it the most.Therefore, the claim settlement ratio should be your first check before buying insurance, as it reflects the insurer’s credibility and commitment to its policyholders. It is a vital factor that can significantly impact your decision-making process when selecting an insurance provider.

Navigating the world of insurance can be overwhelming, with numerous insurers in the market. One crucial metric to consider when choosing an insurer is the claim settlement ratio (CSR). The CSR is the percentage of claims an insurer settles in a given year compared to the total number of claims it receives. It serves as a key indicator of an insurer’s reliability and efficiency in honoring claims. The Insurance Regulatory and Development Authority of India (IRDAI) publishes the CSR annually, providing policy buyers with a transparent and data-backed way to assess the credibility of insurers.

A high CSR indicates that the insurer is dependable and prompt in claim settlements, minimizing the chances of distressing delays or rejections. A CSR of 95% or above is typically considered a sign of trustworthiness. The CSR is calculated using a formula that takes into account the number of claims settled and the total number of claims received. According to IRDAI’s latest data for 2023-24, Acko General Insurance and Navi General Insurance Ltd had the highest CSR among private general insurers, with 99.91% and 99.97% of claims settled within 3 months, respectively.

Among public sector insurers, The Oriental Insurance Co. Ltd had the lowest CSR at 65.08%. Overall, general insurers in India paid out 81.13% of total claims within 3 months of claim intimation. Stand-alone health insurers also had notable CSR performances, with Aditya Birla Health Insurance topping the list at 92.97%, followed by Care Health Insurance at 92.77% and Niva Bupa Health Insurance at 92.02%. The claim settlement ratio is a critical metric that can help policy buyers make informed decisions when choosing an insurer. It is essential to check the CSR before signing on the dotted line, as it is a direct measure of how likely an insurer is to stand by policyholders in their time of need.

The data shows that some insurers are more reliable than others in settling claims. For instance, Star Health and Allied Insurance Co. Ltd had the lowest CSR among stand-alone health insurers but settled the highest number of claims at 16,80,171. This highlights the importance of considering multiple factors when choosing an insurer. The CSR is not just a number; it is a reflection of an insurer’s commitment to honoring claims and providing timely financial support during emergencies. By considering the CSR, policy buyers can make more informed decisions and choose an insurer that is likely to meet their needs.

Even in States That Fought Obamacare, Trump’s New Law Poses Health Consequences

The recent budget law signed by President Donald Trump will have significant consequences for healthcare in the US, particularly in states that refused to expand Medicaid under the Affordable Care Act (ACA). The law imposes new rules for verifying eligibility for subsidized coverage, shortens enrollment periods, and cuts funding for navigators who help people shop for plans. These changes are expected to cause a projected 870,000 Floridians to lose health insurance by 2034.

In states that did not expand Medicaid, such as Florida, Georgia, and Mississippi, the impact will be even more severe. A higher proportion of residents in these states are enrolled in ACA plans, and the changes to the law will erode enrollment and increase the number of uninsured people. For example, Georgia will see as many people lose insurance coverage as California, despite having a population that is less than one-third the size.

The law also trims federal spending on Medicaid by more than $1 trillion over the next decade, which will lead to 10 million people losing coverage over the next decade. The nonpartisan Congressional Budget Office estimates that allowing enhanced subsidies to expire will increase the number of people without health insurance by 4.2 million by 2034.

Hospital executives and health policy experts warn that the consequences of the law will be severe, particularly in non-expansion states. The law will limit financing arrangements that states used to make higher Medicaid payments to doctors and hospitals, which will lead to reduced reimbursement rates and potentially force rural hospitals to close.

The enhanced ACA subsidies, which are set to expire at the end of the year, have been crucial in making health insurance affordable for people like Francoise Cham, a 62-year-old single mom from Miami. If these subsidies are not extended, premiums for Obamacare coverage would rise by more than 75% on average, making it unaffordable for many people.

Health policy experts say that states that expanded Medicaid have made a smart decision, while states that haven’t are facing similar financial pressures without any upside. The budget law includes a $50 billion fund intended to insulate rural hospitals and clinics from its changes to Medicaid and the ACA, but a KFF analysis found that it would offset only about one-third of the cuts to Medicaid in rural areas.

Overall, the budget law will have far-reaching consequences for healthcare in the US, particularly in states that refused to expand Medicaid. The changes to the law will lead to increased numbers of uninsured people, reduced access to healthcare, and potentially devastating consequences for rural hospitals and communities.

Star Health Insurance has achieved a significant milestone, having protected the lives of 30 lakh senior citizens and settled claims worth over Rs. 11,500 crore.

Star Health Insurance has achieved a significant milestone by protecting the lives of 30 lakh senior citizens and settling claims worth over Rs. 11500 crore. This accomplishment showcases the company’s commitment to providing comprehensive health insurance coverage to its policyholders, particularly senior citizens who are often more vulnerable to health issues.

As people age, their health requirements become more complex, and they require specialized care. Star Health Insurance has been at the forefront of providing tailored health insurance products that cater to the unique needs of senior citizens. The company’s efforts have been instrumental in providing financial protection to this demographic, ensuring they receive the necessary medical attention without burdening their families.

The settlement of claims worth over Rs. 11500 crore demonstrates the company’s ability to handle large volumes of claims efficiently. This translates to a significant amount of financial support for policyholders, enabling them to access quality healthcare without incurring substantial out-of-pocket expenses. The prompt settlement of claims also reflects the company’s customer-centric approach, prioritizing the well-being of its policyholders during their time of need.

Star Health Insurance’s achievement is particularly notable given the challenges faced by the healthcare industry in recent years. The COVID-19 pandemic has put a strain on healthcare systems worldwide, and India has been no exception. The company’s ability to navigate these challenges and continue providing comprehensive coverage to its policyholders is a testament to its resilience and dedication to its customers.

The protection of 30 lakh senior citizen lives is a significant milestone, considering the vulnerabilities associated with this age group. Senior citizens often face higher healthcare costs due to age-related health issues, and Star Health Insurance has been instrumental in mitigating these costs. By providing affordable and comprehensive health insurance coverage, the company has helped ensure that senior citizens receive the medical attention they require, regardless of their financial situation.

In conclusion, Star Health Insurance’s achievement of protecting 30 lakh senior citizen lives and settling claims worth over Rs. 11500 crore is a landmark milestone that underscores the company’s commitment to providing comprehensive health insurance coverage. The company’s customer-centric approach, efficient claims settlement process, and tailored health insurance products have been instrumental in supporting the healthcare needs of senior citizens, and its efforts will undoubtedly have a positive impact on the lives of its policyholders.

Association of Healthcare Providers of India (AHPI) has requested hospitals to discontinue providing cashless treatment to policyholders of Bajaj Allianz.

The Association of Healthcare Providers – India (AHPI), representing over 15,000 hospitals nationwide, has announced that its member hospitals in North India will suspend cashless treatment for policyholders of Bajaj Allianz General Insurance Company, effective September 1. This decision comes after hospitals faced repeated challenges with the insurer over reimbursement rates, delays in payments, and prolonged approval times for pre-authorisation and discharge processes.

According to AHPI Director General Girdhar Gyani, medical inflation has consistently been around 7-8% per year, making it unsustainable for hospitals to operate at outdated rates. Despite previous communications with Bajaj Allianz, the insurer has not responded, prompting AHPI to halt cashless services. AHPI has proposed that tariffs be reviewed every two years to keep up with medical inflation, but Bajaj Allianz has rejected these requests and sought further tariff reductions.

As a result, member hospitals will temporarily suspend cashless services for Bajaj Allianz policyholders, although they will continue to provide treatment at self-pay rates, allowing patients to seek reimbursement from their insurer later. AHPI has also issued a similar notice to Care Health Insurance, requesting a response by August 31, 2025, and warning that member hospitals may discontinue cashless treatment for Care Health Insurance beneficiaries if the issue is not resolved.

Despite the standoff, AHPI remains committed to collaboration with insurers and is open to constructive engagement to find a solution that serves the interests of both patients and healthcare providers. Bajaj Allianz General Insurance has expressed surprise at the announcement and stated that it is working with AHPI to find a solution that benefits policyholders. The company’s head of Health Administration Team, Bhaskar Nerurkar, emphasized that the company wants to ensure that policyholders receive the best possible hospitalization experience with fair rates, seamless claims, and quality service.

The dispute between AHPI and Bajaj Allianz highlights the ongoing challenges in India’s healthcare sector, where hospitals and insurers often have differing views on reimbursement rates and payment terms. The suspension of cashless services may cause inconvenience to policyholders, but AHPI hopes that the move will prompt Bajaj Allianz to reconsider its stance and engage in constructive dialogue to find a mutually beneficial solution. With the deadline of September 1 looming, it remains to be seen how the situation will unfold and whether a resolution can be reached that satisfies both parties.

Royal Sundaram Celebrates 25 Years of Trust, Care & Innovation in Insurance

Royal Sundaram General Insurance Co. Limited, India’s first private sector general insurer, is celebrating its 25th anniversary of providing insurance services to its customers. The company was licensed in 2000 and has since become a trusted name in the industry, known for its commitment to simplifying insurance and making it more accessible. Over the years, Royal Sundaram has introduced several industry-first initiatives, including bancassurance partnerships and digital-first platforms, to make customer interactions seamless.

The company has protected over 2 crore customers across various insurance segments, including motor, health, travel, home, and commercial insurance. Royal Sundaram’s leadership, including Vice Chairman Harsha Viji, Managing Director Filip Coremans, and Managing Director Vedanarayanan Seshadri, have expressed their pride and commitment to continuing to support customers and policyholders with their insurance needs.

The company’s 25-year journey is a testament to its values of trust, transparency, and long-term relationships. Royal Sundaram has consistently innovated and adapted to customer needs, and its partnership with Ageas Group has been instrumental in its growth. As the company looks ahead, it plans to deepen its presence in retail and commercial segments, create more phygital experiences that blend personal trust with digital convenience, and leverage AI and advanced analytics for personalized protection.

Royal Sundaram’s vision is to make insurance simple, accessible, and reliable, and it continues to redefine protection for the modern era. The company’s comprehensive portfolio spans various insurance segments, and it is guided by a commitment to delivering customer-centric solutions powered by digital transformation and a human touch. With its strong legacy and commitment to innovation, Royal Sundaram is well-positioned to continue serving its customers and policyholders for many years to come.

The company’s leadership has acknowledged the pivotal role of the regulator in supporting the industry’s progress and enabling Royal Sundaram to serve its customers better. As the company celebrates its 25th anniversary, it is also focusing on strengthening its ESG initiatives to deliver lasting impact for the communities it serves and the environment. With its legacy of 25 years, Royal Sundaram is a leading general insurance company in India, and its commitment to innovation, reliability, and care has made it a preferred insurer for millions of Indians.

Estonia’s health fund is considering the use of artificial intelligence to streamline processes, save time, and enhance primary care services.

The Estonian Health Insurance Fund (EHIF) is facing a financial crisis, but outgoing director Rain Laane has proposed a plan to steer the healthcare system back on track. The plan involves implementing a new system with AI tools to help family doctors manage larger practice lists. Laane presented the plan to the EHIF’s supervisory board, which backed the fund’s treatment funding plans for the coming years. The plan is expected to improve the fund’s finances by €71 million next year, with further growth in the following two years.

The EHIF expects to finish this year €43 million above budget and free up roughly €70 million in next year’s resources. The plan also relies on tapping into €106 million in retained earnings. Laane noted that the healthcare budget increases every year, and with smarter management, the fund can strengthen primary care and improve data management. The new system will use AI to save doctors time on routine tasks, such as drafting discharge summaries, and provide a better overview of a patient’s treatment history.

The rollout of the new system will be done in agreement with family doctors and will start at a moderate pace once the system is ready. Laane believes that family doctors who take on larger practice lists and show that it can be done will set an example for others to follow. The plan is also driven by the need to address the shortage of family doctors, with more doctors retiring than entering the field. This has led to an increase in practice lists for remaining doctors, and the new system is designed to help them manage this increased workload.

Laane’s resignation as director of EHIF was formally approved during the supervisory board’s meeting, and he will remain in office until August 31 to ensure a smooth handover to the acting director. The EHIF’s supervisory board discussed healthcare funding and backed the fund’s treatment funding plans for the coming years. Overall, the plan aims to improve the efficiency and effectiveness of Estonia’s healthcare system, and Laane is confident that it will help to address the financial crisis facing the EHIF.

World Hepatitis Day: Understanding Health Insurance Coverage

On World Hepatitis Day, it’s essential to acknowledge the significance of health insurance in managing and treating hepatitis. Health insurance plans often provide coverage for various aspects of hepatitis treatment, but it’s crucial to understand what is covered and what is not.

What health insurance may cover:

  • Doctor visits and consultations
  • Laboratory tests, including blood work and liver function tests
  • Hospitalization and inpatient care
  • Medications, including antiviral medications and immunoglobulin
  • Liver biopsy and other diagnostic procedures
  • Vaccinations, such as hepatitis A and B vaccines
  • Counseling and support services

What health insurance may not cover:

  • Experimental or investigational treatments
  • Alternative therapies, such as acupuncture or herbal remedies
  • Travel expenses related to treatment
  • Out-of-network care, unless specified in the policy
  • Pre-existing conditions, depending on the policy and provider
  • Certain medications or supplements not approved by the FDA
  • Cosmetic procedures, such as liver transplantation for cosmetic reasons

India has the world’s highest burden of viral hepatitis, with an estimated 40 million people living with chronic hepatitis B and 6-12 million with hepatitis C. Despite this, awareness about insurance coverage for hepatitis remains low. On World Hepatitis Day, experts emphasize the importance of health insurance in easing the financial load of treatment. Most standard health insurance plans cover hepatitis treatment, including hospitalization, diagnostic tests, and prescribed medication. However, coverage often depends on the cause of the disease, and some insurers may exclude treatment if it’s linked to alcohol-related liver damage or other excluded causes.

Pre-existing hepatitis conditions typically have a longer waiting period, usually 2-3 years, before coverage kicks in. New illnesses, on the other hand, usually have a waiting period of 30 days after buying a policy. Non-disclosure of medical history is a common reason for claim rejection, and claims linked to alcohol or sexually transmitted hepatitis are usually not covered. To avoid claim rejection, it’s essential to declare pre-existing hepatitis honestly.

Some wellness plans or add-ons may help pay for vaccination or screening costs, but this varies widely. If you have had hepatitis, your premiums may or may not change, depending on the type and your health status. Hepatitis A is self-limiting and usually doesn’t affect premiums, but hepatitis B, C, or D can become chronic and damage the liver over time, potentially leading to longer waiting periods, higher premiums, or denial of coverage.

To navigate health insurance for hepatitis, experts recommend the following:

  1. Disclose everything: Be upfront about your medical history when buying a policy.
  2. Understand the fine print: Check what your plan covers and excludes.
  3. Ask about waiting periods: Know how long you must wait before claiming.
  4. Consider add-ons: Critical illness covers or OPD riders can help if complications arise.
  5. Use preventive benefits: Some plans offer hepatitis vaccination or screening – use them to stay ahead.

By being aware of the coverage options and exclusions, individuals can make informed decisions about their health insurance and avoid unnecessary financial burdens. It’s essential to prioritize transparency and honesty when buying a policy to ensure seamless claims processing and adequate coverage.

Thousands of DACA recipients in California are set to lose their health coverage this month, as reported by the Fresno Bee.

Thousands of Deferred Action for Childhood Arrivals (DACA) recipients in California are set to lose their health coverage this month due to a change in the state’s Medi-Cal program. As of October 1, California will no longer provide Medi-Cal coverage to DACA recipients who are 26 years or older, affecting approximately 12,000 individuals.

The change is a result of a budget agreement between Governor Gavin Newsom and state lawmakers, which aimed to provide health coverage to low-income undocumented immigrants aged 50 and older. However, this new program will not include DACA recipients who are 26 or older, leaving them without health coverage.

DACA recipients, also known as Dreamers, are young undocumented immigrants who were brought to the United States as children and have been granted temporary protection from deportation. Many of these individuals have been able to access health coverage through Medi-Cal, California’s Medicaid program, due to their DACA status.

The loss of health coverage for these individuals has raised concerns among many, including healthcare advocates and immigration groups. They argue that this change will not only harm the affected individuals but also the broader community, as the lack of health coverage can lead to delayed or foregone medical care, resulting in poorer health outcomes.

Moreover, the timing of this change is particularly concerning, as it coincides with the ongoing COVID-19 pandemic. Many of the affected individuals are essential workers, and their lack of health coverage may increase their risk of contracting and spreading the virus.

Healthcare providers and advocacy groups are urging the state to reconsider this decision and find alternative solutions to ensure that all DACA recipients have access to health coverage. They argue that providing health coverage to all Californians, regardless of immigration status, is crucial for maintaining a healthy and productive population.

In response to the change, some community organizations are offering resources and assistance to help affected individuals navigate the healthcare system and explore alternative coverage options. However, these efforts may not be sufficient to address the scale of the problem, and a more comprehensive solution is needed to ensure that all Californians have access to the healthcare they need. The loss of health coverage for thousands of DACA recipients in California is a pressing concern that requires immediate attention and action from state lawmakers and healthcare leaders.

Claims are now allowed for hospital stays of 2 hours or more.

Over the past decade, medical advancements have revolutionized the way treatments and surgeries are performed, significantly reducing the time required for procedures. According to Siddharth Singhal, head of health insurance at Policybazaar, conditions that previously required overnight monitoring or post-operative care can now be safely managed with just a few hours of hospital stay. This is thanks to minimally invasive procedures like laparoscopy, laser surgery, and advanced imaging that enable quicker diagnostics and faster recovery.

As a result, many common procedures such as cataract surgeries, chemotherapy sessions, angiographies, and emergency observations can be completed within a few hours, eliminating the need for prolonged hospital admission. The insurance industry is adapting to these new medical realities by introducing flexible provisions in health plans that cover short hospital stays. This is a significant development, as traditional coverage often fell short in covering such brief admissions.

Several leading insurers have already rolled out enhanced health plans that reflect this shift. For example, a 30-year-old male non-smoker living in a metro city can opt for ICICI Lombard’s “Elevate” plan with a ₹10 lakh sum insured for an annual premium of ₹9,195. Similarly, CARE Health Insurance’s “Care Supreme” plan is available for ₹12,790 per year, while Niva Bupa’s “Health ReAssure” plan costs ₹14,199 annually. These prices take into account not only risk assessments but also the range of benefits, hospital networks, and additional features offered by each plan.

The insurance sector is evolving to keep pace with the rapid advancements in medical care. With treatments becoming faster and more precise, insurers are responding by offering more flexible and comprehensive coverage options. This development is expected to benefit policyholders, who can now claim insurance even for short hospital stays that were previously not covered. As medical technology continues to advance, the insurance industry is likely to continue adapting, offering more innovative and responsive health plans to meet the changing needs of patients.

Universal Health Care refers to a system where all citizens have access to healthcare, often funded by the government through taxes. This concept has sparked intense debate, with proponents arguing that it is a fundamental human right, and opponents claiming that it is too costly and inefficient.

Pros:

  1. Increased Access: Universal health care ensures that everyone, regardless of income or social status, has access to medical treatment.
  2. Reduced Administrative Costs: A single-payer system can reduce administrative costs, as there is less paperwork and bureaucracy involved.
  3. Improved Health Outcomes: Studies have shown that universal health care can lead to better health outcomes, as people are more likely to seek medical attention when they need it.
  4. Reduced Financial Burden: Universal health care can reduce the financial burden on individuals and families, who may otherwise struggle to pay for medical expenses.

Cons:

  1. High Costs: Implementing and maintaining a universal health care system can be expensive, requiring significant funding from the government.
  2. Long Wait Times: Some universal health care systems have been criticized for long wait times, as there may be a shortage of healthcare providers or facilities.
  3. Limited Provider Choice: In some universal health care systems, patients may have limited choice in terms of healthcare providers or specialists.
  4. Inefficient Bureaucracy: Some argue that universal health care systems can be inefficient, with too much bureaucracy and red tape.

Debate:

The debate over universal health care is complex and contentious, with different countries and systems offering varying models. Some argue that a single-payer system, where the government pays for all healthcare costs, is the most effective way to ensure universal access. Others propose a mixed model, where private insurance companies play a role alongside government funding.

Arguments:

  1. Moral Imperative: Proponents argue that universal health care is a moral imperative, as everyone deserves access to basic healthcare regardless of income or social status.
  2. Economic Benefits: Some argue that universal health care can have economic benefits, such as reducing the financial burden on individuals and families, and improving productivity.
  3. Practical Challenges: Opponents argue that implementing universal health care is a complex and challenging task, requiring significant funding and infrastructure.

Medicare and Medicaid:

In the United States, Medicare and Medicaid are two government-funded programs that provide health insurance to specific populations. Medicare is a federal program that provides health insurance to people over 65, while Medicaid is a joint federal-state program that provides health insurance to low-income individuals and families.

Insurance:

Private health insurance companies play a significant role in many healthcare systems, offering a range of plans and coverage options. However, some critics argue that the private insurance industry can be profit-driven, leading to high costs and unequal access to healthcare.

Key Players:

  1. Government: The government plays a crucial role in funding and regulating healthcare systems, including universal health care.
  2. Private Insurance Companies: Private insurance companies offer a range of health insurance plans, often with varying levels of coverage and cost.
  3. Healthcare Providers: Healthcare providers, including doctors, nurses, and hospitals, deliver medical services to patients.
  4. Patients: Patients are the ultimate beneficiaries of healthcare systems, and their needs and perspectives should be taken into account when designing and implementing universal health care.

The United States has a complex and multifaceted healthcare system, with a mix of private and public providers, insurance companies, and government programs. Despite being one of the wealthiest countries in the world, the US has a significant number of uninsured citizens, with approximately 25.3 million non-elderly Americans lacking health insurance in 2023. The largest group of Americans, 154 million non-elderly people, are covered by employer-sponsored health insurance.

The US is the only high-income country without universal health coverage, and its healthcare system is often criticized for being inefficient and expensive. The country’s healthcare spending is the highest in the world, accounting for 18.3% of its GDP, with an average cost of $12,914 per person. Despite this, the US has poor health outcomes, including low life expectancy, high maternal and infant mortality rates, and high rates of chronic diseases.

There are several types of universal healthcare systems, including single-payer, social health insurance, and national health insurance. Single-payer systems, such as those in the UK and Spain, provide free healthcare to all citizens, funded through taxes. Social health insurance systems, such as those in Germany and France, require individuals to purchase insurance, often through their employers. National health insurance systems, such as those in Canada and Taiwan, use public insurance to pay for private-practice care.

The debate over universal healthcare in the US has been ongoing for decades, with various presidents and politicians proposing different plans. In 2010, the Affordable Care Act (ACA), also known as Obamacare, was passed, which expanded health insurance coverage to millions of Americans. However, the ACA did not establish universal healthcare, and many Americans remain uninsured or underinsured.

There are several arguments in favor of universal healthcare, including that it would lower costs, prevent medical bankruptcy, and improve health outcomes. A single-payer system, for example, could save the US $450 billion annually in healthcare expenditures. Universal healthcare could also improve health outcomes, with studies suggesting that it could prevent thousands of deaths and improve life expectancy.

However, there are also arguments against universal healthcare, including that it would be too expensive, inefficient, and restrictive. Some argue that a single-payer system would lead to long wait times, rationing of healthcare services, and a decrease in the quality of care.

Public opinion on universal healthcare is divided, with 57% of Americans supporting government-ensured healthcare, while 43% oppose it. The partisan divide is stark, with 88% of Democrats and 59% of Independents supporting government-ensured healthcare, while only 28% of Republicans agree.

In conclusion, the US healthcare system is complex and multifaceted, with significant challenges and opportunities for improvement. The debate over universal healthcare is ongoing, with various arguments for and against it. Ultimately, the decision to implement universal healthcare will depend on the values and priorities of the American people and their elected representatives.

The High Court has directed an insurance company to pay an additional ₹40.35 lakh to a paralyzed accident victim, in addition to the previously awarded ₹1.11 crore.

The Bombay High Court has increased the compensation for a 33-year-old road accident victim, Atul Dattaray Wadhane, who was left in a vegetative state after a school bus collided with his motorcycle in 2016. The court ordered the United India Insurance Company Ltd to pay an additional ₹40.35 lakh in damages to cover the victim’s lifelong need for medical care, physiotherapy, and a personal attendant. Wadhane was 25 years old when the accident occurred and was traveling to Borivali on his motorcycle. The bus driver, Sabastian Panthikulangara, took a sharp turn without using his indicator, causing the bus to dash against Wadhane’s vehicle, resulting in a cervical spine fracture and spinal cord rupture.

The Motor Accident! Claims Tribunal (MACT) initially awarded Wadhane a compensation of ₹1,11,64,740, which was challenged by both the insurance company and Wadhane in the Bombay High Court. The insurance company sought a reduction in compensation, while Wadhane sought an enhancement of the award. During the hearing, doctors from the Balaji Hospital in Bhayander testified that Wadhane was suffering from 70% permanent partial disability and required continuous physiotherapy, neurorehabilitation, and medication.

The high court observed that Wadhane’s condition was tragic, and his pain and suffering could not be quantified merely in monetary terms. The court noted that Wadhane was in a vegetative state, entirely immobile, and dependent on others for every basic function. Considering the increasing cost of living due to inflation, the court decided that denying interest on the awarded amount for future medical expenses would be unjust.

The single-judge bench of justice Shivkumar Dige calculated the appropriate compensation for Wadhane and decided that he was entitled to an enhanced compensation of ₹1,52,00,100, which is an additional ₹40,35,360 to the original compensation. The court concluded that Wadhane was entitled to this amount, considering his lifelong need for medical care and support. The ruling highlights the importance of providing adequate compensation to victims of road accidents, particularly those who suffer catastrophic injuries that require lifelong care and support.

Niva Bupa has introduced ‘Rise’, a health insurance product targeting India’s missing middle, a demographic that lacks adequate health coverage.

Niva Bupa Health Insurance Company Limited, a leading standalone health insurer in India, has launched a new health insurance plan called “Rise” designed specifically for the “Missing Middle” population. The Missing Middle refers to approximately 40 crore Indians who earn too much to qualify for government-sponsored health schemes but too little to afford premium private health insurance.

Rise aims to bridge the gap of inadequate coverage for this segment by offering unique, customized benefits that cater to their needs. The plan is based on comprehensive consumer research, which revealed that people in this cohort have seasonal income and are looking for tangible benefits to manage their health due to the lack of good primary private healthcare.

Key features of Rise include:

  1. Flexi-Pay Benefit: Allows customers to pay a token amount of 20% of the total premium and pay the rest anytime during the policy tenure.
  2. Smart Cash Benefit: Offers a guaranteed cash payout of INR 5,000 if the customer decides not to visit a private hospital and opts for treatment in a government hospital.
  3. Return Benefit: Returns 50% of the total premium paid by the customer as an additional sum insured, which accumulates over a lifetime with a 10% bonus added each year.

Additionally, Rise offers unlimited digital consultations in 16 vernacular languages, allowing customers to consult with general practitioners anytime, anywhere. The plan also comes with optional benefits that enable customers to modify their room type category, remove capping on modern treatments, and increase the limit up to the base sum insured.

Rise is available in Individual, Multi-member, and Family floater variants, with zone-wise pricing starting from as low as INR 6,416 to INR 8,669 for a 35-year-old individual for a 10 lakh sum insured. The plan covers a comprehensive range of healthcare expenses, including hospitalization, domiciliary, and home care treatment, as well as pre and post-hospitalization expenses.

According to Dr. Bhabatosh Mishra, Director – Underwriting, Products & Claims, Niva Bupa Health Insurance, “Rise is not only a step forward in bridging the insurance gap for India’s Missing Middle but also aligns with IRDAI’s vision of Insurance for All by 2047.” The plan aims to make health insurance more flexible, rewarding, and accessible, ensuring that every Indian has the confidence to seek the best healthcare without financial strain.

California ‘Dreamers’ are losing their ACA health care coverage

About 2,300 undocumented immigrants in California, also known as “Dreamers,” who were brought to the US as children, are set to lose their health insurance coverage at the end of the month. This decision was made by the federal Centers for Medicare and Medicaid Services, which oversees insurance marketplaces. Last year, the Biden administration allowed Dreamers to buy insurance through state and federally run marketplaces, but the Trump administration reversed this decision in June.

Covered California, the state’s health insurance marketplace, is working to notify all affected individuals that their coverage will end on August 31 and is helping them explore other insurance options. The Affordable Care Act has always barred immigrants living in the country illegally from purchasing health coverage on the marketplace, but Dreamers were an exception.

The decision to terminate coverage for Dreamers is “deeply unfair” according to Jessica Altman, the executive director at Covered California. Without access to the insurance marketplace, Dreamers will have to find coverage through an employer or, if their incomes are low enough, they may qualify for the state’s health insurance program for low-income people, Medi-Cal. This leaves freelancers and self-employed Dreamers in a difficult position if they earn too much to qualify for Medi-Cal but not enough to pay full price for a health plan.

Experts argue that eliminating coverage for young people, such as Dreamers, will actually increase premiums for everyone else. This is because younger and healthier people help balance the cost of covering sicker and older individuals. The federal government’s decision to cut coverage for Dreamers is expected to have a ripple effect on the insurance marketplace, potentially leading to higher premiums for all enrollees.

The Biden administration’s initial decision to insure Dreamers was met with resistance from red states, and a federal judge in North Dakota sided with the plaintiffs, stopping the rule from going into effect in 19 states. The new rule from the Centers for Medicare and Medicaid Services applies to all states, and DACA recipients are the first group of a larger number of immigrants who are expected to lose or drop marketplace coverage soon. The federal budget also eliminates marketplace financial assistance for some lawfully present immigrant groups, including refugees and asylees, starting in 2027. This could lead to many of these enrollees dropping their coverage due to unaffordability, and potentially increasing premiums for all Covered California enrollees by $101 a month starting next year.

Family planning groups have urged the Federal Government to add fertility care to the list of services covered by the National Health Insurance Scheme.

Dr. Ibrahim Wada, a renowned gynecologist and CEO of Nisa Premier Medical Group, has urged the federal government to include fertility treatment in the National Health Insurance Scheme (NHIS). According to Wada, infertility is a significant challenge facing many Nigerian families, with one in six couples struggling to conceive. The high cost of fertility treatment, which can be prohibitively expensive for the average Nigerian, exacerbates the problem. Wada emphasized that fertility solutions are often beyond the reach of most people, and it is essential to make them more accessible.

Wada also stressed that infertility is not solely a women’s issue, as men are equally affected. He cited his 30 years of experience, which shows that infertility affects both men and women equally. He encouraged couples, especially those marrying after the age of 35, to undergo early fertility checks to address any potential issues promptly. Wada also condemned illegal adoption practices and child trafficking, calling for stronger laws to protect families dealing with infertility.

To raise awareness about infertility, Nisa Premier Hospital organized an Infertility Awareness Walk, which took place in Abuja. The event aimed to educate the public about the importance of addressing infertility and the available treatment options. Dr. Esther Emeka-Irem, a consultant obstetrician and gynecologist, noted that late marriages, poor health-seeking behavior, and untreated infections are significant causes of infertility in Nigeria. She emphasized that assisted reproductive treatments like In Vitro Fertilization (IVF) can be an effective solution for many couples.

Emeka-Irem highlighted that IVF in Nigeria is relatively affordable, costing between ₦3 million and ₦4 million, compared to over $10,000 in Western countries. She also mentioned that Nisa Premier Hospital has recorded over 5,000 live births since its first IVF baby in 1996. The hospital’s Infertility Awareness Week, which runs until August 2, 2025, aims to provide free medical consultations and raise awareness about the importance of addressing infertility. By including fertility treatment in the NHIS, the government can help make these life-changing treatments more accessible to those who need them.

Losing health insurance can pose a significant risk to one’s health due to several factors. Firstly, individuals without insurance often delay or forgo medical care, including preventive services, diagnoses, and treatments. This can lead to the progression of untreated conditions, making them more severe and potentially life-threatening.Uninsured individuals are less likely to receive timely medical interventions, such as screenings, vaccinations, and medications, which can exacerbate health issues. Chronic conditions like diabetes, hypertension, and asthma may worsen due to lack of management and monitoring.The financial burden of medical expenses can also have a detrimental impact on mental health, leading to stress, anxiety, and depression. Furthermore, the inability to afford healthcare can force individuals to make difficult choices between paying for medical care and other essential expenses, such as housing, food, and utilities.Studies have shown that uninsured individuals have higher mortality rates compared to those with insurance, highlighting the critical importance of health coverage. The lack of insurance can also lead to poor health outcomes, reduced quality of life, and decreased life expectancy.In addition, the loss of health insurance can disrupt continuity of care, making it challenging for individuals to maintain relationships with healthcare providers and adhere to treatment plans. This disruption can result in fragmented care, mismanaged conditions, and inadequate support for patients with complex needs.The consequences of losing health insurance can be far-reaching, affecting not only the individual but also their family and community. It is essential to recognize the significance of health insurance in maintaining overall well-being and to explore options for affordable coverage to mitigate the risks associated with losing health insurance.

Losing health insurance can have severe consequences on an individual’s health and wellbeing. According to a WebMD article, the lack of health insurance can lead to delayed or foregone medical care, resulting in poor health outcomes. Without insurance, people may avoid visiting the doctor or filling prescriptions, which can exacerbate existing conditions and lead to the development of new ones.

Studies have shown that uninsured individuals are more likely to experience poor health outcomes, including higher rates of mortality, compared to those with insurance. This is particularly true for individuals with chronic conditions, such as diabetes, heart disease, and cancer, who require ongoing medical care and treatment. Without insurance, these individuals may be forced to go without necessary medications, tests, and procedures, which can lead to serious health complications.

The consequences of losing health insurance can be far-reaching, affecting not only the individual but also their family and community. For example, a study found that uninsured individuals are more likely to experience financial hardship, including bankruptcy, due to medical expenses. This can lead to a vicious cycle of debt and poverty, making it even more difficult for individuals to access the medical care they need.

Furthermore, the lack of health insurance can also have a significant impact on mental health. The stress and anxiety of living without insurance can lead to depression, anxiety, and other mental health issues. Additionally, the inability to access necessary medical care can lead to feelings of hopelessness and despair, further exacerbating mental health problems.

The article highlights the importance of maintaining health insurance coverage, particularly for vulnerable populations, such as low-income individuals and those with pre-existing conditions. It emphasizes the need for policymakers to prioritize access to affordable healthcare, including expanding Medicaid and other safety-net programs, to ensure that everyone has access to necessary medical care.

In conclusion, losing health insurance is a health risk in itself, leading to delayed or foregone medical care, poor health outcomes, and financial hardship. It is essential to prioritize access to affordable healthcare and maintain health insurance coverage to protect against these risks. By doing so, we can promote better health outcomes, reduce healthcare disparities, and improve the overall wellbeing of individuals and communities.

Michigan health care costs could be on the rise

The cost of healthcare in Michigan is expected to increase significantly in the coming year. According to a report by the health policy research group KFF, insurers offering plans through the Affordable Care Act (ACA) will raise premiums by 15% next year, with some proposing hikes as high as 20%. Additionally, Medicaid is facing $1.2 trillion in national cuts, which will include work mandates and higher fees. These changes will likely have a significant impact on individuals and families who rely on these programs for healthcare coverage.

The proposed changes to the ACA and Medicaid are part of a larger effort by the Trump administration to reform the healthcare system. However, critics argue that these changes will create barriers to accessing healthcare, particularly for low-income individuals and families. Michigan Attorney General Dana Nessel has joined a multi-state coalition lawsuit challenging a Trump administration rule that would restrict access to healthcare coverage under the ACA.

To understand the implications of these changes, Thomas Buchmueller, a health economist at the University of Michigan, was interviewed on The Metro, a local radio show. Buchmueller explained that the premium hikes and Medicaid cuts will disproportionately affect low-income individuals and families who rely on these programs for healthcare coverage. He also noted that the changes will have a ripple effect, impacting not only those who are directly affected but also the broader healthcare system.

Buchmueller suggested that Michigan can take steps to mitigate the impact of these changes. For example, the state could explore alternative healthcare models, such as expanding Medicaid or creating a state-based healthcare exchange. Additionally, policymakers could work to reduce healthcare costs by addressing underlying issues, such as the high cost of prescription drugs and medical devices.

Overall, the changes to the ACA and Medicaid will have significant implications for healthcare costs in Michigan. While the exact impact is still uncertain, it is clear that individuals and families will face higher costs and reduced access to healthcare coverage. As policymakers and healthcare experts work to address these challenges, it will be important to prioritize the needs of low-income individuals and families who are most vulnerable to these changes.

Thousands of DC residents may be at risk of losing their health coverage without even realizing it, due to a combination of factors related to the city’s healthcare system and the expiration of pandemic-related protections.

An estimated 95,000 people in Washington D.C. are at risk of losing their health coverage in the next decade due to federal cuts to Medicaid. The District’s Department of Health Care Finance warns that many of these individuals may not be aware that they are at risk because they are enrolled in state-branded health programs that are funded by Medicaid. These programs, such as AmeriHealth Caritas in D.C., are often operated by private companies and may not be recognized as Medicaid plans by their recipients.

The federal cuts to Medicaid are part of a larger tax law signed by President Trump, which will result in over $1 trillion in cuts to federal health care programs over the next decade. Adults will be required to verify twice a year that they are working 80 hours a month, are in school, or are doing community service in order to maintain their coverage. However, many Medicaid recipients may not be aware of these new requirements because they do not realize that their health insurance is part of Medicaid.

This lack of awareness is due in part to the fact that many states have adopted unique branded names for their Medicaid programs, such as HUSKY Health in Connecticut and BadgerCare Plus in Wisconsin. While these names may help to reduce stigma and make the programs feel more like regular health insurance, they can also obscure the connection to federal policy and lead to confusion among recipients.

According to researchers, many people who are enrolled in Medicaid do not realize that they have Medicaid coverage. In fact, there is a significant disparity between the actual number of people enrolled in Medicaid and the number of people who report that they have Medicaid coverage. This “Medicaid Undercount” is estimated to be around 15.8 million people, who are not aware that they are enrolled in the program.

The use of managed care organizations, which have contracts with state governments to oversee care, can also contribute to confusion among Medicaid recipients. Many of these organizations are operated by private companies, and patients may interact more with these companies than with their state’s relevant agency. As a result, patients may not realize that their insurance is paid for with federal funds, and may not be aware of the changes to Medicaid that are upcoming.

The Republican-led revisions to Medicaid will require adults to verify their work status twice a year, which critics predict will target Americans who are eligible but will struggle with the paperwork needed to prove it. Researchers have found that similar work requirements imposed in Arkansas resulted in thousands losing their coverage, and have not had a significant effect on employment. Instead, the majority of those who lost coverage became uninsured, rather than moving on to other insurance.

Americans are voicing their concerns about health insurance barriers and the necessity for policy reform, as revealed by the most recent Patient Experience Survey conducted by PhRMA.

A recent Patient Experience Survey conducted by the Pharmaceutical Research and Manufacturers of America (PhRMA) has shed light on the struggles Americans face when it comes to accessing healthcare due to barriers in health insurance. The survey, which gathered insights from patients, caregivers, and healthcare providers, highlights the need for policy changes to improve access to affordable healthcare.

The survey results reveal that many Americans are facing significant challenges in accessing the healthcare they need due to issues with their health insurance. Nearly 70% of patients reported having to make difficult decisions about their healthcare due to cost concerns, such as delaying or forgoing treatment, skipping doses, or cutting back on other expenses to afford their medication. Furthermore, 60% of patients reported having to deal with insurance denials, prior authorizations, or other administrative hurdles that hindered their access to necessary care.

Caregivers and healthcare providers also weighed in on the challenges patients face. A significant majority (80%) of caregivers reported having to help their loved ones navigate the complex healthcare system, including dealing with insurance issues. Similarly, 85% of healthcare providers stated that they have to spend a substantial amount of time dealing with insurance-related administrative tasks, taking away from the time they can spend on patient care.

The survey also highlighted the need for policy changes to address these issues. A vast majority (90%) of patients, caregivers, and healthcare providers agreed that policymakers should prioritize making healthcare more affordable and accessible. Specifically, respondents called for reforms aimed at reducing out-of-pocket costs, simplifying insurance administrative processes, and increasing transparency around insurance coverage and costs.

The PhRMA survey’s findings underscore the need for a multi-faceted approach to addressing the healthcare barriers faced by Americans. By listening to the experiences and perspectives of patients, caregivers, and healthcare providers, policymakers can work towards creating a more patient-centered and equitable healthcare system. This could involve implementing policy changes such as capping out-of-pocket costs, streamlining prior authorization processes, and promoting transparency in insurance coverage and costs.

Overall, the Patient Experience Survey provides a compelling call to action for policymakers to prioritize healthcare accessibility and affordability. By working together to address the barriers and challenges identified in the survey, Americans can have greater confidence in their ability to access the healthcare they need, without breaking the bank or navigating a complex and frustrating system.

States are preparing for a potential reversal of the coverage gains made under the Affordable Care Act, also known as Obamacare, as a result of President Trump’s budget bill.

The Affordable Care Act (ACA) is facing significant changes under a new tax and spending bill pushed by President Donald Trump. The bill, which is expected to be signed into law, includes provisions that could undermine the gains in health insurance coverage made under the ACA. The changes would affect consumers, particularly in the 19 states that run their own ACA exchanges, and could lead to a significant loss of coverage for millions of people.

One of the key changes is the end of automatic reenrollment, which would require consumers to update their information every year before the close of open enrollment. This change is intended to combat enrollment fraud, but critics argue that it would create unnecessary barriers for consumers and lead to a significant drop in enrollment. In fact, estimates suggest that up to half of enrollees in some states could lose or drop coverage as a result of this change, combined with the expiration of enhanced premium subsidies and a new rule from the Trump administration.

The state-run marketplaces, which have tighter control over broker access and additional security measures, have seen few problems with enrollment fraud. They credit their security measures for the relative lack of problems, and argue that the changes would disproportionately affect their policyholders. For example, in Pennsylvania, 65% of policyholders were automatically reenrolled this year, and the state’s ACA marketplace, Pennie, estimates that a minimum of 30% of enrollees could lose coverage, and up to 50% in the worst-case scenario.

The changes would also lead to higher premiums, as older or sicker policyholders are more likely to try to jump through the additional hoops, while those who rarely use coverage would be less likely to enroll. This would lead to a sicker risk pool, which would drive up premiums and make it more difficult for insurers to operate in the market. In fact, federal data shows that about 22% of federal sign-ups in 2024 were automatic reenrollments, versus 58% in state-based plans.

Critics of the bill argue that the changes are unnecessary and would have a devastating impact on the uninsured rate, which has dropped by about half since the ACA was implemented. They point out that the changes would disproportionately affect low-income people and those who are most vulnerable to losing coverage. The administration and its supporters, on the other hand, argue that the changes are needed to combat enrollment fraud and make the ACA more sustainable.

According to a white paper written for Capital Policy Analytics, the changes could push four to six million eligible people out of Marketplace plans, trading limited fraud savings for a surge in uninsurance. The paper concludes that the changes would have little upside and would likely lead to further premium increases and selective market exits by insurers. Overall, the changes to the ACA under the new tax and spending bill could have a significant impact on the health insurance market and could undermine the progress made in reducing the uninsured rate.

Seventy-four percent of Indian financial companies have adopted Generative Artificial Intelligence, according to a report by EY.

In 2024, India’s financial services sector saw significant adoption of Generative AI (GenAI) beyond innovation projects to business-driven implementation. According to an EY India survey, 74% of financial firms have initiated GenAI proof-of-concept projects, with 11% already running in production. Non-Banking Financial Companies (NBFCs) and insurers are at the forefront of this adoption, leveraging GenAI to reduce operational costs by up to 90% in areas such as customer engagement, underwriting, and marketing automation.

The adoption of GenAI has resulted in significant productivity gains, with estimates suggesting a 34-38% boost across banking and insurance functions by 2030. Companies such as Bajaj Finance and Tata AIA Life have achieved notable successes with GenAI. Bajaj Finance saved Rs 150 crore in a year by deploying AI-driven bots for customer care, sales, and onboarding, while Tata AIA Life’s AI-powered chatbot handled 7.5 million customer interactions with a 98% completion rate.

Mid-sized banks have also implemented GenAI with strategic intent, integrating AI-driven orchestration layers with core banking systems. Larger banks, although initially cautious due to compliance concerns, have recently launched ambitious GenAI projects. These include AI copilots for cybersecurity and corporate lending, as well as on-premise GPU cloud deployments to support AI-driven customer care platforms.

NBFCs are pushing innovation further with conversational business intelligence bots, enabling executives to query real-time data beyond traditional dashboards. AI is also transforming customer service through automated voice bots and email management, with companies such as Tata Capital achieving significant reductions in resolution times and cost savings.

However, scaling GenAI in financial services comes with challenges, including strict regulatory requirements, data localization mandates, and cybersecurity concerns. To address these challenges, firms are deploying AI within Virtual Private Cloud environments and adopting PII redaction tools to ensure compliance. Despite these challenges, the adoption of GenAI is expected to continue to grow, driven by its potential to enhance productivity, reduce costs, and improve customer engagement. As the financial services sector continues to evolve, the use of GenAI is likely to play an increasingly important role in shaping its future.

Healthcare regulator, common empanelment for hospitals must for pricing transparency: Bajaj Allianz CEO

The CEO of Bajaj Allianz, Tapan Singhel, has emphasized the importance of having a healthcare regulator and common empanelment for hospitals to ensure pricing transparency in the healthcare sector. He believes that the lack of transparency in medical billing is a significant issue in India, making it difficult for patients to understand the costs of their treatment.

Singhel stated that a healthcare regulator would help to standardize treatment protocols and pricing, ensuring that patients receive quality care at a fair price. He also noted that a common empanelment system for hospitals would enable patients to access a network of hospitals with standardized pricing, making it easier for them to compare costs and make informed decisions.

Currently, patients often face surprise bills and varying costs for the same treatment at different hospitals. This lack of transparency can lead to financial hardship and stress for patients and their families. A common empanelment system would help to eliminate these issues by providing a standardized framework for hospitals to follow.

Furthermore, Singhel highlighted the need for hospitals to disclose their package prices and provide patients with detailed bills, breaking down the costs of treatments, medications, and other services. This would enable patients to make informed decisions about their care and avoid unexpected expenses.

The introduction of a healthcare regulator and common empanelment system would also promote competition among hospitals, driving down costs and improving the overall quality of care. With standardized pricing and transparent billing, patients would be able to choose the best hospital for their needs, based on factors such as quality of care, expertise, and cost.

In addition, Singhel suggested that the government could play a crucial role in promoting pricing transparency in the healthcare sector. He recommended that the government establish a pricing authority to regulate hospital charges and ensure that patients are not overcharged.

Overall, the implementation of a healthcare regulator and common empanelment system for hospitals would be a significant step towards achieving pricing transparency in the healthcare sector. By promoting standardization, competition, and transparency, these measures would help to protect patients from financial hardship and ensure that they receive quality care at a fair price. As Singhel noted, “Pricing transparency is a must in the healthcare sector, and it’s high time we take steps to achieve it.”

How Trump’s Tax Bill Impacts Medicaid, ACA Plans, and Hospitals: Key Takeaways

  1. Medicaid Funding: The tax bill doesn’t directly cut Medicaid funding. However, it repeals the Affordable Care Act’s (ACA) individual mandate, which could lead to fewer people being insured, indirectly affecting Medicaid enrollment and funding.

  2. ACA Plans: Repealing the individual mandate may cause healthier individuals to forgo insurance, leading to a sicker, more expensive pool of insureds. This could increase premiums for ACA plans, making them less affordable for many Americans.

  3. Hospitals: The loss of insured patients due to the repeal of the individual mandate could increase the number of uninsured patients seeking care, leading to higher uncompensated care costs for hospitals. This could especially impact hospitals in states that did not expand Medicaid under the ACA.

  4. Rural Hospitals: Rural hospitals, which often operate on thin margins, could be disproportionately affected by increased uncompensated care costs, potentially leading to more hospital closures.

  5. Healthcare Workforce: The changes could also impact the healthcare workforce, as reduced Medicaid and ACA funding could lead to fewer jobs in the healthcare sector, particularly in rural and underserved areas.

  6. State Responses: Some states may respond to these changes by seeking waivers to implement their own healthcare reforms, potentially leading to a more fragmented healthcare system across the country.

  7. Long-term Care: The bill’s impact on long-term care is less direct but could be significant. Changes in Medicaid funding and the healthcare landscape could affect the ability of individuals to afford long-term care services.

  8. Children’s Health Insurance Program (CHIP): While the tax bill does not directly address CHIP, the broader healthcare policy environment could influence CHIP funding and enrollment, affecting children’s access to healthcare.

  9. Market Stability: The repeal of the individual mandate without a replacement could destabilize the health insurance market, leading to higher premiums and fewer plan options for consumers.

  10. Future Legislative Actions: The impact of the tax bill on healthcare may be a precursor to further legislative actions on healthcare reform, potentially including changes to Medicaid, the ACA, and other healthcare programs.

The recently passed tax and spending legislation in the US Congress is expected to have significant impacts on the country’s healthcare system. The bill, which is awaiting President Donald Trump’s signature, will cut federal health spending by about $1 trillion over a decade, leading to increased healthcare costs for millions of Americans. The Congressional Budget Office estimates that nearly 12 million more people will be without insurance by 2034, which will undermine the finances of hospitals, nursing homes, and community health centers.

The bill’s provisions will affect healthcare access in several ways:

  1. Medicaid work requirement: The bill introduces a Medicaid work requirement, which will require some Medicaid enrollees to work, volunteer, or attend school for at least 80 hours a month to maintain their coverage. This requirement is expected to end coverage for millions of enrollees who do not meet the new standards.
  2. Cuts to rural healthcare: The bill targets states’ use of provider taxes, which will lead to fewer health services, medical professionals, and hospitals in rural communities. Rural hospitals, which often operate on thin profit margins, may be forced to reduce services or close altogether.
  3. ACA coverage changes: The bill makes it harder for people to enroll and retain their Affordable Care Act (ACA) coverage. ACA marketplace policyholders will have to update their income, immigration status, and other information each year, and the annual open enrollment period will be shortened.
  4. Increased out-of-pocket costs: Medicaid enrollees will be required to pay more out-of-pocket for appointments, with costs up to $35 for some services. This may prompt low-income people to forgo needed care.
  5. Loss of subsidized ACA plans for immigrants: The bill will cause hundreds of thousands of lawfully present immigrants, including asylum-seekers, victims of trafficking, and refugees, to lose their ACA marketplace coverage by cutting off subsidies that make premiums affordable.

The bill’s provisions have been criticized for undermining the healthcare gains made during the Biden and Obama administrations, which made it easier for millions of people to access healthcare and reduced the US uninsured rate to record lows. Republicans argue that the trade-off for these gains was higher costs borne by taxpayers and increased fraud. However, health researchers and advocates argue that the bill’s provisions will have little impact on employment and will instead harm vulnerable populations, including low-income individuals, rural communities, and immigrants.

Women Prefer Term Insurance As Top Solution To Secure Their Child’s Future: Survey – Goodreturns

A recent survey conducted by Goodreturns has revealed that women in India prefer term insurance as the top solution to secure their child’s future. The survey aimed to understand the financial priorities and preferences of women when it comes to planning for their children’s future. The results show that term insurance has emerged as the most popular choice among women, followed by savings plans and mutual funds.

The survey found that 71% of women respondents considered term insurance as the best way to secure their child’s future, citing its affordability and comprehensive coverage. Term insurance provides a death benefit to the nominee in the event of the policyholder’s death, ensuring that the child’s education and other expenses are taken care of. Women respondents also appreciated the flexibility of term insurance plans, which allow them to customize the coverage and premium payments according to their needs.

The survey also revealed that women are becoming increasingly financially independent and are taking charge of planning for their children’s future. 62% of women respondents said that they are the sole decision-makers when it comes to financial planning for their children, while 31% said that they make joint decisions with their spouses.

When it comes to the reasons for choosing term insurance, 83% of women respondents said that they want to ensure that their child’s education expenses are covered, while 67% said that they want to secure their child’s marriage expenses. 56% of respondents also said that they want to leave a legacy for their child.

The survey also found that women are increasingly aware of the importance of insurance and are seeking advice from financial experts to make informed decisions. 71% of women respondents said that they consult a financial advisor or insurance expert before making a decision, while 45% said that they research online to understand the various insurance options available.

Overall, the survey highlights the growing awareness among women about the importance of financial planning and the role of term insurance in securing their child’s future. With more women taking charge of financial decision-making, the demand for term insurance is likely to increase, driven by their desire to provide a secure and stable future for their children. As the survey suggests, term insurance has emerged as a top solution for women to achieve their financial goals and secure their child’s future.

Health cover beyond hospital care

The Indian healthcare landscape is undergoing a transformation, driven by medical advancements, growing awareness, and a shift towards preventive care. While corporate health insurance provides a critical safety net for millions of employees, its limitations are becoming increasingly evident. With healthcare costs expected to rise by 13% in 2025, individuals need to re-evaluate their health insurance coverage.

The traditional corporate health insurance model, which focuses on hospitalization and discharge, is no longer sufficient. Modern health challenges, such as non-communicable diseases and mental wellness, require continuous care and support beyond hospital settings. Comprehensive personal health insurance, on the other hand, offers a wide range of benefits, including annual health check-ups, OPD visits, health coaching, and alternative therapies. These plans provide significantly more value, covering both treatment and preventive care, and can be more cost-effective in the long run.

One of the key advantages of personal health insurance is its customizability. Policies can be tailored to meet individual needs based on age, lifestyle preferences, and family dynamics. For instance, a young couple planning a family may want maternity benefits, while an older individual managing a chronic condition may require disease-specific coaching. Insurers are also incentivizing preventive lifestyles by offering rewards, such as lower premiums, for healthy habits.

Technology is driving this shift towards personalized health insurance, making it easier for customers to access services like tele-consultations, digital claims, and AI-led underwriting. The Indian government’s initiatives, such as the Ayushman Bharat Digital Mission, are also promoting digitized health records, making healthcare more efficient, integrated, and intelligent.

While corporate health insurance remains an important employee benefit, it is essential to supplement it with personal top-ups or comprehensive individual plans to ensure broader protection. Financial planners recommend a diversified portfolio, including equity, life cover, and health insurance. Within health insurance, it is essential to have a mix of corporate and personal coverage to address evolving needs.

The future of health insurance is proactive and personalized, with insurers embedding wellness into policy design. The demands of a younger, more digitally-savvy population will shape the next generation of offerings, blending protection with purpose. As the Indian healthcare landscape continues to evolve, individuals must prioritize comprehensive and customizable health insurance to build resilience and ensure financial security. By doing so, they can navigate the complexities of modern healthcare and access the care they need to maintain their well-being.

Bajaj Allianz introduces region-specific health insurance plans to cater to distinct state-wise requirements.

Bajaj Allianz General Insurance has launched a new health insurance policy that is customized to meet the unique healthcare needs of each state in India. The policy, called “State-wise Health Insurance Policy,” takes into account the local hospital infrastructure, prevalent health concerns, and affordability levels of each state to provide comprehensive coverage that is both affordable and accessible. The policy is available in both individual and floater variants, with flexible sum insured options ranging from INR 5 lakh to INR 20 lakh.

The policy offers extensive coverage, including inpatient hospitalization, pre- and post-hospitalization expenses, and day care procedures. It also covers advanced treatments such as robotic surgeries and stem cell therapy, as well as organ donor expenses. The policy has a lifetime renewal option, ensuring continuous coverage without age restrictions.

To enhance protection, the policy offers optional add-ons, including the Unlimited Sum Insured Reinstatement feature, which allows policyholders to restore their sum insured an unlimited number of times within a policy period after making a claim. The Super Cumulative Bonus rewards customers with up to 200% sum insured for claim-free years, enhancing coverage year after year.

The policy is available in 25 states and 5 Union Territories, each with a unique name inspired by the local language and cultural context of the state it represents. Bajaj Allianz offers special discounts for family coverage, loyalty benefits, and direct online purchases. The policy also promotes a healthier lifestyle by offering a wellness discount at renewal, with customers eligible for a 5% or 10% discount based on their daily step count.

The policy can be purchased through Bajaj Allianz General Insurance’s extensive network of branches, partner banks, agents, and digital platforms. The company aims to make healthcare security accessible, relevant, and truly personal for every Indian, with a focus on affordability, state-specific pricing, and comprehensive protection.

Bajaj Allianz General Insurance is India’s premier private general insurance company, with a wide range of general insurance products, including motor insurance, home insurance, and health insurance. The company has consistently expanded its reach to be in close proximity to its customers, with a presence in nearly 1,500 towns and cities across India. With the launch of this initiative, Bajaj Allianz is setting a new benchmark in health insurance, making coverage more personal, relevant, and beneficial for every region.

ED withdraws summons issued to Arvind Datar in Care Health ESOP investigation

According to a recent news report, advocate Datar, who has a history of representing the Securities and Exchange Board of India (SEBI) in high-profile cases, such as the Sahara fundraising matter, has made a statement to Enforcement Directorate (ED) officials. During an interaction, Datar is said to have informed the ED officials that lawyers cannot be summoned for investigations that involve their clients. This assertion is based on the principle of professional privilege, which is a fundamental concept in the legal profession.

Datar is understood to have emphasized that lawyers are prohibited from disclosing any legal advice they have given to their clients. This means that even if a lawyer is summoned by investigative agencies, they are not obligated to reveal any confidential information related to their client’s case. The idea behind this principle is to ensure that clients can trust their lawyers with sensitive information, without fear of it being disclosed to others.

By citing professional privilege, Datar is essentially arguing that lawyers have a duty to maintain confidentiality and cannot be compelled to breach this duty, even by investigative agencies. This privilege is not unique to India and is a widely accepted principle in many jurisdictions around the world. It is designed to promote trust and candor between lawyers and their clients, which is essential for the effective administration of justice.

The implications of Datar’s statement are significant, particularly in cases where lawyers are summoned by investigative agencies. If lawyers are indeed prohibited from disclosing client information, it could limit the ability of agencies like the ED to gather evidence and investigate cases. On the other hand, it also underscores the importance of upholding the principles of professional privilege and confidentiality, which are essential to the functioning of the legal system.

In conclusion, Datar’s statement to ED officials highlights the complex and often nuanced relationship between lawyers, clients, and investigative agencies. As the legal profession continues to evolve, it is likely that issues related to professional privilege and confidentiality will remain at the forefront of discussions around the administration of justice. Ultimately, striking a balance between the need for effective investigations and the need to uphold the principles of professional privilege will be crucial in ensuring that the legal system functions fairly and effectively.

CEO Siddhartha Mohanty of LIC says stake acquisition in health insurance company to be decided by March 31.

The Life Insurance Corporation of India (LIC), the country’s largest insurer, is planning to expand its presence in the insurance market by acquiring a stake in a health insurance company. According to CEO Siddhartha Mohanty, a decision on the potential acquisition is expected to be made by the end of March, before the close of the current financial year. However, Mohanty clarified that LIC is not looking to acquire a majority stake, with a holding of 51% or more.

The move into health insurance would mark a significant expansion for LIC, which currently sells life insurance policies, pension plans, and investment-linked insurance products, but not health insurance. By entering the health insurance market, LIC would be competing with established players such as Star Health Insurance, Aditya Birla Health Insurance, Niva Bupa Health Insurance, and Care Health Insurance.

The insurance market in India has become increasingly competitive in recent years, with private insurers ramping up their presence in the health insurance segment to tap into growing consumer demand. LIC’s potential acquisition of a stake in a health insurance company would be a strategic move to diversify its product offerings and tap into the growing demand for health insurance products.

Separately, LIC is also in discussions with the Reserve Bank of India (RBI) on the issuance of longer-term bonds, with maturities of 50 years or 100 years. Currently, India issues bonds with maturities of up to 40 years, but LIC is seeking longer-term instruments to manage its investment portfolio. According to Mohanty, discussions with the RBI are ongoing, and the central bank is considering the proposal. If successful, the issuance of longer-term bonds would provide LIC with more flexibility in managing its investment portfolio and matching its long-term liabilities.

Senate Republicans propose deeper Medicaid cuts, a move that could have significant implications for millions of low-income Americans who rely on the program for healthcare. The proposed cuts would reduce federal funding for Medicaid, potentially leading to reduced benefits, increased costs, and decreased access to healthcare services for vulnerable populations, including children, pregnant women, and people with disabilities.

Senate Republicans have proposed a new healthcare bill that includes deeper Medicaid cuts than previously suggested. The bill, which aims to replace the Affordable Care Act (ACA), would significantly reduce federal funding for Medicaid, a program that provides health insurance to low-income individuals, children, and people with disabilities. The proposed cuts would have far-reaching consequences for millions of Americans who rely on Medicaid for their healthcare needs.

The bill would convert Medicaid from an entitlement program, where the federal government matches state spending, to a block grant program. This means that states would receive a fixed amount of funding from the federal government, rather than a matching amount based on their spending. The block grant would increase at a rate lower than the current matching rate, resulting in significant funding reductions over time.

The proposed cuts would lead to a reduction of $772 billion in Medicaid funding over the next decade, compared to current law. This would result in an estimated 15 million people losing their Medicaid coverage by 2026. The cuts would disproportionately affect vulnerable populations, including low-income children, pregnant women, and people with disabilities.

The bill would also allow states to impose work requirements on Medicaid recipients, which could lead to further reductions in enrollment. Additionally, the bill would give states more flexibility to manage their Medicaid programs, which could result in reduced benefits and higher costs for recipients.

The proposed Medicaid cuts have been met with criticism from healthcare advocates, who argue that they would lead to reduced access to healthcare for millions of Americans. The cuts would also shift the financial burden to states, which could lead to increased taxes or reduced funding for other important programs.

The Senate Republicans’ proposal is a significant departure from the House-passed healthcare bill, which also included Medicaid cuts. The Senate bill is expected to face significant opposition from Democrats and some moderate Republicans, who are concerned about the impact of the cuts on vulnerable populations. The proposal is likely to undergo significant changes as it makes its way through the legislative process. Ultimately, the fate of Medicaid and the healthcare of millions of Americans hangs in the balance.

Bajaj Allianz Life Insurance achieves 99.29% claim settlement rate in FY 2024-25.

Bajaj Allianz Life Insurance has achieved a milestone in its claim settlement process, with a 99.29% individual death claim settlement ratio in the fiscal year 2024-2025. The company settled 13,994 individual life insurance claims, disbursing a total of Rs 862.79 crores in claim payouts. This impressive feat demonstrates the company’s commitment to its customers and its ability to deliver on its promises.

The company’s claim settlement process has been streamlined, with 96% of eligible non-investigative claims being settled within one day of being notified. This is made possible by the company’s robust digital platforms and simplified processes, which enable customers to submit and track claims easily across multiple channels. The company’s focus on customer satisfaction is evident in its “Customer First Promise,” which drives every decision it makes.

Bajaj Allianz Life Insurance has also retained its highest issuer rating of AAA (Stable) from CARE Ratings for three consecutive years, reflecting its strong creditworthiness and consistent claims performance. The company’s solvency ratio and assets under management stood at 359% and Rs 1.23 lakh crore, respectively, as of March 31, 2025. These indicators demonstrate the company’s financial strength and stability.

The company’s managing director and CEO, Tarun Chugh, commented on the achievement, stating that the company remains committed to raising the bar even further. By strengthening its internal processes, leveraging new-age technologies, and driving innovation, the company aims to be the trusted partner in helping its customers achieve their life goals.

In addition to its impressive claim settlement ratio, Bajaj Allianz Life Insurance has also declared its highest-ever PAR Bonus of Rs 1,833 crore for over 11 lakh eligible policyholders. This bonus is a testament to the company’s commitment to rewarding its customers for their loyalty and trust.

Overall, Bajaj Allianz Life Insurance’s achievement of a 99.29% claim settlement ratio in FY 2024-2025 demonstrates its dedication to its customers and its position as a leading life insurance company in India. With its robust digital platforms, simplified processes, and commitment to customer satisfaction, the company is well-equipped to continue delivering exceptional service to its customers.

Healthcare providers are considering the potential effects of MinnesotaCare eliminating coverage for adult undocumented immigrants.

In Minnesota, a significant change is set to take place in January 2026, as undocumented adult immigrants will no longer be eligible for state healthcare. This decision was made by lawmakers who voted to amend the policy, allowing only children to remain covered. The motivation behind this change, according to Republicans, is to reduce spending and prioritize the needs of Minnesota residents. However, Democrats strongly disagree, arguing that this move will ultimately lead to increased costs in the long run, as undocumented immigrants will be forced to seek medical attention without insurance.

Currently, at least 15,000 undocumented adult immigrants are enrolled in MinnesotaCare, the state’s healthcare program. According to Steve Knutson, executive director of Neighborhood Healthsource, a clinic that treats a significant number of immigrants, the prospect of losing this insurance coverage is a major concern. Without insurance, the cost of treatment for these patients will fall on the clinic, which may lead to reduced services, staff cuts, or even site closures. Knutson estimates that the cost of treating uninsured patients is at least $250 per visit.

Moreover, Knutson warns that the lack of insurance coverage will likely drive undocumented immigrants to seek medical attention in emergency rooms, which will ultimately result in higher costs for commercially insured patients. This is because the costs of uncompensated care are often subsidized by insured patients, leading to higher prices for everyone. The impact of this change is still unclear, and major hospital systems in Minnesota have not yet responded to requests for comment on how this will affect their costs.

The consequences of this decision are far-reaching and may have significant implications for the healthcare system in Minnesota. As Knutson notes, the number of undocumented immigrants in the state has increased in recent years, and the loss of insurance coverage will put a strain on clinics and hospitals that provide care to these patients. With the change set to take effect in January 2026, it is essential to consider the potential long-term effects and explore alternative solutions to ensure that all individuals, regardless of their immigration status, have access to necessary healthcare services.

Life Insurance Corporation (LIC) plans to acquire a stake in a health insurance firm by March 31, according to CEO Mohanty.

The Life Insurance Corporation of India (LIC) is planning to acquire a stake in a standalone health insurance company by the end of the current financial year, according to its Managing Director and CEO, Siddhartha Mohanty. The company is in the final stages of discussions, but the name of the potential investee has not been disclosed. Mohanty stated that entering the health insurance sector is a natural choice for LIC, given the growing demand for health insurance products in India.

LIC is currently considering investing in one of the seven standalone health insurance companies in India, including Star Health & Allied Insurance, Niva Bupa Health Insurance, and Care Health Insurance, among others. However, Mohanty clarified that LIC will not be acquiring a majority stake in the company, suggesting that the investment will be a minority stake.

The move is part of LIC’s strategy to expand its presence in the health insurance sector, which is expected to grow significantly in the coming years. The company had earlier indicated its interest in the health insurance business and had stated its intention to invest in a standalone health insurance firm in the first quarter of the current financial year.

In addition to its plans to invest in a health insurance company, LIC is also seeking to issue additional long-term bonds. The company has requested the Reserve Bank of India (RBI) to issue 50-year and 100-year bonds, which would provide LIC with longer-term investment options to manage its asset-liability mismatch. The RBI has already introduced 50-year bonds to meet the growing demand from insurance and pension funds, and LIC is hopeful that a decision on the longer-term bonds will be made soon.

Overall, LIC’s plans to invest in a health insurance company and issue longer-term bonds reflect the company’s efforts to expand its presence in the insurance sector and manage its investments more effectively. With the health insurance sector expected to grow significantly in the coming years, LIC’s move is seen as a strategic one, and the company is hopeful of completing the investment by the end of the current financial year.

Protecting Rhode Islanders’ health coverage begins with the passage of the affordability act.

Rhode Island has made significant progress in expanding access to healthcare, with over 97% of its residents having insurance coverage. However, proposed cuts in Congress’ reconciliation bill threaten to undermine this progress, particularly the enhanced premium tax credits under the Affordable Care Act, which will expire at the end of 2025. These tax credits provide critical financial assistance to low- and middle-income families, allowing them to afford private insurance.

The expiration of these tax credits will affect 40,000 working-class Rhode Islanders, who will see their premiums jump by an average of 85%. For example, a 45-year-old minimum wage worker will see their monthly premium increase by 387%, while a couple aged 64 making $85,000 combined will see their premium jump from $602 to $1,992. This will make health insurance unaffordable for many, forcing them to choose between paying rent and seeing a doctor.

To address this issue, the Individual Market Affordability Act (2025-H 5996/2025-S0707) has been introduced. This legislation creates a state-based affordability program to close the $40 million gap left by the expiration of the enhanced tax credit program. The program will be funded by a modest expansion of an existing assessment across all health insurers, without relying on state general revenue.

The authors of the legislation, State Representative June S. Speakman and Senator Pamela J. Lauria, urge their colleagues in the General Assembly to support the Individual Market Affordability Act. They argue that this legislation is essential to protect tens of thousands of Rhode Islanders from dramatic increases in their health insurance costs. The Protect our Healthcare Coalition has also worked with the sponsors to develop this legislation.

The consequences of not passing this legislation are severe. The Congressional Budget Office predicts that nearly one in three people who purchase their insurance in the marketplace will lose coverage by 2030 due to the cut in enhanced tax credits. This will lead to delayed treatment, skipped preventive care, and financial ruin from unexpected medical bills.

The authors emphasize that Rhode Island has an opportunity to protect its residents from the negative consequences of federal inaction. By passing the Individual Market Affordability Act, the state can ensure that tens of thousands of its residents continue to have access to affordable healthcare. This is not only a moral imperative but also essential for the well-being and prosperity of the state as a whole.

Santa Clara County has taken over a managed health care program.

Santa Clara County leaders are seeking to reduce the financial burden of supporting the county’s public hospital system by streamlining the management of Medi-Cal reimbursements. The county has established a plan to consolidate the management of Medi-Cal, a program for low-income families, foster youth, disabled people, and older adults, under a single-plan model. This move aims to improve reimbursement rates, eliminate inefficiencies, and reduce duplicative costs. As part of this plan, the Board of Supervisors voted unanimously to replace most of the governing board of the Santa Clara Family Health Plan with county employees.

The Santa Clara Family Health Plan, established in 1995, is a significant entity in the county’s healthcare system, with around 300,000 enrolled members. However, county leaders argue that its governance structure has created a barrier to funding care, as it functions more like a separate insurance company focused on cost containment and surplus revenue. County Executive James Williams stated that the plan’s lack of a financial backstop, such as the county’s general fund, encourages it to reimburse hospitals at lower rates.

The proposed changes aim to give the county more control over reimbursement rates and improve the overall management of Medi-Cal. The plan would make the Family Health Plan the sole Medi-Cal and Medicare provider, replacing private insurance providers like Anthem. However, the state Department of Health Care Services must approve the request, which could take several years.

The decision has been met with opposition from the leadership of the Santa Clara Family Health Plan, who claim that the move is a “hostile takeover” that disrespects the governing board, staff, and members. The plan’s CEO, Christine Tomcala, argued that the proposal is “frankly reprehensible” and prioritizes the county’s interests over the needs of its members. The Family Health Plan filed a lawsuit against the county, requesting a temporary restraining order, but a judge denied the request.

County leaders argue that the changes are necessary to mitigate the impact of federal funding cuts and ensure the stability of critical safety net services. Supervisor Susan Ellenberg assured residents that the actions taken by the board would not affect patients, but rather aim to provide the best care available from trusted healthcare professionals. The county is seeking to improve the efficiency and effectiveness of its Medi-Cal strategy, and the proposed changes are seen as a crucial step in achieving this goal.

House Republican Health Agenda Cuts Coverage, Raises People’s Costs – Center on Budget and Policy Priorities

The Center on Budget and Policy Priorities has analyzed the House Republican health agenda and concluded that it would cut health coverage and raise costs for millions of Americans. The agenda, which includes several bills and proposals, would repeal and replace the Affordable Care Act (ACA), also known as Obamacare, with a system that would leave many people without access to affordable health insurance.

One of the main components of the agenda is the American Health Care Act (AHCA), which was passed by the House in 2017. The AHCA would repeal the ACA’s expansion of Medicaid, which has provided health coverage to millions of low-income adults, and replace it with a system of block grants to states. This would result in a significant reduction in federal funding for Medicaid, leading to cuts in coverage and benefits for vulnerable populations, including low-income children, pregnant women, and people with disabilities.

The agenda would also allow states to waive important consumer protections, such as the requirement that insurance plans cover essential health benefits like maternity care, mental health treatment, and prescription medications. This would enable insurance companies to sell skimpy plans that do not provide adequate coverage, leaving people with significant out-of-pocket costs and financial risk.

Furthermore, the agenda would repeal the ACA’s subsidies that help low- and moderate-income individuals purchase health insurance. This would make it difficult for many people to afford coverage, leading to a significant increase in the number of uninsured Americans. The agenda would also impose an “age tax” on older adults, allowing insurance companies to charge them up to five times more than younger people for the same coverage.

The Center on Budget and Policy Priorities estimates that the House Republican health agenda would result in 23 million people losing health coverage, including 14 million who would lose Medicaid coverage. The agenda would also increase costs for millions of people, including those with pre-existing conditions, older adults, and low-income families. The increased costs would be particularly devastating for people who rely on Medicaid, as they would be forced to choose between paying for health care and other basic necessities like food and housing.

Overall, the House Republican health agenda would have devastating consequences for millions of Americans, cutting health coverage and raising costs for those who need it most. It is essential to protect and strengthen the ACA, rather than repealing and replacing it with a system that would harm vulnerable populations and increase health care costs for everyone.

India’s Mother’s Day 2025 brand campaigns feature notable contributions from Kotak Life, Blue Tribe Foods, Wondrlab, Mahindra Tractors, Morepen, and BML Lead.

In celebration of mothers in 2025, several Indian companies launched campaigns that showcased the strength, wisdom, and legacy of mothers. Kotak Life Insurance, in partnership with Wondrlab, created a film titled “Ma Ki Di Hui Viraasat” that highlighted the unspoken lessons and values that mothers pass down to their children. The campaign aimed to reflect the values that are passed from one generation to the next, and the creators described it as a nostalgic process that reconnected them with their own childhoods.

Meanwhile, Blue Tribe Foods hosted a Mother’s Day event in Mumbai, where children and their mothers learned about sustainable eating through interactive activities such as puppet shows and live tastings. The brand demonstrated how simple changes in diet can help both people and the planet, and the guests sampled plant-based food options such as soya chaap and sweet potato fries.

BML Munjal University released a self-shot film titled “She Taught Me First,” which featured students and faculty sharing personal messages about the earliest lessons they received from their mothers. The film aimed to remind viewers that learning begins at home, long before any classroom, and reflected the university’s commitment to values-based education.

Mahindra Tractors launched a national campaign called “Rag Rag Laal Hai,” which involved a convoy of six red Mahindra tractors traveling across India to thank the people who keep India’s fields alive. The campaign celebrated not just the machines, but the families and mothers who support farmers every day.

Morepen Laboratories also contributed to the celebration with a wellness-focused tribute, spotlighting key products that support mothers’ health and well-being. The campaign emphasized that health is an expression of care and that mothers must also be cared for with intention.

These five campaigns offered different expressions of the same truth – that motherhood is legacy, nurturing, resilience, nourishment, and vision. They showed that honoring mothers is not about clichés, but about commitment. Each campaign highlighted the importance of mothers in different ways, whether through values, sustainability, education, or health and wellness. Overall, they celebrated the strength and wisdom of Indian mothers and the impact they have on their children and communities.

LIC CEO Mohanty stated that the firm will finalize acquiring a significant stake in a health insurance company by March 31.

The Life Insurance Corporation of India (LIC) is planning to reveal details of its latest acquisition by the end of the current fiscal year, according to MD and CEO Siddhartha Mohanty. The state-owned insurance company is in the final stages of acquiring a major stake in a standalone health insurance company, with the goal of finalizing the deal by March 31. While Mohanty did not disclose the name of the target company, he confirmed that the process is nearing completion and that the acquisition is a strategic move for LIC to enter the health insurance sector.

LIC is one of the largest insurance players in India, and its entry into the health insurance market is expected to have a significant impact. The company had announced its intention to enter the health insurance sector through a stake purchase in a standalone health insurer earlier in the fiscal year. There are currently seven standalone health insurance companies in India, including Star Health & Allied Insurance, Niva Bupa Health Insurance, and Care Health Insurance.

Mohanty clarified that LIC will not be acquiring a controlling stake in the firm, but rather a significant minority stake. The acquisition is subject to regulatory approvals, which are expected to be completed within the current fiscal year. The move is part of LIC’s strategy to expand its presence in the insurance market and diversify its product offerings.

In addition to its health insurance plans, LIC is also engaging in discussions with the Reserve Bank of India (RBI) regarding long-term bond issuances. The company has requested bonds with maturities of 50 and 100 years, which would align with its long-term investment strategy. The RBI has already introduced 50-year bonds to address the increasing demand from insurance and pension funds, and LIC is negotiating for even longer-term bonds to manage its assets and liabilities effectively. With its long-term investment approach, LIC is seeking to capitalize on the growing demand for health insurance and expand its presence in the Indian insurance market.

New India Assurance Co. Ltd., Oman receives the prestigious Times of Oman Best Brand in Customer Experience Award

New India Assurance Co. Ltd., Oman, has been honored with the prestigious Times of Oman Best Brand in Customer Experience Award in the insurance category at the Oman CX Awards 2025. This recognition is a testament to the company’s unwavering commitment to delivering exceptional service and customer satisfaction across the Sultanate. The award was received by Mr. Gaurav Sharma, Chief Operating Officer of New India Assurance, Oman Operations, on behalf of the company.

The Oman CX Awards 2025 celebrated excellence across 35 product and service categories, with winners determined through nationwide consumer voting. The event highlighted the critical role customer experience plays in brand reputation and long-term success. New India Assurance’s win is a result of its customer-centric approach, which has been reflected in its recent innovations, including the launch of a state-of-the-art Customer Care Centre in December 2024. The centre offers direct call lines and WhatsApp support to enhance client accessibility and responsiveness.

Mr. Majid Abdul Rahim Jaffer Al Bahrani, the visionary leader of New India Assurance, Oman, expressed his gratitude to customers and partners for voting for the company as the Best Brand in Customer Experience. Mr. Gaurav Sharma commented, “This award is a testament to the exceptional service delivered by our team. We are deeply honored and extend our sincere appreciation to all our valued customers and partners for their continued trust and support.”

The award ceremony was attended by prominent figures, including His Highness Sayyid Mohammed Bin Salem Al Said and Mr. Ahmed Essa Al Zadjali, CEO of Muscat Media Group. The recognition is a significant milestone for New India Assurance, which is celebrating its 50th year of operations in Oman. The company continues to set industry benchmarks, reflecting the enduring trust and confidence of its customers.

New India Assurance’s commitment to customer experience is evident in its efforts to enhance client accessibility and responsiveness. The company’s Customer Care Centre is a testament to this commitment, providing direct support to customers through various channels. As the company looks to the future, it remains dedicated to delivering exceptional service and customer satisfaction, solidifying its position as a leading insurance provider in Oman. With its customer-centric approach and innovative solutions, New India Assurance is well-positioned to continue setting industry benchmarks and exceeding customer expectations.

The Congressional Budget Office (CBO) has revised its estimate regarding the number of individuals who would lose health insurance coverage.

A recent analysis by the nonpartisan Center on Budget and Policy Priorities has estimated that approximately 15.7 million Americans could lose their health insurance coverage if the bill passed by the House of Representatives on May 22 becomes law. This figure is significantly higher than previous estimates and is based on revised numbers published by the Congressional Budget Office (CBO) after the House Republican caucus made changes to the bill. The analysis, entitled “By the Numbers: House Bill Takes Health Coverage Away From Millions of People and Raises Families’ Health Care Costs,” breaks down the estimated number of people who would lose coverage due to various provisions in the bill.

According to the analysis, roughly 15 million people would lose health coverage and become uninsured by 2034 due to Medicaid cuts, the failure to extend enhanced premium tax credits, and other changes to the Affordable Care Act (ACA) marketplace. This figure includes 7.6 million people who would become uninsured due to Medicaid policies, 1.8 million due to codification of Trump Administration marketplace rule provisions, 2.1 million due to marketplace policies, and 4.2 million due to the failure to extend premium tax credit enhancements.

The analysis also found that the bill’s Medicaid cuts would be the largest in the program’s history, with an estimated $716 billion in cuts. This would put between 9.7 million and 14.4 million people in the expansion population at risk of losing Medicaid due to a harsh work requirement. The Center estimates that if coverage losses mirror those experienced in Arkansas, which implemented similar requirements, some 7 million people would lose coverage.

The analysis emphasizes that when people lose health coverage, they lose access to essential care, including preventive and primary care, care for life-threatening conditions, and treatments for chronic conditions. The bill’s work requirement would harm parents, people with disabilities, and those with chronic illnesses, as past experience has shown that exemptions often do not work and people get caught in bureaucratic red tape. The Center notes that two-thirds of people aged 19-64 receiving Medicaid in 2023 worked during the year, and many of those who didn’t were taking care of a family member or had an illness or disability.

Overall, the analysis suggests that the bill passed by the House of Representatives would have devastating consequences for millions of Americans who rely on health insurance coverage. The estimated 15.7 million people who could lose coverage would face significant barriers to accessing essential healthcare, which could have serious consequences for their health and well-being.

Health and Care Sector: Latest Developments

The UK’s National Health Service (NHS) is facing significant changes and challenges. GP leaders are warning against plans to fragment primary care services through neighborhood health teams, which could lead to a “one size fits all” approach being abandoned in favor of targeted services based on patient groups. The Royal College of General Practitioners’ chair, Professor Kamila Hawthorne, has expressed concern that this could undermine general practice as the universal healthcare gateway and lead to missed diagnoses.

Meanwhile, Joe Harrison CBE has been appointed chair of the NHS Advisory Board for Procurement and Supply, bringing over a decade of acute hospital leadership experience and expertise in digital transformation and innovation. The NHS Advisory Board works with senior healthcare leaders to shape national procurement strategy and drive system-wide improvements.

The Labour party has claimed a “massive increase” in NHS appointments, with 3.6 million additional appointments achieved in the first eight months of the year. However, new data reveals that this figure actually represents a slowing down in new NHS activity, with a larger rise of 4.2 million extra appointments over the same period the year before under the previous government. The rise in appointments represents a less than 3% increase in the number of appointments carried out in the year to June 2024.

In an effort to improve patient experience, the NHS app will now allow patients to track their prescriptions “Amazon-style”, showing when a prescription has been shipped for delivery and when it is ready for collection. This development aims to reduce the administrative burden on pharmacies and free up hardworking pharmacists.

Finally, research has found that vape shops have surged across England, rising by nearly 1,200% in a decade, with almost all local authorities now having at least one vape shop. The research reveals stark regional and economic differences, with northern England having twice as many vape shops as the south, and deprived areas containing three times more vape shops. This has raised concerns about the impact of vaping on public health, particularly in disadvantaged communities. Overall, the NHS is facing significant challenges and changes, from primary care reform to procurement and patient experience, and it remains to be seen how these developments will impact the health service and its patients.

Concerns are growing over potential medical coverage losses stemming from the proposed healthcare legislation, dubbed the big, beautiful bill.

The Hill recently reported on growing concerns over the potential loss of medical coverage for millions of Americans under the new healthcare bill proposed by the Republican Party. The bill, touted as a replacement for the Affordable Care Act (ACA), has been dubbed the “big, beautiful bill” by President Trump. However, critics argue that the proposed legislation would lead to significant losses in medical coverage, particularly for low-income individuals and families.

The Congressional Budget Office (CBO) estimates that the bill would result in 24 million fewer people having health insurance by 2026, with 14 million losing coverage in the first year alone. This is largely due to the bill’s proposed changes to Medicaid, which would shift the program from an open-ended entitlement to a per-capita cap system. This change would limit the amount of federal funding available to states for Medicaid, potentially leading to reduced coverage and benefits for low-income individuals.

Additionally, the bill would allow states to waive certain ACA requirements, such as essential health benefits and community rating, which could lead to skimpier insurance plans that do not provide adequate coverage. This could result in individuals and families being unable to afford the care they need, particularly those with pre-existing conditions.

The bill’s proposed changes to tax credits and subsidies would also disproportionately affect low-income individuals and families. The tax credits would be based on age rather than income, which could leave many people unable to afford coverage. Furthermore, the bill would eliminate the cost-sharing reductions that help low-income individuals pay for out-of-pocket expenses, such as deductibles and copays.

The concerns over medical coverage losses have been voiced by a range of groups, including patient advocacy organizations, healthcare providers, and insurers. The American Medical Association, the American Hospital Association, and the National Association of Community Health Centers have all expressed opposition to the bill, citing concerns about the potential harm it could cause to patients and the healthcare system as a whole.

Overall, the proposed healthcare bill has sparked widespread concern about the potential loss of medical coverage for millions of Americans. The bill’s changes to Medicaid, tax credits, and subsidies could lead to reduced coverage and benefits for low-income individuals and families, leaving many without access to necessary care. As the bill moves forward, it is essential to consider the potential consequences for patients, healthcare providers, and the healthcare system as a whole.

Man who lost leg in bus accident near Pune awarded Rs 1 crore

A 34-year-old man, Abhijit Pujare, from Nalasopara, has been awarded a compensation of approximately Rs 1 crore, including interest, by the Motor Accident Claims Tribunal. The amount will be paid jointly by the owner of the bus, M/s RN Cabs Pvt Ltd, and the insurance firm United India Insurance Co Ltd. The accident occurred in 2021 when the bus, in which Pujare was a passenger, overturned near Pune due to the driver’s rash and negligent driving.

Pujare, who worked as a manager for a private firm in Delhi at the time, earning a monthly salary of Rs 25,000, suffered severe injuries in the accident, including amputation of his right leg above the knee, injuries to both hands, and a head injury with a frontal laceration. The tribunal stated that the evidence on record establishes that the accident occurred due to the driver’s rash and negligent driving and that Pujare sustained permanent partial disability as a result.

The tribunal considered Pujare’s functional disability to be 100% and awarded the compensation, stating that he cannot work as a manager due to his injuries. Pujare had moved the tribunal in February 2022, seeking compensation of Rs 1.25 crore. The tribunal’s award of Rs 1 crore, including interest, is a significant recognition of the severity of Pujare’s injuries and the impact they have had on his life and career.

The accident occurred on January 21, 2021, when the bus was traveling towards Solapur highway in Indapur taluka of Pune district. The driver’s reckless driving led to the bus dashing into a roadside divider and overturning, resulting in Pujare’s severe injuries. The tribunal’s decision highlights the importance of responsible driving and the need for drivers to exercise caution and care while on the road to prevent such tragic accidents.

Tata AIA has launched two new funds, aiming to capitalize on the growing consumption trends in India.

Tata AIA Life Insurance has launched two new funds that aim to capitalize on the growing consumption trends in India. The company has introduced the “Tata AIA Life Insurance Consumption Fund” and the “Tata AIA Life Insurance India Opportunities Fund”, which will invest in companies that are expected to benefit from the increasing consumer spending in the country.

The Indian economy has been witnessing a significant shift towards consumption-driven growth, with rising incomes, urbanization, and a growing middle class driving demand for goods and services. The launch of these two funds is a strategic move by Tata AIA to tap into this trend and provide investors with opportunities to benefit from the growth of consumer-facing companies.

The Tata AIA Life Insurance Consumption Fund will invest in companies that are involved in the production and distribution of consumer goods, such as food, beverages, and personal care products. On the other hand, the Tata AIA Life Insurance India Opportunities Fund will have a broader mandate, investing in companies across various sectors that are expected to benefit from India’s consumption story, including retail, hospitality, and entertainment.

Both funds will be managed by Tata AIA’s experienced investment team, which has a strong track record of delivering returns in the Indian market. The funds will be available to policyholders of Tata AIA Life Insurance, providing them with an opportunity to diversify their investment portfolio and benefit from the growth of the Indian economy.

The launch of these funds is expected to be well-received by investors, given the strong growth prospects of the Indian consumer market. India is expected to become the third-largest consumer market in the world by 2025, with consumer spending projected to reach $6 trillion. The government’s efforts to boost economic growth, including initiatives such as the “Make in India” program, are also expected to contribute to the growth of the consumer sector.

Overall, the launch of the Tata AIA Life Insurance Consumption Fund and the Tata AIA Life Insurance India Opportunities Fund is a strategic move by the company to capitalize on the growing consumption trends in India. With a strong investment team and a well-diversified portfolio, these funds are expected to provide investors with attractive returns and help them benefit from the growth of the Indian economy.

Care Health Insurance launches bold new ‘Who Cares?’ campaign to highlight healthcare accessibility

Care Health Insurance, a specialized health insurer, has launched a new digital campaign for its Care Supreme Health Insurance product. The campaign aims to make quality healthcare accessible and affordable for everyone. Through a series of engaging and quirky 15-second digital ads, the campaign explores the question “Who Cares?” in everyday scenarios that highlight common health insurance concerns. The ads use humor and insight to creatively underscore the importance of comprehensive health coverage, addressing factors such as affordability, room rent limits, and the long-term benefits of continuing a comprehensive health insurance plan.

The campaign challenges common perceptions of health insurance and reinforces Care Health Insurance’s core belief that true care goes beyond policies and into real-life support. According to Ajay Shah, Head of Distribution at Care Health Insurance, the campaign aims to speak directly to consumers while showcasing the unique strengths of the company’s products. The goal is to make healthcare decisions more meaningful and personal, rather than just about policies. The campaign blends the emotional power of care with the practical advantages of the company’s offerings, ensuring that healthcare is not just accessible but also deeply meaningful to every individual.

To reach a wider audience, the campaign is being rolled out in five languages, including Kannada, Malayalam, Marathi, Tamil, and Telugu. This multilingual approach strengthens Care Health Insurance’s commitment to inclusive and customer-centric communication, allowing people across diverse geographies to connect with the message in a meaningful way. The campaign’s strategic rollout aims to ensure a pan-India reach, making it a significant effort by the company to promote its products and values. Overall, the campaign is a creative and engaging way to raise awareness about the importance of comprehensive health coverage and the benefits of Care Health Insurance’s offerings.

The 2025 budget reconciliation is expected to have significant implications for the Affordable Care Act (ACA), Medicaid, and the uninsured rate in the United States. Several key provisions are anticipated to be included in the reconciliation, which may lead to changes in healthcare coverage and accessibility.Firstly, regarding the ACA, potential modifications could impact the health insurance marketplaces, including subsidies for individuals and families purchasing coverage. The reconciliation might extend or make permanent the enhanced subsidies provided under the American Rescue Plan Act, which could help maintain or increase the number of individuals covered under the ACA. This, in turn, could stabilize or even expand the health insurance marketplaces, potentially enhancing the overall stability of the ACA.Secondly, the budget reconciliation may also affect Medicaid, a joint federal-state program that provides health coverage to low-income individuals and families. Provisions could include incentives for the 12 states that have not expanded Medicaid under the ACA to do so, potentially covering hundreds of thousands of additional individuals. Other potential changes could involve adjustments to Medicaid eligibility, benefits, or reimbursement rates, which could either expand coverage or alter the scope of services provided to Medicaid beneficiaries.Lastly, the changes to the ACA and Medicaid through the 2025 budget reconciliation are likely to impact the uninsured rate in the U.S. If the reconciliation leads to more generous subsidies, incentives for Medicaid expansion, and other provisions that make healthcare more affordable and accessible, it could result in a decrease in the uninsured rate. Conversely, if changes lead to less affordable or less comprehensive coverage options, the uninsured rate might increase. The ultimate effect will depend on the specific provisions included in the reconciliation and how they are implemented by states and the federal government.Overall, the 2025 budget reconciliation has the potential to significantly influence the landscape of healthcare coverage in the United States, with implications for the ACA, Medicaid, and the number of uninsured individuals. The exact nature of these changes will be determined by the final provisions included in the reconciliation package.

Congressional Republicans are considering a budget reconciliation package that would significantly alter Medicaid and the Affordable Care Act (ACA). The proposed changes include work and reporting requirements for certain Medicaid enrollees, codifying changes to the ACA Marketplaces, and allowing states to impose new cost-sharing requirements. These changes are estimated to increase the number of uninsured people by at least 13.7 million by 2034, according to the Congressional Budget Office (CBO).

The Medicaid provisions in the proposal would reduce enrollment by at least 7.7 million people, primarily due to new work and reporting requirements, stricter eligibility renewal processes, and lower federal matching rates for states that cover immigrants. Additionally, the proposal would delay streamlined eligibility and enrollment processes, impose new verification requirements, and reduce retroactive coverage.

The codification of the ACA Marketplace Integrity and Affordability Proposed Rule would also lead to an estimated 1.8 million more uninsured people by 2034. This rule would shorten the open enrollment period, restrict special enrollment periods, and impose new documentation requirements for income verification.

Furthermore, the expiration of enhanced premium tax credits, which are set to expire at the end of 2025, would lead to an estimated 4.2 million more uninsured people. These tax credits have reduced premium payments by an average of $705 per year and have led to a significant increase in ACA Marketplace enrollment. Without these credits, enrollees’ out-of-pocket premium payments would increase by over 75% on average, with lower-income and older enrollees being disproportionately affected.

Overall, the proposed changes would lead to a significant increase in the uninsured rate, reversing years of progress in reducing the number of uninsured Americans. The CBO estimates that the uninsured rate would increase by about 30% if these changes go into effect. The proposed changes would also have a disproportionate impact on vulnerable populations, including low-income individuals, older adults, and people with disabilities.

Star Health has introduced a complimentary healthcare initiative called Doc Kendra in Tiruppur.

Star Health and Allied Insurance Co. Ltd has introduced a community healthcare initiative called Doc Kendra in Tiruppur, Tamil Nadu. The primary objective of this initiative is to provide free primary healthcare services to the local community through its branches. Each Doc Kendra will be equipped with a doctor and a paramedic, and patients will also have access to general physicians and specialists via telemedicine. This will enable individuals to receive consultations and guidance from specialists remotely, enhancing the overall quality of care.

The Doc Kendra clinics will operate six days a week, from Monday to Saturday, making healthcare services more accessible and convenient for the community. The initiative aims to complement the existing healthcare infrastructure in the region and provide a reliable first point of contact for medical care. By doing so, Star Health seeks to guide individuals towards appropriate treatments and ensure they receive the right care.

According to Balaji Babu, Executive President of Star Health, the company aims to leverage its branch network to provide a trusted gateway to healthcare for the community. The Doc Kendra initiative is designed to offer accurate and timely healthcare services, addressing the medical needs of the local population. By providing free primary healthcare services, Star Health hopes to make a positive impact on the community and improve overall health outcomes.

The launch of Doc Kendra in Tiruppur is a significant step towards enhancing the healthcare infrastructure in the region. With its focus on accessibility, accuracy, and timeliness, the initiative has the potential to make a meaningful difference in the lives of individuals and families in the community. As the healthcare landscape continues to evolve, initiatives like Doc Kendra are essential in ensuring that quality healthcare services are within reach of everyone, regardless of their geographical location or socio-economic background.