Private Health Insurance In Europe: Complementary Or Competing? – Health Insurance Valuation and Implications for Private Health Insurance Dr. Ehab Abul-Magd *President of the Afro-Asian Congress on Health Insurance and Managed Care.
Presentation on theme: “HTA Evaluation and Impact on Private Health Insurance Dr. Ehab Abul-Magd *President of the Afro-Asian Congress on Health Insurance and Managed Care.”— Presentation Transcript:
Private Health Insurance In Europe: Complementary Or Competing?
1 Evaluation of HTA and Impact on Private Health Insurance Dr. Ehab Abul-Magd *President of the Afro-Asian Congress on Health Insurance and Managed Care *Chairman of the Egyptian Society for Healthcare Management
South Africa’s National Health Insurance Bill Has Noble Aims But Leaves Too Much Uncertain: It Needs More Work
Responding to public needs Responding to limited resources Health care income Health equity Financial equity Accountability Sustainability of health care financing Efficiency of health care Financial protection of households 2
Duplicate PHI: PHI that offers coverage for health services included in public health insurance, but also offers access to different providers (eg, private hospitals) or levels of service (eg, faster access to care). It does not exempt individuals from participating in public health care programs. Substitute PHI: An alternative to statutory insurance and available to groups of people who may be excluded from public coverage or eligible to opt out of the public system
Extra insurance: Offers faster access to services, a wider choice of providers or improved convenience Extra services: covers services excluded from the government-funded benefits package Extra user fees: covers user fees for goods or services in the government-funded benefits package
Many low- and middle-income countries (LMICs) are moving towards expanding universal health care (UHC). Adequate financing of comprehensive health coverage is difficult due to lack of resources. The role of private health insurance should be adjusted to the package of benefits in the public health care system. Personal health insurance (PHI) may take on a new role in the form of providing supplementary (CompHI) and supplementary health insurance (SuppHI). to the state health insurance system. Many low- and middle-income countries (LMICs) are moving towards expanding universal health care (UHC). Adequate financing of comprehensive health coverage is difficult due to lack of resources. The role of private health insurance should be adjusted to the package of benefits in the public health care system. Personal health insurance (PHI) may take on a new role in the form of providing supplementary (CompHI) and supplementary health insurance (SuppHI). to the state health insurance system. Source: Syreon Research Institute
Getting Health Insurance In France
Private health insurance can support the implementation of universal health coverage by covering areas where the benefit package of public insurance does not fully cover. If UHC does not cover 100% of the population, PHI can increase the number of insured by offering basic private health insurance. In order to increase the quantity and quality of services covered by public health insurance, private health insurance can offer additional and complementary services. To reduce cost-sharing (the co-pay for a service), private health insurance may cover co-payments for patients. This application is called (user fees) Source: Syreon Research Institute
Reference: Almasi T, Fasseeh AN, Elezbawy B, George M, Abouelmaged E, Arnaiz F, Abaza SA, Nagy B, Kalo Z. The role of complementary and supplementary private health insurance in selected countries. European ISPOR Conference, Barcelona
Effective prioritization of health care interventions and their quality improvement consistent decision-making reduce the signal of inappropriate variation “value” informs the choice of indicators to assess performance and motivate providers in the industry, especially in a per capita context Bottom line: indicators are not always just financial incentives.
In most countries, pricing and reimbursement decisions are based on HTA recommendations. If a basic benefits package is established, it creates an opportunity to provide additional and complementary services to private health insurance.
Complementary Health Insurance For Eu Officials
Increasing the evidence base and transparency of decisions in private health insurance Improves the sustainability of private health insurance A tool for private health insurers’ price negotiations The potential for cooperation between private (and public) health insurers to match the basic benefit package with complementary and additional services
Download ppt Dr. Ehab Abul-Magd *President, Afro-Asian Congress on Health Insurance and Managed Care.
The Munich-headquartered financial services company offers international health insurance plans for international students, professionals, couples and families. Depending on the policy, Allianz Care covers routine medical expenses, emergency treatment, dental consultations, maternity, surgical treatment and outpatient fees.
Multimodal Machine Learning In Precision Health: A Scoping Review
APRIL International is a health and travel insurance provider operating in 180 countries. Their range of insurance products is tailored to the needs of expats, whether relocating your family, studying abroad for a semester, taking a working holiday or simply traveling. 130,000 expats already trust APRIL International.
Cigna Global is a healthcare company serving expatriates and globally mobile individuals in more than 200 international jurisdictions. Cigna Global policies are easily customized for coverage and cost requirements, and customers can choose from three coverage levels, modular plans and multiple cost-sharing options.
In 2016, France introduced PUMA, its universal healthcare system for all residents, including expats. The system provides excellent quality subsidized health care for everyone, but foreigners must live in France for three months before they are eligible for public health insurance. Private or international health insurance can be used to cover this residency gap, as well as any costs not covered by public funding, such as alternative or complementary therapy treatments.
France has one of the best healthcare systems in the world and is ranked #1 by the World Health Organization. However, medical care is not cheap and public insurance plans only cover about 70-80% of the costs. Private health insurance can be used to cover remaining costs, access treatments not included in government coverage, and cover any gaps in initial coverage. Private insurance is also required by anyone who cannot access subsidized PUMA treatment (eg short-term visitors).
Health Care In Spain
If you decide to choose private health insurance in France, make sure you research the market carefully and choose the best package for your needs from among the many offers.
All family members are eligible for coverage under the French public PUMA scheme, and children under 16 are automatically covered. Individual insurance packages usually only cover the applicant. You should ask about family coverage and estimate the costs.
2. Whether the policy contains any restrictions, limitations or exclusions, e.g. related to age or pre-existing conditions?
Individual policies usually have premiums based on risk factors such as age, lifestyle and medical history. Check what is and isn’t included before signing up.
Top 100 Medical Device Companies In The World (free Chart Included)
Residency requirements to access PUMA are three months, so all new residents without some form of international health insurance (eg European Health Insurance Card) must purchase private insurance to cover this initial period.
French public health insurance covers you for certain types of treatment in other EU/EEA countries and anywhere that has a reciprocal healthcare agreement with France. Frequent travelers are offered an expat-friendly international health insurance package that provides global coverage.
PUMA coverage is very broad and includes treatment by doctors and specialists, hospital care, maternity care, dental care and a range of preventive examinations, but it does not cover treatment by psychologists, chiropractors or osteopaths. This may be covered by individual plans.
Pdf) Australian Integrative Oncology Services: A Mixed Method Study Exploring The Views Of Cancer Survivors
Our scorecard evaluates each state’s health care system based on how well it provides quality, affordable, and equitable care. Read the report to see your state’s ranking.
: statutory insurance of 109 non-profit “sickness funds” covering 88% of the population. High earners and civil servants can opt out of full replacement private insurance, which covers 11% of the population.
Sickness funds: Mandatory salary contributions to sickness funds on a risk-adjusted per capita basis, divided equally between employers and employees; additional income-related contributions paid directly to sickness funds; total tax revenue. Personal insurance: individual premiums.
Sickness Fund subscribers purchase supplemental or additional policies that cover certain co-payments and small benefits that SHI does not cover, including private hospital rooms.
Real World Evidence To Support Payer/hta Decisions About Highly Innovative Technologies In The Eu—actions For Stakeholders
Covered drugs: 10%, minimum €5.00 ($56.60) and maximum €10.00 (or the price of the drug) (or the price of the drug), plus the difference between the price and the reference price.
Hospital inpatient expenses are limited to 28 days per year. Total medical expenses are capped at 2% of household income; 1% of income for people with chronic illness.
Private providers paid through regionally agreed FFS payments
Private guides in europe, largest private companies in europe, private equity in europe, medicare or private health insurance, private universities in europe, best private bank in europe, private health insurance europe, health insurance in europe, health insurance companies in europe, private banking in europe, private equity firms in europe, private banks in europe