OBJECTIVE to analyze health promotion programs in the supplementary health care. METHODS This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis. RESULTS Home care has been ...

Typically, however, consumers do not bear the cost of their hospitalization directly, as either all or most of the cost is borne by an insurer. Similarly, consumers’ choices of both which hospital to patronize and what care to consume are determined substantially by their insurer through selective contracting and utilization review.1 This is especially true of HMO patients who often pay little ...

BACKGROUND Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI). This study provides an overview of PHI in different health care systems and discusses factors that affect its upt...

BACKGROUND Korea achieved universal health insurance coverage in only 12 years; however, insufficient government funding has resulted in high out-of-pocket payments and, in turn, a demand for supplementary private health insurance (PHI). Supplementary PHI provides a fixed amount of benefits in the event of critical illness (e.g., cancer or stroke), surgery, or hospitalization. In this study, we...

OBJECTIVE To assess health coverage of elderly people receiving supplementary health care and these users' sociodemographic characteristics. METHODS Descriptive study of elderly population living in Brazil and in the states of São Paulo and Rio de Janeiro in 2006. Data was collected from the National Supplementary Care Beneficiary Information System and the National Household Sample Survey. T...

The aim of this report is to provide an overview of the reform of health insurance in the Federation of Bosnia and Herzegovina (FBH). Health financing and resource allocation policies in the FBH are also summarized. Health financing should be ensured through three types of health insurance: compulsory, supplementary, and voluntary. The revenues for the compulsory health insurance will be ear-ma...

FEDER-41, EMPLOYEES and annuitants and their dependents who are aged 65 and over are potential beneficiaries of two Federal health insurance programs-health insurance for the aged (Medicare) and lie&h insurance for active and retired Federal employees. The two programs are in considerable measure duplicatory and most Federal employees and nnnuitnnts aged 65 and over are unable to take full adva...

THE AMENDMENTS TO THE Social Security .1ct passed in 1967 (Public Law 90-248) made several changes in the old-age, survivors, disability, hospital, and supplementary medical insurance system.’ Some of these changes affected significantly the actuarial status of the system. The principles used to determine tile financing stability of the program were not altered, however. This article discusses ...

introduction: the rapid increase in health costs across the world has forced governments to use insurance programs. uncontrolled costs would reduce the financial ability of insurance organizations in providing services. abuse of health insurance wastes 3-15% of the health budget annually. this study was conducted to determine cases of violating the rules and regulations of medical services insu...

background: the iranian healthcare system is primarily an insurance based system. this structure has an important influence on the efficiency and equity of the provision of healthcare in iran. this paper reviews the history of the iranian healthcare system and the impact of the iranian health insurance system on healthcare performance based on the results of interviews with key opinion leaders ...