by: Maureen Farrell

They're back. They're slimy. And they want your money. They are health care hucksters.

In recent months, insurance regulators have been wrestling with what looks like a new wave in health-care scams, perpetrated mainly against the weakest of the flock: individuals and small-business owners.

Many of these frauds are similar to those that siphoned millions of dollars from unsuspecting consumers in the early 2000s. A few new nettlesome flavors have popped up, too--such as discount cards promising savings on doctors' visits and hospital stays (often marketed as real insurance) and human-resource service providers who also peddle sham health insurance.

In Pictures: Seven Slimy Health-Care Scams

"We've seen far too many [health-insurance fraud] cases recently," says Nevada's commissioner of insurance, Alice Molasky-Arman. In the past six months, six cases have landed in Nevada's insurance department--twice what bubbled up last year during the same time period.

The Coalition Against Fraud--a trade group comprised of major insurers, consumer groups and government agencies--has also seen more fraud cases spring up in the past year, after a drop-off for several years. "It's hard to say right now whether it's a tsunami revival of these frauds or a handful of isolated warning flares, but clearly these scams don't die easily," says James Quiggle, director of communications for the Washington-based organization.

In the last U.S. scam wave, between 2001 and 2003, four fake insurers left consumers high and dry with approximately $85 million in unpaid medical bills, according to research by the Commonwealth Fund, a New York-based health-care research foundation and the Georgetown University Health Policy Institute.

There's a reason perps pick on the little guy. Individuals and small-business-sponsored health insurance is governed by state regulations, not federal, which are offer greater consumer protection. (The feds keep an eye on the large-group insurance market).

In many states, insurers can deny individuals with pre-existing medical conditions. And if they do offer coverage, it comes at steep rates. As for small businesses, many can't afford to offer much in the way of health benefits. Just 45% of companies with three to nine workers offer them, according to the 2007 annual survey from the Kaiser Family Foundation; overall, some 60% of companies now offer health benefits, down from 69% in 2000. Meanwhile, the total number of uninsured Americans clocks in at roughly 47 million, or 16% of the U.S. population.

Choking health-care costs have individuals and entrepreneurs desperately scrambling for any relief--even into the waiting arms of scammers.

"Anytime you have an insurance need that is not met by the industry, it provides an arena for crooks to get involved," says Robert Brace, partner at Hollister & Brace, a Santa Barbara, Calif.-based law firm, who represented prosecutors against Employers Mutual, an unauthorized health-insurance company that defrauded thousands of health policyholders out of $30 million in unpaid claims. Last February, James Graf, architect of the scam, was sentenced to 25 years in prison and ordered to pay $20 million in restitution.

The Employers Mutual debacle (and others) led to a crackdown on fraudsters. State insurance departments launched consumer-awareness campaigns. This paid off for awhile, but now the bad guys are back. One big reason: "It's really easy to do," says Brace. "I could sell phony insurance."

Sham insurers can take many forms, including phony associations (think the Scuba Divers Association of Nebraska) or even third-party human-resource administrators. Some look and sound very legitimate, with real offices and Web sites, says Brace. They go fishing with below-market rates and target buyers who don't qualify for regular health insurance. Some hucksters might even pay a few claims to build trust. Eventually, though, they cut and run.

Herewith, some common scams and how to beat them:

Dreaded Disease Policies

In this time-worn scheme, an insurance provider claims to offer coverage for medical expenses related directly to a so-called "dreaded" disease like cancer, heart attacks, strokes or just an unfortunate accident. But when the bills come, the sham company is long gone with your premiums in its pocket.

There are some legitimate versions of these policies, too, but they come with plenty of loopholes. Limitations include: time frames with no option to renew, fixed dollar amounts and quirky caps on care. (Examples: Cancer treatments may only be covered in an in-patient setting, or the policy may provide no coverage for other illnesses related to a disease.)

Bottom line: With the right health insurance, you don't need these policies. If you don't have insurance and want to take a flier, make sure both agent and insurer are licensed in your state. Check with your state's insurance department.

Discount Cards

The promise of 15% off doctors' visits and hospital stays may sound like a bargain, but often these offers aren't real--unlike the crooks that market them. Some legitimate insurers offer discounts for "up to" a certain percentage, when in fact most of the time the savings are far more modest. These savings may also apply only to very specific treatments.

"In the last several years, there's been lots of activity in the discount-card area," says Mila Kofman, assistant research professor at Georgetown University's Health Policy Institute and the author of several studies on insurance fraud.

To sniff these scams out, vet the list of providers and find out if those doctors indeed honor discounts. Double-check the prices. Also check with your state's insurance department to see if there have been any past complaints with regard to those discounts.

Stacked Policies

Imagine a bunch of "dreaded disease" policies piled on top of each other. At best, the policies are mis-marketed; at worst, the insurer is a fraud.

Swiss cheese has nothing on some of these policies, though they may not be fraudulent per se. Exceptions abound, and you may end up paying higher premiums while missing out on basic coverage. Call your state regulator and read the fine print before getting suckered. Actually, don't bother--just avoid these plans altogether.

Faith-Based Plans

These programs collect attractively priced monthly premiums from members of a local or national congregation. (Most require members to uphold certain standards, such as no smoking, alcohol or premarital sex.) While plan members take it on faith that their medical bills will be covered, many won't be. Worse, there is little recourse to extract the money because programs tend not to be regulated.

Given the lack of transparency, it's hard to know which faith-based plans are legit and which aren't. Still, check with your state insurance department to see if consumers have filed complaints. Sometimes financial statements are available to the congregation, and some programs may even have a board of directors you can investigate.

Sadly, battling health-care scammers is a lot like trying to plug holes in a dike. But that doesn't mean you have to make it easy on them. "The bottom line is that health insurance is expensive for a reason, mostly because medical care is expensive," says Kofman. "Health insurance isn't going to be a lot cheaper depending on how you sell it."

In other words, if it smells too good to be true, it probably is.

Source: Forbes.com

The stamina is the a power or energy of the body to sustain its composure against the excoriation of the physical world which can be of sports, exercises, work or some other activity that requires physical action. Commonly the level of stamina varies from person to person. It also depends on age, sex and conditions like diseased or injured body. After mentioning some facts about stamina, do you know that there's a fact that a ones stamina can be increased by constant and deliberate efforts?

Having a short stringed stamina causes common disadvantage like lethargy and fatigue due to which we feel the tediousness, our efficiency to act and move decreases and become prone to diseases. From these fact we can conclude that the key to prolonged and happy life is to improved oneself's level of stamina.

We can improve our stamina with these simple procedures:

Running briskly:- This is a method which is commonly used to increase and improve the stamina. In this procedure you can go out for jogging in the morning for a distance every day for a cardiopulmonary exercise and after few days you increase your speed for covering the distance. After certain days you can further increase the speed as well as the distance. This improves the stamina of the body as well as strengthening your heart and lungs.

Weight training:- This training method is one of the famous method for improving and increasing stamina. It is applied with the guidance of a trainer one is new to this method. In this way of improving your stamina weights are used which are increased steadily and slowly. By this training you can increase your stamina while get muscles get toned up and make you more strong.

Swimming:- It is one of the most affective method of increasing the stamina of the body. Swimming makes each and every muscle of the body exercised and gets toned up, and if continued this method with increase in duration or limit, swimming will tremendously improve and increase the stamina.

Increasing the limit of exercises:- Stamina can also be increased and improved by increasing the duration or limit of every exercise we go into, slowly but surely it will increase the stamina.

Hiking and Trekking:- Trekking and Hiking also helps in improving the stamina as it requires lots of power and energy. Trekking and hiking is also effective for improving the balance and agility of the body. It also exercises a lot of muscles in the body which can get strongly built. So if you can find a trekking or a hiking place near by, you should go for trekking on a regular basis.

Yoga:- Nowadays yoga is becoming more popular day by day for staying fit and healthy. In yoga there are certain Aasans which help in body exercising, improving organ health and increasing stamina.

So you can improve and increase your stamina with enjoyable efforts by these simple methods and tips but you always bear in mind that don't push your limits and over do these exercises .Keep doing them till you feel comfortable.

Health insurances, like other forms of insurance, is a form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses. The collective is usually publicly owned or else is organized on a non-profit basis for the members of the pool, though in some countries health insurance pools may also be managed by for-profit companies. It is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial care needs. It may be provided through a government-sponsored social insurance program, or from private insurance companies. It may be purchased on a group basis (e.g., by a firm to cover its employees) or purchased by an individual. In each case, the covered groups or individuals pay a fee, premium, or tax---to help protect themselves from unexpected healthcare expenses. Similar benefits paying for medical expenses may also be provided through social welfare programs funded by the government.

By estimating the overall risk of healthcare expenses, a routine finance structure (such as a monthly premium or annual tax) can be developed, ensuring that money is available to pay for the healthcare benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.

How It Works

A health insurance policy is a contract between an insurance company and an individual or his sponsor (e.g. an employer). The contract can be renewable annually or monthly. The type and amount of health care costs that will be covered by the health insurance company are specified in advance, in the member contract or "Evidence of Coverage" booklet. The individual insured person's obligations may take several forms:

Premium: The amount the policy-holder or his sponsor (e.g. an employer) pays to the health plan each month to purchase health coverage.

Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor's visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care.

Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $45 co-payment for a doctor's visit, or to obtain a prescription. A co-payment must be paid each time a particular service is obtained.

Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.

Exclusions: Not all services are covered. The insured person is generally expected to pay the full cost of non-covered services out of their own pocket.

Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.

Out-of-pocket maximums: Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and the health company pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.

Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.

In-Network Provider: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.

Prior Authorization: A certification or authorization that an insurer provides prior to medical service occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it matches what was authorized. Many smaller, routine services do not require authorization.

Explanation of Benefits: A document sent by an insurer to a patient explaining what was covered for a medical service, and how they arrived at the payment amount and patient responsibility amount.

Prescription drug plans are a form of insurance offered through some employer benefit plans in the U.S., where the patient pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan.

Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay. The insurance company pays out of network providers according to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider's standard charges. It generally costs the patient less to use an in-network provider.

Source: Wikipedia