Affichage des articles dont le libellé est Evaluate. Afficher tous les articles
Affichage des articles dont le libellé est Evaluate. Afficher tous les articles

dimanche 29 septembre 2013

Evaluate Your Health and Fat Patterns

Evaluate Your Health and Fat Patterns | Health tips img#wpstats{display:none}Health tips empower your best health and live longer!Home pageDiet & FitnessDietDiet tipsFitnessCardioStrengthYogaDiseasesAlphabeticalAids & HivAllergiesBack PainCancerBreast CancerCervical CancerColon CancerLung cancerProstate CancerCholesterolCold & FluDiabetesHeart DiseaseOsteoporosisFamily HealthChild’s healthMen’s healthWomen’s healthNutritionEat rightRecipesMind and BodyBeautySkin careMindAnxietyDepressionHeadachesPersonalityStressWellnessAgingChild’s healthOral careQuit SmokingMen’s healthSleepWomen’s healthMenopause Your Are Here: Health tips ? Diet & Fitness ? Diet ? Fat burn ? Evaluate Your Health and Fat PatternsEvaluate Your Health and Fat PatternsSeptember 26, 2013 - Jean-Paul Marat + - Fat burn - Tagged: BMI, body fat percentage, body mass index, High-density lipoprotein, Low-density lipoprotein, Muscle, obesity, Weighing scale - no comments(adsbygoogle = window.adsbygoogle || []).push({});
Usually being overfat is something that creeps up gradually with age. One of the last things my team and I always do when we evaluate people who enroll in my Fat-Burning tips is take front-, back-, and side-view “before” photographs so that they can really and truly see what they look like and compare these images with their “after” photos. For most, it is a great surprise to suddenly perceive an overweight person on the film because our inner image of ourselves is usually much thinner, leaner, and younger. I have had clients express shock or even burst into tears when they really looked at these pictures. It is truly as if they were seeing themselves for the first time.
While I find it important to help my clients establish an accurate per­ception of their outward appearance, it is also important to help them establish an accurate perception of their internal health. Knowing that you are bulging over the belt of your pants or your skirt does not tell you any­thing about your cholesterol, triglycerides, or percentage of body fat ver­sus lean muscle.
Are You as Healthy as You Look?
I often work with men and women who everyone else would consider healthy because they are elite athletes at the height of their profession, and they are paid huge salaries to play their sport. A highly respected NFL lineman, 6 feet 5 inches, came into my program weighing 328 pounds. He had a BMI greater than 36, a 51.7-inch waist, and a total cholesterol of 227. His HDL was low at 29. Since his triglycerides were 467, we couldn’t get an accurate reading on his LDL because, as my doctors tell me, exces­sively high triglycerides almost always skew the LDL reading. His glucose was 120, just 6 points below the diabetic classification. The real shocker was his blood pressure, which was 190/120. We found out that he had stopped taking his blood pressure medicine and failed to tell either his trainer or the team doctor. If he had not come to us for help, it is highly likely that in the near future he would have had a stroke right there on the field. And this man was considered to be a world-class athlete.
The appearance of health is not always the same as true health. Some­times the way a person looks can be very deceiving, especially in the case of someone who is fairly slim and exercises regularly. I once worked with a thirty-three-year-old world champion athlete. With a body fat of 9 per­cent, this man was certainly not overweight. But when we evaluated him, we found that he had an abnormal stress test, an elevated total cholesterol of 260, and an LDL of 190. When we took his family history, we discov­ered that there was a lot of heart disease present. If this man had continued to ignore his cholesterol for ten more years, he would have ended up with damage to his arteries, resulting in cardiovascular problems.
Learn How to Accurately Evaluate Your Health
With all of the confusing information in the media and in diet and fitness books these days, people really do not have a good idea of what constitutes a healthy body. Our parents never taught us—they didn’t grow up eating processed foods, living a physically inactive lifestyle, and facing the kinds of daily stressors that we face—and the great majority of us do not have wellness programs in our workplace. Nor do we understand how to monitor our health and risk factors as we grow older. Somehow we have developed the misconception that staying vigorous and healthy is an intu­itive process.
That is why it is so important to have the proper tools for health evalu­ation. During my thirty years of experience with thousands of clients as a performance enhancement and fitness consultant, I have come to clearly understand the definitions of good health and poor health because I have seen these scenarios played out so many times. And the dozens of top med­ical professionals with whom I have worked in my Fat-Burning tips and the Ochsner Clinic Foundation have helped to acquaint me intimately with the science behind state-of-the-art health care and health evaluation.
The Fat-Burning tips questionnaires presented on this website are simple and straightforward guides to help you understand how overfat you are and how healthy you really are, both inside and out. Some people will find that they might not have to lose an enormous amount of weight, but they will need to lower their cholesterol, raise their HDL, reduce their overall body fat, develop healthy eating habits, and/or learn how to exercise properly. Others will discover that they are seriously overfat and will face life-threatening health risks such as heart disease and type 2 diabetes unless they change their lifestyle.
The Fat-Burning tips Self-Evaluation in this post covers two main areas:
How you measure up. This includes common indicators of risk fac­tors such as high scale weight, body fat percentage, BMI, and waist measurement.Your overall body measurements, which will help you see where you are holding your fat. These measurements will be retaken at the end of the basic Fat-Burning tips (and every four weeks after that if you continue with Modules 2 and 3) to help you quantify how much body fat you are actually losing and how hard and lean you are becoming.
You are only as strong as your weakest link. But be assured that the lifestyle, nutritional, and exercise programs offered on this website have worked for thousands of overfat men and women.
I suggest that you make a photocopy of the Fat-Burning tips Self-Evaluation Questionnaire so that you can keep a record of your progress. As you work your way through each section of this post, you will learn how to fill in the blanks. I describe why each of these criteria is an important indicator of overall health and how you can use them to build an accurate picture of how you measure up. In subsequent posts I will help you to evaluate your lipid profile and glucose levels, your level of human growth hormone and your thyroid function, and your stress levels.
The Fat-Burning tips Self-Evaluation Questionnaire
Age ____
Gender ____
Height ____
Scale Weight ____ lb.
% Body Fat ____
Fat ____ lb.
Lean Muscle ____ lb.
Body Mass Index ____
Overall Body Measurements:
Arm ____ in.
Forearm ____ in.
Chest ____ in.
Waist ____ in.
Abdomen ____ in.
Hips ____ in.
Thigh ____ in.
Calf ____ in.
Waist-to-Hip Ratio ____
How Do You Measure Up? Learn the Six Basic Health CriteriaHealth Criterion #1: Scale Weight
Weight gain has become a problem of epic proportions in our society. In 1905, only 5 percent of the population was obese, but that figure has been growing at an alarming rate. In the last decade alone, obesity has risen 8 percent. About 97 million people over age twenty—that is, 60 percent­ are either overweight or obese. Of that number, 12.5 million are severely overweight, and 2 million are morbidly obese. These people are at great risk for life-threatening health conditions such as heart disease, stroke, diabetes, and some types of cancer.
You need to know your scale weight to complete the Fat-Burning tips Self-Evaluation Questionnaire. To get an accurate scale weight that you can track over the twelve weeks of this program, it is important to have access to a fairly good scale—either a good bathroom scale or one at your gym. Ideally, you should weigh yourself nude first thing in the morning before you have eaten breakfast. If you weigh your­self with clothing at the gym or at a doctor’s office, you might deduct 1 or 2 pounds for shoes and clothes.
Health Criterion #2: Body Fat
Your scale weight does not tell the whole story—far from it. A bodybuilder might weigh 250 pounds on the scale but have a total body fat of 8 percent. Someone might not be that much overweight according to the scale but may carry an unhealthy amount of body fat for his or her age. Men or women with big bones and a large frame will naturally weigh more than those with small bones and a delicate frame. To really understand how overfat you are, you need to calculate how many of your scale pounds rep­resent body fat. This chart defines healthy and unhealthy body fat percent­ages for men and women:
BODY FAT PERCENTAGE
LevelMenWomenAthletic<11 data-blogger-escaped-air="" data-blogger-escaped-bese22="" data-blogger-escaped-fat18="" data-blogger-escaped-lean11="" data-blogger-escaped-ood="" data-blogger-escaped-p="" data-blogger-escaped-verage15="">It used to be that men and women past age fifty were expected to be out of shape and carrying a larger amount of body fat. Some charts in doc­tors’ offices or magazine articles will even allow greater amounts of “healthy” body fat for men and women who are middle-aged or older. I do not really follow those guidelines because experience has shown me that people in their fifties, sixties, or even seventies do not have less of a capac­ity to lose body fat and build lean muscle than younger people. An article in the Canadian Journal of Applied Physiology reports that studies on sar­copenia (loss of lean muscle mass with aging) unequivocally show that older muscle tissue has the same, if not an even greater capacity, to respond to a vigorous bout of resistance exercise than younger muscle does.
Age is not the issue; metabolic fitness is the issue—that is, how effi­ciently your metabolism burns fat, which is based on how much lean muscle you have, what and how often you eat, how much and at what intensity you exercise, and how balanced your body’s hormonal systems are, especially those hormones that regulate the burning of nutrients as fuel or cause their storage as fat.
Three Techniques for Measuring Body Fat
There are several popular methods for measuring body fat. Following are three of the most popular:
1.    Hydrostatic weighing, in which a person’s mass is measured both in and out of a tank of water, is considered to be the gold standard for measuring body fat. This test is based on the assumption that lean tissue is denser than fat—that is, lean tissue will sink and fat tissue will float. This test costs between $100 and $150 and can be performed at your local health club, hospital, university, or well­ness center. Some mobile units may even charge as little as $45 for this service.2.    Skin fold measurement with a caliper involves measuring subcuta­neous (under-the-skin) fat with a caliper at certain points on the body. Since this test has been around for quite some time, you can get it done at YMCAs, health clubs, dietitians’ offices, physical therapy centers, and universities.3.    Anthropometric measurement is a test you can do at home. This test is based on the assumption that fat is distributed at certain sites on the body such as the neck, wrist, and waistline. Muscle tissue is usually found at sites such as the biceps, forearm, and calf.
The following two anthropometric tests—one for males and one for females—will help you ascertain your percentage of body fat. These for­mulas are from Philip L. Goglia’s book, Turn Up the Heat: Unlock the Fat-Burning Power of Your Metabolism, and have a plus or minus error rate of 5 percent. All you need is a cloth tape measure and a calculator.
AT-HOME BODY FAT TEST FOR MALES
Step 1: Taking Measurements
Height in inches ____Hips in inches ____Waist in inches ____Weight in pounds ____
Step 2: Determining Your Percentage of Body Fat
Multiply your hips (in.) ____ x 1.4 = ____ minus 2 = ____ (A)Multiply your waist (in.) ____ x 0.72 = ____ minus 4 = ____ (B)Add A plus B = ____ (C)Multiply your height (in.) ____ x 0.61 = ____ (D)Subtract D from C, then subtract 10 more: (C – D) – 10 = ____ % fat
Your answer will be your approximate body fat percentage if you are a male.
AT-HOME BODY FAT TEST FOR FEMALES
Step 1: Taking Measurements
Height in inches ____Hips in inches ____Waist in inches ____Weight in pounds ____
Step 2: Determining Your Percentage of Body Fat
Multiply your hips (in.) ____ x 1.4 = ____ minus 1 = ____ (A)Multiply your waist (in.) ____ x 0.72 = ____ minus 2 = ____ (B)Add A plus B = ____ (C)Multiply your height (in.) ____ x 0.61 = ____ (D)Subtract D from C, then subtract 10 more: (C – D) – 10 = ____ % fat
Your answer will be your approximate body fat percentage if you are a female.
You do not necessarily have to get your body fat tested to know that your body composition is improving. If you have been exercising and eating properly and your clothes begin to feel looser, if you find yourself taking in your belt a notch or two, or if you observe increased strength and muscularity, you will know that you are losing fat and gaining lean muscle.
Calculate Pounds of Body Fat and Lean Muscle
The final step is to take your total weight and calculate how many pounds of fat you carry and how many pounds of lean muscle. Use the following two formulas:
Total weight (lb.) × percent body fat = total pounds of fat
Total weight – total pounds of fat = total pounds of lean muscle
For example, if you are a woman weighing 200 pounds and you find that you have 35 percent body fat, calculate the number of pounds of fat you carry using the following formula:
200 lb. × .35 (% body fat) = 70 pounds of fat
To calculate your pounds of lean muscle, use the following formula: 200 lb. – 70 lb. of fat = 130 pounds of lean muscle
Health Criterion #3: All-over Body Measurements
As you work through this Fat-Burning tips, your all-over body measurements, which I will ask you to take every four weeks, will be another indication that you are losing fat and building lean muscle. You will become leaner and trimmer.
To take accurate all-over body measurements, follow these instruc­tions. I have provided drawings for both men and women to help you to accurately measure each area of your body.
Arm: With your arm to the side of your body, measure the circumfer­ence midway between the shoulder and the elbow.
Forearm: With your arm hanging downward and slightly away from your trunk and your palm facing forward, measure at the maximum forearm circumference between the wrist and the elbow.
Chest: For a woman, measure across the widest part of the chest marked by the nipples. (For older women with very large hanging breasts, this might be slightly higher. See illustration for guidance.)

For a man, measure the widest area of the chest across the nipples.
Waist: Measure at the narrowest part of the torso, above the belly button and below the rib cage.
Abdomen: Measure at the level of the belly button.
Hips: Measure at the maximum circumference of the hips or buttocks region, whichever is larger.
Thigh: With your legs slightly apart, measure at the maximum circumference of the thigh.
Calf: Measure at the maximum circumference between the knee and the ankle.
Health Criterion #4: Why Waist Circumference Is So Important
In both men and women, one of the most important and accurate indicators of obesity, the potential for cardiac disease, and other health risks is the circum­ference of the waist. This is because an increased measurement in the waist always indicates an increase in abdominal fat (and the ratio of body fat–to– lean muscle in general). For a woman, who naturally carries her fat in her hips and thighs, an increased waist measurement indicates a reverse fat pattern.
Since fat is three times the size of lean muscle tissue, it is possible for scale weight and BMI to remain the same with aging yet for the waist to increase as lean muscle is lost and fat storage is increased through inactiv­ity and poor nutritional habits. One doctor I know had a 7-inch increase in his waistline after retirement even though his scale weight did not change.
In the book It Can Break Your Heart, Dr. J. Pervis Milnor III and coau­thors write that a waistline greater than 35 inches in a woman and 40 inches in a man increases the risk for developing higher cholesterol levels, which lead to coronary disease, and type 2 diabetes. According to the National Heart, Lung and Blood Institute, a man whose waistline is 42 inches or greater is more likely to have erectile dysfunction than his leaner counterparts.
Of course, a waist measurement of 35 inches in women or 40 inches in men is not always an absolute indicator of health risks. You should take into consideration factors such as height, body type, and bone structure. A 35-inch waistline on a woman who is 5 feet 11 inches tall with a large frame would represent less of a health risk than the same waist circumfer­ence on a woman who is 5 feet 2 inches tall with a small frame.
Health Criterion #5: Calculate Your Waist-to-Hip Ratio
The value of the waist-to-hip ratio is that it helps to give you a more accu­rate idea of where you carry your fat. When fat is stored around and above the waist, it results in a higher risk for diabetes, heart disease, and some types of cancers. The person with upper body fat distribution (the apple shape) loses fat more quickly than the person with lower body fat distribu­tion (the pear shape), but a smaller amount of fat stored above the waist is more dangerous than a larger amount of fat stored below the waist.
To get this ratio, measure your waist at its narrowest circumference and your hips at their widest. Then divide your waist measurement by your hip measurement. For example, if you have a waist of 30 inches and a hip measurement of 42 inches, your hip-to-waist ratio is 0.71.
My waist measurement is ____. My hip measurement is ____. My waist-to-hip ratio is ____.
RANGE OF WAIST-TO-HIP RATIOS
Excellent         Good         Average          High        Extreme
Male<0 data-blogger-escaped-.85="" data-blogger-escaped-p="">0.85–0.90.91–0.950.96–1.0>1.0Female<0 data-blogger-escaped-.75="" data-blogger-escaped-p="">0.75–0.80.81–0.850.86–0.9>0.9
Keep in mind that this measurement does not tell you anything about your total body weight or body composition. It just gives you an indication of where your excess fat is located and therefore your health risk relative to fat deposition.
Women must especially watch this ratio during and following menopause when hormonal fluctuations, poor nutrition, and lack of activ­ity can result in abdominal weight gain, leading to a reverse fat pattern. The National Cancer Institute has shown that a woman with a lower than normal waist-to-hip ratio is eight times more likely to get cervical cancer than a woman with a normal ratio.
Used alone, this ratio can be deceiving in some people. As we have seen, once abdominal obesity sets in, especially as a reverse fat pattern, the waist-to-hip ratio can become skewed because at this point both genders are gaining weight above and below the waist. So as the waistline goes up, the hips go up, often in tandem. This is just another reason why no single method of measuring fat storage is infallible. It is important to look at the bigger picture when evaluating your health and fat patterns.
Health Criterion #6: Body Mass Index
The Body Mass Index or BMI is another important tool to help ascertain how overfat you are. Sometimes the BMI can be misleading. For example, a 240-pound bodybuilder who is 5 feet 11 inches would have a BMI of 34, which would appear to put him in the very highest risk category. But if that same person has only 8 percent body fat, this changes the entire story.
However, for most readers of this website, a high BMI will be a red flag predicting many health risks. For example, a recent study published by the American College of Sports Medicine has shown a direct correlation between a high BMI and increased levels of C-reactive protein. High CRP is an accurate indicator of inflammation in the body, which increases the risk of a first cardiac event (heart attack), even after adjustments have been made for risk factors such as age, smoking, and body weight. Exercise and increased levels of physical activity, which result in weight loss and low­ered BMI, have been shown to reduce a person’s level of CRP. So while the BMI is not an infallible standard by which to measure how fat you are, taken together with other factors it is a useful tool for helping to create an accurate health profile and can serve as an early warning system for heart disease.
BMI is defined as your weight in kilograms divided by your height in meters squared. To save you the trouble of converting pounds to kilograms and inches to meters, I have done the math for you. Simply look up your BMI in the chart provided. Your height can be found in the left-hand col­umn and your weight (in pounds) runs along the top of the chart. Your BMI is where both points intersect. Because people between 5 feet and 5 feet 2 inches tall generally have a lighter frame, we have included a different chart for them.
Interpret Your BMI
If your BMI is below 20. Unless you are an athlete with a very high ratio of lean muscle–to–body fat, a BMI this low might mean that you are too thin and are possibly compromising your immune system.If your BMI is between 20 and 22. This range is associated with liv­ing the longest and having the lowest incidence of serious illness.If your BMI is between 23 and 25. These numbers are still within the acceptable range and are associated with good health.If your BMI is between 26 and 30. Now you are entering the zone where there are serious health risks. A BMI this high puts you at risk for developing heart disease, stroke, type 2 diabetes, and some kinds of cancers. You should definitely lower your weight through diet and exercise.If your BMI is over 30. This is the worst-case scenario where you are definitely putting yourself at risk for all of the diseases mentioned above. It is imperative that you begin to lose weight and exercise.BODY MASS INDEX1001101201301401501601701801902002102202302402502602702805’0?202224262729313335373941434547495153555’1?192123252728303234373941434547495153555’2?192022242628293133353637394143444648501201301401501601701801902002102202302402502602702802903005’3?212325272830323436373941434446485051535’4?212224262829313334363840414345464850525’5?202223252728303233353738404243454748505’6?192123242627293132343637394042444547495’7?192022242527283031333536383941424446475’8?182021232426272930323435373840414344465’9?181921222425272830313334363738404143445’10?171920222324262729303233353637394042435’11?171820212224252728293132343536383941426’0?161819202223242627293031333435373839416’1?161719202122242526282930323334363738406’2?151718192122232426272830313233353637396’3?151618192021232425262829303133343536386’4?151617182021222324262728293032333435376’5?141517181920212324252627293031323334366’6?14151617192021222324252728293031323435
According to a study done in the New England Journal of Medicine, having a BMI over 25 may cause your life span to decrease significantly. If your BMI is higher than 30, your life span may decrease even more sharply. Studies show that 59 percent of American men have a BMI over 25 and almost as many women. For those who have a BMI over 35, health care costs are likely to be more than twice those of individuals with a BMI between 20 and 25. Treatment of diabetes, hypertension, and cardiovascu­lar disease count for much of this spending.
Compare Your BMI and Waist Measurement
As we have seen, BMI can be skewed by factors such as frame size and the percentage of lean muscle that you carry on your frame. One tool that I have found useful in deciding whether your BMI is in the healthy range is the comparison between BMI and waist measurement. Here is a chart that compares ranges of BMI with waist measurements in men and women.
RELATIONSHIP BETWEEN BMI AND WAIST MEASUREMENTSHealth CategoryBMIMen’s Waist (in.)Women’s Waist (in.)Normal18.5–24.934.3–38.531.1–36.1Overweight25–29.938.6–42.836.2–40.4Obese I30–34.942.9–48.740.5–45.2Obese II>-35>-48.8>-45.3
If both your BMI and your waistline fall into the same category, you can be fairly certain of the health classification.
Bo Walker: The Inches Melted Off and the Numbers Went Down
Let’s take a look at a client of mine who completed the Fat-Burning tips as part of a makeover I did for Let’s Live magazine: a forty-year-old radio personality named Bo Walker. When Bo first came into my program, he carried 250 pounds on his 5-foot 10-inch frame, had a body fat percentage of 34.5, a BMI of 35.85, a waist measurement of 48, and a waist-to-hip ratio of 1.0. As you can see, all of these figures put him into the very highest risk category.
Bo was concerned about his health because he and his wife had a young child. “I knew I was headed in the wrong direction. My father had died at a very early age, fifty-nine years old, from a heart attack and com­plications with diabetes. I knew that if I continued on this path and stayed in the 250 weight range—or worse—I was probably headed for the same fate. I wanted my kid to know who I am and I wanted to live long enough to enjoy my life with my wife.” Bo was also facing the stress of having just lost his job.
Over the course of twelve weeks, Bo saw dramatic changes in his overall body measurements. I have included some of his statistics to demonstrate his total transformation.
BO WALKER’S MEASUREMENTSDate5/1/20035/17/20035/31/20036/26/20037/12/20038/1/2003% Body Fat34.5027.8024.8023.2023.2020.80BMI35.8534.733.9133.4133.4132.4Weight250242236.5233233226Girths: Left/RightBicep–Left151413.751413.7513.5Bicep–Right141413.7513.7513.7513.75Forearm–Left11.7511.75121211.75Forearm–Right1212121212Thigh–Left27272525.525.523.5Thigh–Right27262525.252523.75Calf–Left1615.515.2515.2515Calf–Right16.516.516.2516.2516Hips46.547.545.754544.7542.75Waist4847.546.545.754543.75Shoulders5452.7552.55352Chest494947.7546.546.545.25
As you can see, Bo lost 24 pounds and his body fat dropped 13.7 points, from 34.5 percent to 20.8 percent. If we plug this into the formula I gave you, he started out carrying 86.5 pounds of fat and 163.5 pounds of lean muscle. At the end of 12 weeks, he was carrying only 47 pounds of fat and 179 pounds of lean muscle—a dramatic change. If you interpret these figures from a slightly different perspective, in terms of conversion from fat to muscle, Bo lost 39.5 pounds of fat and gained 15.5 pounds of lean muscle. Quite impressive!
All of Bo’s other measurements decreased as well. His BMI dropped from 35.85 to 32.4 and his waistline shrunk from 48 to 43.75, a loss of 4.25 inches. His hip measurement dropped from 46.5 to 42.75, a loss of 3.75 inches, resulting in a waist-to-hip ratio of 1.0, which is identical to his for­mer ratio. This is a perfect example of the shortcomings of looking only at this measurement, as discussed earlier in this post. As I explained, when taken alone, the waist-to-hip ratio is not a reliable indicator of health risk. When a man has developed a reverse fat pattern, as Bo did, at first the waist and hips will shrink in tandem with one another as the body is normalizing.
In extreme cases of the reverse fat pattern, such as Douglas Daniels, the waist-to-hip ratio will actually increase before it goes down. The reason is that the hips are not a normal place for a man to store fat. The rule is that the last fat gained is the first to be lost.
Bo still has a distance to go, but he looks and feels better than he has in years, which is a strong motivator for him to continue with the plan. Your body could also look great after only four weeks on the Fat-Burning tips.
Share this Health tip:Share on Tumblr Pin ItMorePocketPrintEmail
You may also like:
The Classic Female Fat Pattern There are many nicknames for female fat. We downplay it by using cute or nonoffensive labels such as saddlebags, chunky body, looking healthy, or dimples...The Classic Male Fat Pattern Fat in men has been christened with a variety of names. We call it the beer belly, the spare tire, or simply the gut. We...Health risks of being overweight – the difference between “calories in” and “calories out” The contradictions are endless, and the real message is that there’s no single tactic that makes losing weight easy for everyone. But that doesn’t mean...Hypertriglyceridemia– Causes, Symptoms, Diagnosis, Treatment and Ongoing care Hypertriglyceridemia is a common form of dyslipidemia characterized by an excess fasting plasma concentration of triglycerides (TGs)....Oxidative Stress and Cardiovascular Disease This post will focus on the potential roles of fat-soluble nutrients and fat-soluble antioxidants in preventing cardiovascular disease (CVD). Two fat-soluble vitamins will be discussed...Plant Sterols and Cholesterol Reduction 1 Introduction: cholesterol as a risk factor in cardiovascular disease An increased blood cholesterol concentration is an established modifiable risk factor for coronary heart disease...Learn the Health Risks Associated with Excess Body Fat Learn the Difference between Male and Female Fat Patterns Where you carry your weight has serious health ramifications. The most dangerous type of weight is...Dietary control of conventional risk factors: cholesterol, blood pressure, type 2 diabetes and obesity Diet and blood cholesterol Cholesterol is a determinant of CHD mortality, and its blood level is at least partly regulated by diet. However, few epidemiological...Dietary strategies to prevent the development of heart disease For several decades, the prevention of CHD (including the prevention of ischaemic recurrence after a prior AMI) has focused on the reduction of the traditional...Blood Cholesterol (HDL, LDL, & Triglycerides) Your blood cholesterol level can be determined through a simple blood test. Some cholesterol tests give you an overall cholesterol level, and the best tests...Cholesterol and Brain Health – How to prevent a Stroke Cholesterol: Good and Bad There’s plenty of evidence that blood cholesterol is heavily involved in atherosclerosis that clogs and stiffens the blood conduits of the...Atherosclerosis – Causes, Symptoms, Diagnosis, Treatment and Ongoing care Basics Description Atherosclerosis is the common form of arteriosclerosis in which deposits of yellowish plaques (atheromas) containing cholesterol, lipoid material, and lipophages are formed within...Hypercholesterolemia– Causes, Symptoms, Diagnosis, Treatment and Ongoing care Serum cholesterol >200 mg/dL (5.18 mmol/L):Due mainly to lifestyle habits in Westernized countries; however, genetic and secondary causes should be considered....Brain-damaging Triglycerides can disturb Mood You may know that high triglycerides, a type of fat in your blood, can be hazardous to your heart. But it’s not widely known that...How to manipulate your appetite hormone and why sitting at work counteract my fitness gains In recent years, scientists have identified a set of hormones that control eating behavior. A German study in 2008 showed that even a single night...Conclusion and future trends in cardiovascular disease prevention On the basis of these considerations we can conclude that there is compelling evidence that enhanced oxidative stress is detectable in patients with classic risk...The role of fat replacers in reducing cardiovascular disease There is a general consensus that a high-fat diet is linked with the development of obesity, high serum cholesterol level, and cardiovascular disease. In addition,...Estrogen, Toxins, Good Fat and Bad Fat for Breast health Fat Fat intake appears to be a significant risk factor for breast cancer. One of the first hints came in the 1950s, when researchers found that...14 January Healthy day tip – The “Write” Way to Eat Smart A bite here, a nibble there, a sip here, another taste there. How much did you eat today? Want to get a better picture of your day-to-day...Exercise’s effect on you People who exercise regularly have fewer and milder colds—at least that’s what we tend to hear. Exercise enthusiasts always brag that they’re sick less than... Leave a Reply Cancel replyYour email address will not be published. Required fields are marked *Name *E-mail *WebsiteComment You may use these HTML tags and attributes:
Notify me of follow-up comments by email. Notify me of new posts by email. Interact with US: Follow us on Twitter.Subscribe RSS Feeds Subscribe to Health tips by EmailRead more great tips about:
Home Design

House and Home Tips

Smart travel

Tips for ITs
Top Posts & PagesAbscess, Psoas - Diagnosis, Treatment and Ongoing careHow long does it take to get in shape?Skin care solutions for Wounds, Scars or Stretch MarksL-Carnosine - Anti-aging supplementEustachian Tube Dysfunction – Causes, Symptoms, Diagnosis, Treatment and Ongoing careChlamydia Pneumoniae – Causes, Symptoms, Diagnosis, Treatment and Ongoing careIdiopathic Hypertrophic Subaortic Stenosis (IHSS)Periorbital cellulitisPneumonia or when a cold turns serious: Symptoms, Diagnosis, Treatment and Complications of Mycoplasma Pneumonia 6 Tips That Will Make Your Libido Soar - Boosting diet and Herbal remedies to restore low Sex drive(adsbygoogle = window.adsbygoogle || []).push({}); Copyright:All content are property and copyright of their owners.
Copyright © health.tipsdiscover.com

rel=author">Jean-Paul Marat
CategoriesSelect Category365 Healthy days!!!Diet & Fitness   Diet      Diet tips      Fat burn      Mediterranean   Fitness      Aerobic      Cardio      Strength      YogaDiseases & Conditions   Aids & Hiv   Allergies   Alphabetical      A      B      C      D      E      F      G      H      I      K      L      M      N      O      P      R      S      T      U      V      W      Z   Anatomy      Brain      Breast      Cardiovascular      Colon      Ear      Endocrine      Eye      Genetics      Intestinal      Kidney      Liver      Lungs      Mental      Musculoskeletal      Neurological      Periodontal      Sexually transmitted disease      Skin      Stomach      Tongue   Anxiety   Back Pain   Bacteria   Cancer      Breast Cancer      Cervical Cancer      Colon Cancer      Common cancer         Melanoma         The Leukemias      Laryngeal Cancer      Lung cancer      Prostate Cancer      Therapy   Cholesterol   Cold & Flu   Depression   Diabetes   Headaches   Heart Disease   Menopause   Natural Remedies   Osteoporosis   Quit Smoking   Stroke   VirusLegal   Health Insurance   Life careMind and Body   Beauty      Hair      Skin care   Mind      Memory   personalityNutrition   Beans   Detoxification   Eat right   Fruits      Apple      Apricot      Banana      Cherrie      Grape      Grapefruit      Melon      Nectarines      Peaches      Pears      Plums   Grains   Legumes   Recipes      Indonesian      Lamb      Pasta dish      Skillet      Thai   VegetablesWellness   Aging   Child’s health   Men’s health   Oral care   Sleep   Stress   Women’s health
Health tips is proud to be powered by WordPressPrivacy Policy

vendredi 13 septembre 2013

How to Evaluate Your Health Insurance Plan Options

This post gives you an understanding of the major fea­tures of each type of plan, such as fee-for-service, HMO, and PPO. As you read, refer often to the Checklist in a later post, about how to choose your new health insurance plan. The Checklist is a tool to help you keep tabs on what fea­tures of health insurance plans are important to you. For details and exact provisions, always read the specific policies, contract, and/or plan document; follow up with questions to your plan administrator and state insurance agency.

To get the most from this post, know the following definitions:

Deductible: The amount of covered charges that you must pay before the insurance company will pay any benefits.Coinsurance: The set percentage of covered charges that you must pay after you have met (paid) the deductible.Copayment: A fixed fee that you must pay each time you use a specified service. Sometimes called an encounter fee.

Note: Some discussions of health insurance use the terms copayment and coinsurance interchangeably. This website uses copayment as a fixed dollar amount and coinsurance as a fixed percentage of a fee.

Most people in the United States are covered by a health insurance plan that their employer or a family member’s employer offers. Often the employer pays a portion or all of the insurance’s cost. Many other people are members of groups — such as unions, professional associations, religious or veterans’ organizations, fraternal groups, and organizations of entrepreneurs or small businesses — that have contracts with insurance companies to provide health care coverage.

To qualify for a group plan, you must meet the sponsoring organization’s or association’s eligibility requirements. For example, you may have to work a minimum number of hours weekly to participate in the plan.

Enrolling in a group plan has several advantages. You may be able to choose from among several plans that your employer offers. The cost of premiums is usually lower because of the large number of participants. If you enroll when you are first eligible to do so — such as when you start a job, when you experience a life status change (as defined by the IRS), or during an open enrollment period (an interval during which members of a plan can change health plans or coverage) ­ neither you nor your spouse or dependents have to provide evidence of insurability. In a group plan, you can’t be excluded or charged a pre­mium that is higher than that of the rest of the group.

When you select a plan, whether individual or group, avoid surprises: Carefully read the policy, contract, and/or plan doc­ument and make sure that you understand it. Before you pur­chase the plan, confirm that it includes a free-look clause. Many insurance companies include this clause, which gives you at least ten days to review the policy after you receive it. If you choose to return the policy, the company will refund your premium.

You can buy individual health insurance plans from an insur­ance agent or broker or directly from the insurance company. Start with the agent or broker who handles your car, life, homeowner’s, or renter’s insurance. Ask friends, neighbors, and work associates about their agents. Check out at least three agents. Call insurance companies, HMOs, and PPOs (see “Managed Care Plans,” later in this post) directly. Use the Yellow Pages in your telephone directory as a source for names of insurance companies. Look under the heading “Insurance” for entries that mention health insurance. Search the Internet or check out insurance company Web sites. If you don’t have a specific type of health plan in mind, ask the company representative to explain the types and cost of plans the company sells.

When you leave a job, most group plans allow you to con­tinue your coverage with the same benefits under COBRA (discussed in detail later in this post). You may also be able to convert your group plan to an individual plan, which may offer benefits that differ from the group benefits. The advan­tage of this option is continuity of coverage. You don’t have to repeat the enrollment process, so you won’t have to qual­ify or worry about a waiting period based on a pre-existing condition (a medical condition that is actively being treated during the application process).

When you apply for coverage in an individual plan, be pre­pared to answer many questions in detail about your med­ical history and the history of family members you want to cover. You may have to take a physical and/or release med­ical records to the insurance company. Depending on your (or a dependent’s) health condition, an insurance company may write a plan that excludes a pre-existing condition, or the company may charge a higher premium for the policy.

Don’t be surprised at the much higher price and lower ben­efits (including prescription benefits) of an individual plan — you don’t have the advantage of group clout. How­ever, in an effort to keep costs down, you may be able to work with the insurance company to customize a plan that fits your specific needs. For example, you can choose a higher deductible to lower your premium costs.

With a noncancellable policy, your coverage continues as long as you keep paying the monthly premium. Under this type of policy, the insurance company can increase your premi­ums but can’t cancel your coverage. Another type of policy is a conditionally renewable policy. This qualification allows an insurance company to cancel all policies similar to yours but protects your policy from being individually selected for termination.

In some cases, insurers may consider you a high risk, perhaps because of a pre-existing condition. If you can’t get health insurance anywhere, you may be eligible for your state’s high-risk pool.

High-risk pools make health insurance available to everyone, regardless of their health. Costs are high, coverage may be minimal, and you may have to pay higher deductibles and coinsurance, so consider this type of coverage only after you exhaust other possibilities. The structure of high-risk pools varies from state to state, so be sure to check with your state’s insurance department for specific information. If you want to insure dependents who aren’t high risk, finding another health insur­ance plan is much more economical.

Health insurance in the United States, Health maintenance organization, Managed care, insurance companies, health insurance plan, health insurance plans, health care coverage,

Fee-for-service health insurance plans (also known as indem­nity plans) are what people think of as traditional health plans: Insurance companies pay the fees for covered services, gen­erally after you pay a deductible. This type of plan allows you to choose any doctor, and you can change doctors at any time. You can go to any hospital, anywhere in the country. This type of plan is more common in individual policies than in group policies. Fee-for-service policies usually offer com­prehensive coverage, a combination of basic coverage and major medical coverage.

Basic coverage includes benefits for expenses you incur dur­ing a hospital stay, such as

Hospitalization, including room and board and regu­lar nursing services during the hospital stayOther hospital charges, such as inpatient X rays, lab tests, anesthesia, supplies, and medicationsSurgical expenses, including surgeons’ charges and other charges for surgery both inpatient and outpatientPhysician expenses, including visits to the doctor’s office and visits the doctor makes to the patient at home or in the hospital

Note: This plan may not cover preventive care, such as check­ups, so you may have to pay these expenses yourself.

You usually receive benefits during a hospital stay for a set number of days; the plan also has a maximum amount that it pays per day. In both cases, you’re likely to be responsible for the balance. A plan may pay for extended home care for a short time or not at all. Some plans don’t pay for prescrip­tion expenses.

Some indemnity plans pay a fixed amount to the provider or to the insured person, regardless of the amount charged for the actual expense. Scheduled plans set a maximum amount they pay for each service. These amounts reflect the reason­able and customary — also called usual and customary — fees for such services in the same geographic area in which they are provided. (See a later post for more on reasonable and cus­tomary fees.) You may have to pay the difference in cost ­ in addition to the deductible and coinsurance you’ve already paid — between what your provider charges and the reason­able and customary fee.

Before your treatment, ask your provider to submit a pre­treatment review to the insurance company so that both you and the provider know up front what the insurance company will pay and what your cost will be for the procedure.

Avoid paying the difference in cost between what your provider charges and the reasonable and customary fee by asking your doctor to accept your insurance company’s pay­ment of the reasonable and customary fee as payment in full. If this tactic doesn’t work, consider looking for another doc­tor who will accept this amount.

Major medical coverage, normally purchased along with basic coverage, supplements basic policy benefits by covering the major expenses of a catastrophic illness or injury. Major med­ical coverage comes into play when basic coverage benefit amounts are used up. After the insured pays the deductible (toward the amount for covered charges that basic coverage did not pay), major medical insurance may reimburse expenses for the greater portion of covered charges — the serv­ices that go beyond what a basic plan covers. These charges may include unpaid, covered hospital expenses such as

Hospital room and boardGeneral nursing servicesAdditional hospital servicesSurgeon’s and physician’s feesAnestheticsAnesthesiologists’ servicesCharges incurred out of the hospital such as for home care for extended periods and prescriptions

Policies usually include a maximum level of benefits, too. The maximum amount the insurance company will pay for a par­ticular service or over the lifetime of the policy is called a cap.

Most major medical coverage includes an annual out-of-pocket maximum clause. This provision limits the initial amount (deductible and coinsurance) that you must pay during a set period, usually a year. (Premiums aren’t considered part of the out-of-pocket expenses.) After you pay this amount, the insurer pays 100 percent of all remaining, covered expenses that you incur during that period.

Enrollees in a fee-for-service plan pay a monthly premium. After they meet the deductible, members share subsequent covered expenses with the insurance company. For example, assume that you have a $2,500 deductible. You pay the first $2,500 of covered expenses within a calendar year. You may then share the cost of the next covered expense you incur ­ perhaps the insurance company pays 80 percent of your next covered doctor visit, and you are responsible for the remain­ing 20 percent (your coinsurance).

To receive payment for fee-for-service claims, you most likely have to fill out claim forms and send them to your insurance company. Sometimes your doctor’s staff fills out claim forms for you.

Keep your needs in mind and ask some of the following ques­tions during your investigation of fee-for-service plans:

What is covered?What are the limitations?What is the total annual cost? The total annual deductible? The total annual coinsurance?What is my maximum out-of-pocket expense?What is the lifetime maximum the insurer will pay?

Table 1-1 lists the pros and cons of fee-for-service plans.

Table 1-1: Pros and Cons of Fee-for-Service Plans

Pros                                     Cons

Members can choose            May not cover certain preventive

any doctor or hospital            services, such as routine

and can consult any              physicals, to the extent that

specialist they choose.          HMOs and PPOs do.

You must pay a deductible before receiving benefits.

You must file your own claim forms.

Consider fee-for-service plans if you want to make your own health care choices, even though doing so is more expensive and involves more paperwork. Make sure that the plan you buy offers both basic and major medical coverage.

All managed care plans require you to pay a monthly pre­mium. You or your employer may pay the entire premium, or you may share the cost with your employer.

A health maintenance organization (HMO) is an insurance plan that provides health care by hospitals, doctors, and other medical professionals within a network. Plan members must use the providers within this network for the HMO to cover their medical expenses. In emergencies or when deemed med­ically necessary, HMOs may make exceptions and permit members to use providers outside of the network.

In almost all HMOs, you must have a primary care physi­cian (PCP). Sometimes the plan assigns a PCP to you; some­times you get to choose one. The responsibility of the primary care physician is to keep an eye on your health, pro­vide most of your medical care, and refer you to specialists and other health care professionals when necessary.

If you see a specialist without a referral from your primary care physician, you may have to pay the specialist’s bill yourself.

Many HMOs offer a point-of-service (POS) plan, which entitles members to refer themselves outside the plan and still get some coverage (an advantage to members who may need out-of-network specialists for certain medical conditions).

Not all HMOs offer the same services. Some plans may limit services such as outpatient mental health care. However, HMOs usually provide preventive care as a cost-saving meas­ure. Because HMOs receive a fixed fee for your covered med­ical care, preventing serious, costly illness is in their interest.

Each time you use the services of the HMO, you pay either nothing or a small copayment, perhaps $5 or $10. You don’t have to pay a deductible. Your total medical costs with an HMO are probably lower than with fee-for-service insurance.

Your paperwork is minimal in an HMO. By displaying your membership card at the time of service, you don’t have to fill out claim forms for office visits or hospital stays.

During your research, talk with people who belong to the plan, and ask them about the plan’s pros and cons. Addi­tionally, ask the plan representative questions such as

How large is the pool of primary care physicians I have to choose from?How difficult is changing primary care physicians and spe­cialists? How often can I change primary care physicians?How far in advance do I have to make appointments with the doctor? Is this wait the same regardless of which doctor I use?What are the limitations on services?How do emergency services work?What do I do if I need treatment while I’m out of town or out of the country?

Table 1-2: Pros and Cons of HMOs

Pros                                     Cons

Always covers preventive       You must use providers and

care (physicals and               hospitals within the network.
immunizations).

Has low out-of-pocket          Your primary care physician

costs.                                  must refer you to specialists.

Requires no claim forms.       You receive limited services, such

as for mental conditions and substance abuse services.

No deductibles.                        You may have to wait longer to get

an appointment.

Preferred provider organizations (PPOs) combine features of traditional fee-for-service plans and HMOs. PPOs have con­tracts with doctors, hospitals, and other providers to accept lower fees from the insurer for their services. As with HMOs, members must use the network (preferred) providers for med­ical expenses to be fully covered.

With emergency care in some PPO plans, both the hospital and the attending physician must be in the network in order for the entire service to be considered in-network.In a PPO, members can use (without a doctor’s referral) doc­tors outside of the plan and still receive some coverage. This flexibility lets you keep your current doctor, even one who isn’t part of the PPO’s network.

In a PPO you pay more of the expenses than in an HMO and may have to fill out claim forms.

If you select a primary care physician who is not in the net­work, the cost is higher, which means that you have to meet a deductible and pay coinsurance based on those higher charges. You may also have to pay the difference between what the provider charges and what the plan pays.

PPOs usually cover preventive care. Your copayment is small when you see an in-network doctor, and you don’t have to fill out any claim forms: Just present your membership card.

Carefully study the pros and cons of PPOs, listed in Table 1-3; they incorporate some features of both fee-for-service plans and HMOs.

Table 1-3: Pros and Cons of PPOs

Pros                                     Cons

You sometimes receive        You do have to fill out claim

coverage for preventive        forms if you see a doctor outside

care.                                    the network.

Your out-of-pocket costs You face higher out-of-pocket

are lower within the               costs outside the network; you

network; you generally          usually have to meet a deductible

don’t have to meet a              before the insurance company will

deductible for in-network consider their portion of the out-

services.                              of-network claim.

You can use and refer          You have to deal with more

yourself to doctors               paperwork for approvals.

outside the network.             (Membersof PPOs usually need to

obtain prior approval for inpatient care and certain outpatient procedures, whether or not the providers belong to the network.)

Your costs are paid as          May offer a range or only

fee-for-service but at             limited services.

reduced cost.

By law, group plan administrators must give beneficiaries of a plan written notice of their rights to continue and convert cov­erage. They must do so when the employee’s plan becomes effective, as well as when the plan changes to incorporate a new conversion option. Administrators must also give notice to beneficiaries within a specified number of days of a qualifying event (but the beneficiary — you — must notify the admin­istrator that the qualifying event occurred). This notice should explain the deadline by which beneficiaries must tell the employer whether they plan to continue or convert coverage.

If you miss the deadline for notifying the employer of your intent to continue or convert coverage, you may lose your opportunity to do so.

Most plans require that an employee be enrolled in the group plan for at least three months before beneficiaries can exer­cise their continuation and/or conversion options. A covered spouse who divorces or separates from the employee and cov­ered children no longer eligible for coverage under the employed parent’s plan are the people most likely eligible for the conversion option. They don’t need to submit proof of insurability, and pre-existing conditions — other than exclu­sions that already exist under the group plan — don’t affect conversion, either.

Laws and provisions may vary. Always check your state’s laws and your insurance policy, contract, and/or plan document for eligibility and other requirements governing continuation and conversion of coverage.

Another kind of continued coverage is COBRA, a federal law under which certain workers and their families, previously enrolled in a group plan, may continue the same coverage with almost no change in premiums for a specified period. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires certain companies, such as those with 20 or more employees, to offer health insurance cover­age under COBRA. However, employers not subject to COBRA, such as certain church plans and some union-sponsored plans, often provide some conversion coverage, most likely with fewer benefits than those available under the group plan.

If an insurance carrier terminates a group plan, you can’t con­tinue your coverage or convert it to COBRA.

COBRA can furnish excellent short-term coverage, bridging the gap until you find a new job with health coverage or another policy elsewhere.

You have 60 days from the date of group coverage termina­tion to decide whether to enroll in COBRA. If you choose to do so, the coverage effective date is retroactive to the date the group plan ended. You then have 45 days from the date you choose to enroll in CORBA to make your first premium payment. When your coverage under COBRA runs out, you may convert your plan as described in the previous section.