Step-By-Sep Guide To Choosing A Health Insurance Plan
Good health is the key to a good life. However, when health-related issues do occur they not only have an emotional toll but also a financial one. A well-designed health insurance plan can enable you to at least alleviate the financial pressure associated with healthcare and allow you to seek the best medical care.
Health Insurance policies can seem complicated and be putting them to scrutiny is your best move in choosing a health insurance plan, BUT we have tried to make it easier for you through the following step-by-step guide:
STEP 1: CHECK WITH YOUR EMPLOYER
If you are an employed individual, check if your employer offers health insurance. The health insurance policy offered by your employer can help save on premium costs as either the employer will provide you a total amount assigned to you as medical benefit (e.g. 1 gross salary for the year as benefit) or a discounted premium (30% cost of the premium will be borne by you and the rest by the employer)
Most employers in Pakistan also offer extended health insurance for your spouse and children up to a certain limit and may even offer coverage of some form for your parents as well.
However, if you are self-employed or your employer does not offer a health insurance policy, the best way to start your research is to compare various policies. Sites such as Karlocompare offer a reliable and quick way to understand the various benefit offered by various health insurance policies in Pakistan.
STEP 2: UNDERSTAND THE POLICY
Nothing is more vital than knowing what benefits to expect from your policy. Usually, health insurance plans cover the following areas:
- In-patient care (Healthcare received inside the hospital)
- Emergency services (accidents)
- Out-patient care (Healthcare received outside the hospital such as in clinics or doctor appointment costs)
- Prescription drugs
- Pregnancy, maternity, and newborn baby care
- Laboratory Tests
Moreover, if you have a pre-existing condition such as diabetes of heart conditions or are on special prescription medication, ensure that the health insurance plan covers that. Moreover, if you or someone in your family also being covered suffers from mental health problems, include that in the policy as well.
STEP 3: CALCULATE THE TOTAL COST
This is one of the most crucial steps. There are two main costs involved in a health insurance plan; the premium and the out-of-pocket expense.
Firstly, know your budget and how much premium you can afford to pay every month. Moreover, talk to your insurance provider and comprehend how exactly the premium is calculated. Different companies calculate premium differently and it may depend on factors such as pre-existing conditions, previous medical history, what is covered by the health insurance plan
Secondly, know the out-of-pocket expense. These come in the form of Co-payments, deductible, and co-insurance. Although understanding the exact calculation can be complex, it is very important to know how much out-of-pocket expense you will have to pay in case of medical check-ups or emergencies etc. Most health insurance policies in Pakistan have a maximum out-of-pocket expense limit after which all costs are covered by the insurance company.
A quick tip: If you are prone to health problems, it is a good idea to have a higher premium and more coverage and lower out-of-pocket expense. The reverse would be true if you are in good health.
STEP 5: KNOW THE FINE PRINT
It might seem tedious to go through the fine print, but it is non-skippable. Reading the fine print will help you know what the health insurance plan covers and does not cover. You do not want to end up paying for expensive healthcare just to find out that it is not covered by insurance. Most health insurance policies in Pakistan have a time constraint on covering pre-existing conditions e.g. your plan may cover diabetes-related expenses for 4 years. Also, if you are planning to start a family soon, it will be a good idea to check if your health insurance plan covers maternity and childbirth expenses
Moreover, you also need to know which doctors are on the insurance panel. An appointment with a doctor on the panel will cost you nothing and the bill will be immediately picked up by the insurance company. On the other hand, the bill for a doctor not on a panel may be partially covered or not covered at all.
STEP 6: REVIEW YOUR POLICY
One of the biggest mistakes people make is not reviewing their policy after a couple of years. As your circumstances change, the Health insurance policy that fully covers you and your family in the best and most inexpensive manner will also change. Also, some benefits might expire after a given period of time so getting a new policy or revising the old one can help you save both cost and worry!