What to Look for In A Health Insurance Plan

What to Look for In A Health Insurance Plan
October 25, 2018 K Compare

What to Look for In A Health Insurance Plan

Accidents are not planned. People do not put a day and time in their schedules to get hurt or need medical care; it almost always happens suddenly. Also, with time, the costs of medical care are steadily increasing, and most treatments have become quite heavy on the average person’s pocket. The answer to all these problems is health insurance. A good health insurance plan covers you in case of unexpected medical costs and protects you from heavy treatment fees with discounts in network covered hospitals and in some cases, free or discounted preventive care like vaccines.

While choosing good health insurance in Pakistan or anywhere else, you must keep in mind your own particular medical needs and the fine print of the insurance plan itself. Selection of a health insurance plan is a serious decision as it impacts not only yourself but your family and dependents as well. There are several important factors to consider when selecting health insurance, which we will look at below:

Costs to Consider:

Before selecting a health insurance plan, it is important to understand and consider the following important related costs:

Premium: The monthly payment made to the insurance company as fee for the selected plan

Deductible: The amount of money you need to spend before the insurance cover kicks in and the insurer starts to pay for your medical care. This amount is separate from the premium. There are various forms of deductibles, such as co-pays, fixed fee per visit, annual deductibles etc. The type and amount of deductible you pay depends on your insurance plan

Maximum out-of-pocket: The maximum amount you have to pay each year for health care expenses

Healthcare provider network:

Check the size and quality of the plan’s provider network. Does it have the healthcare centers you prefer going to, or would be willing to switch to? It is also important to note whether the plan provides coverage for out of network care, and if yes, then what is the maximum amount of such coverage. Medical insurance in Pakistan usually covers major hospitals in all major cities, in the form of:

  • preferred providers: most amount of discount due to agreements with the insurance companies
  • participating providers: lesser discount rates
  • part of a tiered network: different costs for different providers

The sum insured:

Sum insured is the total amount that you are insured for, i.e. the total amount of expenses your insurance plan will cover in case a medical service is needed. Choosing the sum insured requires careful consideration of the medical requirements of yourself and dependents to be covered (including any pre-existing medical conditions), inflation rates and your financial standing.

Restore Limit:

A restore limit is like a top up to your sum insured; in case of any unfortunate circumstances where your sum insured is fully utilized but you require further healthcare, an insurance plan with a restore limit will ensure there is no added financial stress in hard times.

Buy through reputed brokers:

Always buy health insurance through reputed insurance brokers/companies who are reliable and trustworthy. There are several worthy insurance companies in Pakistan who can be trusted to take care of your insurance needs, such as Jubilee insurance, EFU life, Allianz, etc. Websites like https://karlocompare.com.pk can help to compare the many different options and choose the best one suited to your needs.


Sub-limits are limits on categorized expenses, which are often hidden in the fine print. They are most commonly applied on expenses such as room rent, doctor’s fees, etc. Check for sub-limits when choosing a health insurance plan and make sure you will not be surprised with extra expenses if you are put in a room of a different category.

Pre-existing conditions:

One of the most important things to consider while choosing a health insurance plan is their policy regarding pre-existing ailments, if any. Most plans have a waiting period after the start of your insurance coverage and the pre-existing ailments are only covered after you have crossed the waiting period. Check what the waiting period is for your medical needs and whether it is suitable for you or not.

These are just some of the aspects to consider while choosing a health insurance plan. It is optimal to buy health insurance as soon as possible in your lifespan, and be completely truthful while disclosing your medical information to the insurance company so that they can provide you with the best and most suitable coverage.

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