In theory, health insurance – also called private health insurance or PMI for short – is simple and straightforward. In exchange for paying your premium, insurance usually covers the cost of medical care (minus any excess) when you need it.
In practice, of course, it’s a bit more involved and complicated than that, given the wide variety of plans, prices, and providers.
The many potential variables make it important that before you buy, you compare health insurance very carefully.
What are the main points to be taken into account in such a comparison?
Fully covered health insurance
- As the term suggests, it represents the gold standard in health insurance, as it provides more comprehensive coverage and, usually, greater choice in the private hospitals and clinics where you can choose to be treated.
- However, to obtain such coverage, you will need to disclose your full medical history, you may need to authorize your general practitioner to provide a medical report and you may need a medical examination.
Health insurance moratorium
- Generally a less expensive option, moratorium health insurance takes a different approach to your pre-existing medical condition.
- This needs to be disclosed and insurance companies can charge what is Money Saving Expert describe as a “blanket” exclusion on some or all of those you’ve listed.
What does it cover?
- When you compare health insuranceperhaps the greatest variation – and therefore the need for caution – lies in what medical conditions are covered and what treatments are offered.
- As a general rule, it’s important to remember that health insurance is designed to cover acute conditions that can be treated, any necessary medical tests, and any required surgeries – usually, it does not cover so-called chronic diseases and conditions (such as asthma), except chronic diseases. has reached an acute stage.
- Even so, that still leaves a lot of leeway between the different plans for different levels of coverage and the choices you might make in some of the following key areas.
Operation
- Surgery and a series of surgical procedures may be included, both on an inpatient basis and as an outpatient.
Hospital care
- If you need to stay in the hospital for any surgery or procedure, the costs are usually included – with more expensive health insurance plans offering a better choice of hospitals and standard of accommodation;
- The cost of care during your visit as an outpatient or stay in the hospital as an inpatient is also covered.
Consultations and tests
- Private health insurance gives you quicker access to the consultant of your choice and reduced waiting time is probably one of the main reasons people choose health insurance.
- Any tests and examinations ordered by the consultant – whether inpatient or outpatient – are also covered by your health plan.
Exception
- Pre-existing medical conditions may be excluded from your cover or you may need to pay an additional premium to be included.
- Treatment for long-term care (such as kidney dialysis, for example) is usually excluded, as is treatment during normal pregnancy, infertility, organ transplantation, treatment for drug abuse, and non-essential cosmetic surgery.
With so many variables to consider, it’s clear that you need to compare health insurance plans with a lot of care and forethought to make sure you buy the coverage that fits your needs and your particular circumstances.
