The first thing you need to understand is, what does health insurance in Pakistan cover? Health Insurance is a Medical Insurance Program specially designed for individuals or organizations to be better equipped to take care of Health related concerns of themselves, their employees and their family members. The best health insurance providers offer diverse health plans designed with a variety of innovative and consumer directed options.
While looking for the best health insurance plan you have to find the health insurance providers who have a well-established Health Insurance Department. The best health insurance companies in Pakistan include Alfalah insurance company, Allianz EFU health insurance, Jubilee general insurance, among many others.
The staff should be competent and well experienced. They should be able to serve the insured members with the best possible healthcare at an affordable cost. In th end it is all about the economy, the efforts and your relationship with the company.
Health insurance in Pakistan is not something everyone understands or takes advantage of. Here we have outlined a few question that you should ask your health insurance provider before making any decision.
1. How to pay the monthly premium at the most affordable price possible?
First, you need to ask your employer if he offers Health insurance. Avail this opportunity if presented to you. This is generally the best option around because the employer typically contributes 50% or more of the monthly premium thus making it more affordable. You do not have to pay for it all on your own.
Secondly, remember to let your broker know your (or your family’s) annual projected income for the upcoming year. Why? Simply because this exercise will determine if you are eligible for premium assistance through your state or otherwise.
Third, determine as soon as possible whether it is better to go with a high deductible plan to keep your premium cost down while applying for an individual/family plan. This will help you save money at least on the monthly premium.
2. What is the best plan for you and your family, and why?
The best possible way to answer this is by first understanding what you can afford, your needs and medical usage history. After discussing this with your health insurance provider, you can look over the advised plans, and choose what suits your needs.
Another thing to consider is that can you change the plan if it is necessary later, and how much change will it be to move to a different plan if your situation changes.
3. What Does the Plan Cover?
Different health insurance plans might cover different types of medical care. For example, some might not cover mental health, prescription drugs, or maternity care. All insurance plans must cover these ten “essential health benefits”, or most of them.
- Emergency services
- Laboratory tests
- Maternity and newborn care
- Mental health and substance-abuse treatment
- Outpatient care (doctors and other services you receive outside of a hospital)
- Pediatric services including dental and vision care
- Prescription drugs
- Preventive services (such as immunizations and mammograms) and management of
- chronic diseases such as diabetes
- Rehabilitation services
The rules for insurance provided by larger health insurance companies might be different but most of them will cover these set of benefits. If you are selecting from plans from a larger employer and are unsure what the plans cover, ask your employer to provide you with the Summary of Benefits and Coverage (SBC), which is a standard form that will state exactly what the plan covers and does not cover.
4. How Much Does the Plan Cost?
When you’re looking at the cost of health insurance plans, consider two main factors:
First, what will be the amount that you will pay to the insurance company for your plan, usually paid monthly. This is called the premium.
Secondly, and quite important what is the amount you will pay out of your own finances when you receive medical care.
These amounts will be reflected as a combination of deductibles, coinsurance, and copays.
These are called your out-of-pocket costs.
To make plan and cost comparison easier, the plans will be displayed in standardized various combinations of premiums and out-of-pocket costs. If not, you should ask your health insurance provider for these.
Make sure you understand the new plan coverage levels. Which plan coverage will be right for you depends on your health and financial situation. If you have an expensive medical condition or have a planned medical procedure, consider a plan with a higher premium that covers more of your costs. If you are generally healthy you might come out ahead by paying a lower premium and a bigger share of your health costs. Of course, you need to be prepared to pay more if you unexpectedly become sick or injured.
5. Ask about everything you are unsure of
Will you be able to continue seeing your current Doctors? Ask about the things you need to keep in mind when choosing your doctors and hospitals. Ask for a list of the doctors and hospitals that are covered to decide if the plan is right for you, and make sure all is in order.
What information do you need to provide to the health insurance provider in order to receive a health insurance plan? Now days only the basic information such as names, address, birth dates, social security numbers are needed. and if you are applying through a state your family income and proof of residency are required amongst a few other things.
In the end you will have to rely on your health insurance provider to guide you, so keep in mind that you have to find a health insurance .provider who you feel comfortable with. They should take time to listen, understand your economical and medical history, and give you advice and support to make the critical decision of choosing a health insurance plan which will be smooth and easy. Just remember to think through everything.