Health Insurance in Pakistan: 6 Tips If You Are Buying First Time

Alifiya Aun Ali
January 04, 2020

Health insurance is a compulsion in today’s times as the cost of treatment and medication is skyrocketing and people are also now more prone to lifestyle illnesses than before. However, there is nothing as an ideal sum insured as this depends on various factors such as age, income, family size, the city of residence, preferred hospitals, etc.

Metro cities like Karachi, Lahore, Islamabad etc. have high treatments costs hence anything less than coverage in lakhs for a family of 2 adults and 2 young kids would be insufficient in today’s day and age. Also, it is advised to opt for a complete protection plan which includes various value-added benefits like OPD, international treatment for critical illnesses, loyalty rewards irrespective of claims, etc.

One should also top up their health insurance portfolio with a critical illness plan since it offers a lump sum payout, and acts as a second financial buffer.

As there are a lot of firms selling HEALTH INSURANCE POLICIES in Pakistan, with multiple plans and coverages selecting one can really become a daunting task. Apart from a lot of plans to choose from, intimidating jargon which otherwise are called policy wordings adds to the confusion. While buying health insurance is a tough choice, there are a few factors you should consider when zeroing down on a plan. Below are the few things to consider before purchasing health insurance:

1. Things to Know Before Finalizing

Claim Process
The simpler the claims process and the faster the settlement of the claims, the better it is for the insured. Therefore, these two are major factors when it comes to the selection of a policy. Good customer support is an additional advantage one should look for.

Family Health Insurance
When purchasing health insurance plans, make sure that you do so keeping your family members and their age in mind. Before buying the insurance, consider their present ailments if any as well as the family’s medical history. In addition, check with your family members for any pre-existing diseases before buying a policy.

Selecting the right insurance amount
At the time of selecting health insurance plans, one should select the amount wisely as it covers the medical expenses for a year. Take your age into account; the younger you are, lower the sum insured you need.
One should also take a look at his or her income levels to analyses the premium affordable. Another vital aspect is the add-ons for they impact premium amounts. Make sure you chose a sum insured which won’t fall short in case of an emergency and whose premium is not too exorbitant.

Network hospitals
One should always check the CASHLESS NETWORK OF HOSPITALS with the insurance company. At the time of a medical emergency or hospitalization, the hospitals in the network offer a cashless option—insurer settles the medical bills directly with the insurer. Go for insurers which have a high number of network hospitals such as HDFC ERGO that has over 5000 hospitals in its network.

Maternity benefits
Majority policies in Pakistan don’t cover the pregnancy/maternity expenses. When buying health policy ensure that these benefits are included in the policy or you need to buy an additional cover for the needed benefit to be covered through your health insurance provider.

Pre/post-hospitalization
Before a hospitalization, you visit the doctor, get medicines, and undergo tests. You are hospitalized and after treatment, some expenses occur—the expenses include follow up with the doctor, medicines to be taken and many others. Choose an insurance plan which covers these aspects too which means it does not only cover during your stay at the hospital but also covers your pre-and-post hospital expenses.

Renewal with increased coverage
Look for health policies which offer lifetime renewability. There is a higher chance of suffering from diseases and illnesses when you are old compared to when you are young, a health policy which offers renewability till your retirement is the one must buy as some providers give you coverage for your pre-existing conditions after a certain period of renewability so that is the plan you should buy.

Apart from all these, there are few other things you need to keep in mind
Listen to what the insurance agent has to say, but don’t feel obliged to buy from him
You should be open to what the agents have to say and not totally avoid insurance agents like the plague because when buying insurance for the first time you would not be 100% sure what plans you need.

If you have no clue where to start, which normally don’t when you think of buying health insurance very first time and are looking for valid information? It would probably benefit you to make an appointment with an insurance agent in your social circle or even one of the random ones who’s accosted you on them at your office or mall or any random public place. Sit down with them and have them explain the various types of insurance policies.

2. Listen First, Buy Later:

You’re not going to need all of the plans the agent talks about, for instance, be aware that the agent is likely to try to get you to sign up for a plan of a company he is linked too, which may not be a good idea. But some plans are more appropriate as your first insurance policy, such as health insurance and personal accident insurance.

The agent will be able to give you pretty comprehensive overviews of what the various insurance plans are for. Of course, there is no substitute for reading the actual policy. But if you’re totally clueless, an agent can give you a good introduction. Or you can check all the plans at smartchoice.pk a free digital aggregator which provides you with information regarding the available plans in the market and the coverage the plan incurs.

3. Understand what insurance you actually need:

Once you’ve parted ways with the agent, you should have a decent idea of what the various types of insurance entail. Now you need to figure out what you really need—obviously, if the agent had his way, you’d be buying everything.

As a general rule of thumb, a health insurance plan is highly recommended for every young Pakistani who’s started working and wants to save the hard-earned money from medical expenses that would burn a hole in your pocket. Understand the need and get the right plan for your needs and your family requirements. Yes, we have the government hospitals you can avail bur you’ll be stuck in overcrowded government hospitals if you have only that to rely on.

If you have dependents—such as children, aged parents, a non-working spouse—who rely on you financially, you should also consider life insurance along with health insurance. Note that there is a big difference between health insurance and life insurance.

4. Compare plans from the various insurance companies:

Don’t jump up and sign up for any health insurance plan immediately. The last thing you want is to regret your first insurance policy. You now need to compare plans between several companies.

You can do this for free using Smartchoice.pk insurance customer’s adviser. Here’s one for personal accident insurance. The personal accident insurance customer care makes it easy to compare quotes from multiple insurance companies.

5. Understand how your first insurance policy works before buying:

When you’ve narrowed down your search to a few plans, you want to delve into the nitty-gritty details and really understand how each one works before making your final decision.

Other than looking at and comparing the lists of what’s insurable and exceptions, you also want to understand concepts like pre-and-post hospitalization, thirty days waiting period, cashless hospitalization and other terms that may affect your decision to buy your health insurance.

6. Check if you can afford the premiums:

The more coverage amongst us might immediately jump at the chance to get insured for every mishap under the sun.
But before you sign up for an add-on in an insurance policy, ask yourself if it’s really what you need, and whether you can afford the premiums. Take into account that premiums for, say, health insurance will rise as you get older, for example, if you by TPL Health insurance for your family for a certain premium, you can add maternity benefit additional cover after the payment of a certain amount.

While it can be tempting to get insurance for everything short of the common cold, resist the urge, as over-insuring yourself could cost even more than all the payouts you claim over a lifetime.

Whenever going for something new…and diving in with full force make sure that all information you have is unbiased and accurate, it can be ensured through a third party unprejudiced and impartial platform that can make your life easy, also it can help you choose a plan that is customized as per your need and requirements. Live Wisely, Choose Smartly!

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