Do you think you need additional coverage for medical eventuality? Are you thinking of taking out health insurance? Do you know how to choose the policy that best suits your needs? Follow this guide and find out how they differ from each other and what you should take into account when making your decision.
Without a doubt, being protected against an accident, illness or any other medical unforeseen is a priority in the life of any person.
However, and although the National Health System is used by more than 100 million Americans, the coverage provided by the State is not enough for many families who expect more and better quality care.
Given this, many have found the solution to private health insurance. Fewer waiting lists, the possibility of choosing the care center and professionals, speed of services, cutting-edge technology … the list of benefits of medical coverage goes on and on.
But, given the great offer in the market and the great variety in prices and types of insurance, how do you know which one to choose?
Outpatient insurance policy, with copayment, with reimbursement or with medical charts. Do you need help choosing the health insurance that best suits your needs? Pay attention, because here are eight tips to make the right decision.
Analyze your needs
The first step when choosing the best health insurance is to analyze your needs and those of your family group.
For this, it is important that you consider a series of factors that are decisive when calculating the price of a policy and its degree of coverage. Among them are:
- Age of each of the insurance beneficiaries
- Health status of family members
- Life habits
It is important that you know your situation and that of the people who will appear in the insurance because this will make it much easier for you to choose the appropriate coverage.
It is important that you know that basic health insurance gives you access to various medical services such as general medicine, childcare, nursing, rehabilitation, family planning, oral treatments, or preventive medicine, among others.
However, subscribing more or less complete insurance will depend exclusively on your health needs.
Today, the market offers special, such coverages as optical insurance, dental insurance, health insurance for women, or other additional guarantees.
Choose the best insurance company
Choosing the best health insurer is another important point to keep in mind before hiring health insurance.
It is necessary that you put yourself in the background of the different companies that operate in your place of residence and that you analyze how reliable they can be.
What is your experience? What doctors are you working with? Do you have international coverage? Do you know someone who already has medical insurance with that company? … all the information can be useful when choosing.
Find out about existing coverage
Do you already know your needs and those of your family? Then it will be necessary to know the types of coverage available at the time of contracting health insurance.
Currently, each insurance company has a wide range of possibilities and they will vary according to your own requirements.
Let’s review the coverage you can have access to:
- General medicine
- Medical specialties
- Family planning
- Dental treatments
- Preventive medicine
- Diagnostic tests
- Ambulatory surgical interventions
- Hospital interventions
- Emergency service
- Ophthalmological care, etc.
Do not forget that it is you who decides the insurance coverage and the guarantees that it will include.
Think about the type of medical insurance you want to contract
Regardless of the type of coverage you want to contract for your medical insurance, it is important that you think about what type of modality you want to subscribe to, as this decision will have a direct impact on the premium that you will have to pay for your private medical coverage.
The modalities you can access are the following:
Medical chart insurance
With this type of insurance, you will be able to access the list of professionals and clinics associated with your company.
In this case, you can go to a medical consultation as many times as you want and, depending on the chosen formula, without any type of surcharge.
The medical chart modality is perfect for those who do not have a lifelong treating physician or for those who need to consult various specialists.
However, if your GP is not on your insurer’s list and you don’t want to change your professional, it is best to opt for another type of modality.
With or without copays
Insurance with or without copayment is an option that you can choose when subscribing to a medical chart policy.
Medical insurance with copayment: both the insurer and the insured pay a part of the medical fees or services. This option is ideal for those who do not usually go to the doctor regularly.
Medical insurance without copayment: the insurer assumes all health expenses. This option is ideal for those who need continuous care and who regularly attend the doctor.
Unlike medical insurance, with this type of modality, you can go to the doctor or clinic you want without the need for it to be on the list of professionals of the insurer.
However, you must assume a part of the cost of the care which, depending on the company; is usually between 70 and 100%.
Mixed insurance is the modality that brings together medical insurance and reimbursement insurance in the same policy.
In this way, you can go to both the doctors who are part of your insurer’s list and the professionals of your choice.
Find out about all the exclusions
It is important for you to know that health insurers have the power to reject a potential client if they consider them as unprofitable.
Among the best-known exclusions that companies set are:
- Physical disabilities caused by attacks, wars or epidemics
- Sports injuries
- Detoxification treatments for addictions (drugs, tobacco, alcohol, etc.)
- Plastic surgery
- HIV treatments
- Studies of the genetic map, etc.
For this reason, it is very important that you declare any type of illness or deficiency (physical or mental) to your insurer.
Otherwise, your coverage could be canceled for not having declared your situation and lied about your health.
Find out about the waiting periods set by your insurer
The grace period is the time that elapses between signing up for insurance and the day you can start using your coverage.
And although all insurers have similar terms regarding grace periods, you need to be clear about them before signing your insurance.
Among the usual deficiencies, the periods are the following:
- Surgical interventions or hospitalizations = 6 months
- Delivery = between 8 and 10 months
- Assisted reproduction treatments = about 24 months
- Complex diagnostic tests or clinical tests = between 3 and 6 months
Look at the complementary services
One point that you should not miss before deciding on your health insurance is to ask about the complementary services that will be associated with your policy.
Many times, insurers include complementary services in their health insurance that you have not requested but that will automatically increase your annual premium.
Compare the offers
Finally, it is very important that you compare the offers that the market offers. Read the fine print of contracts, quote, evaluate prices … anything goes when making the best choice.
Today, there are different sites specialized in the comparison of health insurance, do not hesitate to use them.