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Keys To Choosing The Best Medical Health Insurance Plan

Posted on 2016-08-03

Identify the must haves

We don’t anticipate an injury or illness but when it comes to medical needs there are some health needs that we have to come across like a maternity cover. As a potential buyer note that not all the plans have this benefit in place. If there is a family history of some pre-existing and chronic diseases it is very important to have a cover that takes care of the same.

Compare several plans

Visit websites like PESABAZAAR.COM for this comparisons in Kenya market, it only takes a few minutes to review all the benefits offered by different companies in the market. Some health plans have very enticing benefits but at the end of the day there is a cost sharing clause and others appear to be "cheap" only to turn out expensive at the end of the day because of clauses put in place.

Overall annual limits

Medical Insurance have annual limits, this is the amount the underwriter (Insurance Company) pays your bills up to in any occurrence. In Kenya the industry has from as low as Kes 100,000.00 for retail inpatient covers limit and Kes 25,000.00 for outpatient cover limit, depending on one’s need, this has to be considered to avoid any disappointment in future. It’s key to note that the high the limits the better the benefits and the higher the premium.

Check on the provider list

If you have a family doctor, primary care physician or specialist you like, be sure they are available in the panel of providers of the plan you are interested in. Policies will share a lower cost of out of network services or even none at all depending with the companies. It is always advised to request for the list of preferred health providers when looking at the available options.

Consider your dependents

Dependents are your children, kids below the age of 18 years in Kenya are allowed to come under their parents cover and when they hit 18 years they take their own cover. Some companies will take up to 20 years before they ask for the kids to take their own policies even if it’s being paid for by their parent.

Know your share of the costs

Medical Insurance has to state how much you are required to pay. Insurance in Kenya is a cash and carry service for the companies although some have plans with creditors to finance for a client’s premium. In such cases there should be a clear work out on the Instalment payment plan shown after the final premium calculation. In the same policies we have what we term to as co-pay this should be shown for us to know how much is required from us any time we need to access the services

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