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Why Health insurance Matters

Is there any good argument against the fact that your health is your single most important asset in this life? Good health is such a foundational matter in life since without good health, it becomes difficult to achieve any important goal. This simple, yet profound fact is the driving force behind an ever growing health insurance sector not just in Kenya, but the entire world in general. So, what are the most significant reasons why you need to consider health insurance for yourself, your family, and your dependents?

Covers cost of consultation

The cost of consultation varies widely in Kenya, from a few hundred shillings in low cost hospitals to a several thousand shillings in high end hospitals. The cost of seeing a doctor is usually covered by the insurance company, and is the first benefit you will have when you buy a health insurance policy.

Covers cost of specialists

Specialists such as gynecologists, dermatologists, psychiatrists and others, usually have a higher consultation fee. In case a general doctor (general practitioner) refers you to a specialist, the insurance company will meet the cost associated with your visit to the specialist. You should however consult your insurer to find out whether they have an approved panel of consultants before seeing a specialist.

Covers cost of lab-work

Health insurance policies usually cover the costs associated with lab tests. It is important to highlight this benefit because not all medical conditions will require medical testing before treatment can be administered. That said, some insurance companies will require you to notify them if certain tests are recommended so that they can issue their approval.

Covers cost of medicine

Meeting the cost of drugs is also one of the benefits a health insurance cover should provide. In this case, the medicine may be obtained from the hospital’s pharmacy, or from a chemist accredited by the insurance company. In general, health care policies do not cover the cost of non-medical supplements and cosmetics, even if they are recommended by a doctor.

Covers cost of hospitalization

In the event a policyholder is hospitalized, the insurance company will meet the costs associated with hospitalization. In this case, the insurance company will pay for accommodation (bed) as well treatment costs. Accommodation in a hospital increases the cost of healthcare because the hospital must operate several departments to support the patients. These departments include catering services, laundry services, among others. The hospital also must be in operation full time, which means hiring more staff members.

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Covers cost of Ambulance

Some covers may include an ambulance  benefit. In this case, the insurance company provides an ambulance to take you to hospital should you need on. Some policies also include an air rescue component in partnership with air ambulance services. This benefit may require the payment of additional premiums.

Cash Back for days hospitalized

in some cases, the policy may also include a “cashback” clause where the insurance company pays out a daily allowance for everyday the policyholder is hospitalized. The rationale is that long term hospitalization may lead to loss of income. The cash paid to the policyholder helps to even out loss of income during the days they are hospitalized.  

How to Choose a Health Insurance Policy?

How do you arrive at an appropriate decision regarding the type of health insurance policy you should buy? If this question is currently bothering you, then you are the perfect person to see this. The choice of a medical insurance policy is an important one. It has implications relating to the type of care you can access. It will also have an impact on the limits of care you can access. Here are some of the key factors that you need to consider.

  • Needs assessment: First carry out a needs assessment to see what you are looking for. When we speak of needs, we mean your needs and those of your dependents. Your needs will mostly be defined by your current state of health, which will have an influence on how frequently you need medical attention. The type of care you will need is also a good consideration to make.
  • Budget: The next thing you need to look at is your budget. How much are you willing and able to spend on health insurance? While someone would feel safest having all the benefits a medical insurance policy can buy, spending too much money on one item can compromise your financial plans, especially of you have many dependents. In this case, make a decision on how much you can spend on health insurance based on your needs and based on your capacity. The whole point of this exercise is to make sure that you get the best possible deal for your budget.
  • Benefits assessment: Thirdly, with actual policy documents, assess the benefits associated with each policy. Compare the limits of each policy to see just how much would be available to you. In addition, look at the complete list of benefits provided by each of the policies you are considering. It is wise to pick policies whose benefits match your needs as closely as possible.
  • Company choice: Finally, decide on your preferred insurer. It’s a reality that some health insurance companies have better products and customer service than others, even of their policies may be more expensive. Finding a company that fits within your needs is the important thing in this situation.

Once you have understood what your needs are, compare the policies available, assessed the benefits of these policies, and finally you have settled on a provider, then and only then, are you ready to buy health insurance.