Would you ever buy a car without checking its specifications? Would you invest in a house without checking the floor plan? Then why would you risk buying a health insurance policy without understanding its benefits? Whether you decide to opt for a basic health insurance plan or a premium one, it is important to know exactly what it is that you’re buying.
So, before you enroll into a health insurance plan, go through this seven-point checklist to help you decide if it is the right one for you and your family.
All health insurance plans have an aggregate coverage upper limit. So a plan that offers an aggregate annual coverage of AED 150,000 will come at a lower premium compared to a plan that covers you up to AED 500,000 annually. Keep in mind that in case of plans with a co-insurance clause, this aggregate could be inclusive of the co-insurance payable.
Health insurance policies by most providers in the UAE are offered with local, regional or international coverage. Assess your personal requirements before applying for a policy and make sure you read the fine print. For example, some local plans might only cover one emirate while some might cover more than one. International plans offered in the UAE may or may not cover the US and Canada.
This is the percentage of medical expenses that you have to pay out of your pocket. Check if the insurance policy has a co-insurance payable or not. Policies with little or no co-insurance will cost you more than the ones with a high co-insurance percentage clause.
Go through the list of network hospitals under the health insurance policy, and check if the hospital you visit most often is covered or not. Usually, the higher the insurance premium, the wider the network of covered hospitals and clinics. Also check if the hospital of your choice offers direct billing or a pay-and-claim arrangement.
Before you buy a health insurance policy, check if there is a premium discount available. Some insurers may offer you a no-claim bonus in the form of a discount if you renew without making any claims in the previous year. Others may also offer discounts if you buy insurance for all your family members together.
Within the maternity benefits offered by a health insurance provider, check what’s included in terms of both out-patient and in-patient services. While out-patient services include check-ups with the obstetrician, investigative tests, ultrasound scans and such, in-patient services include delivery and emergency medical procedures. Check the total coverage limit in both cases – normal delivery as well as a C-section.
To make sure your insurance claim is not rejected in the future, it is important to know what’s excluded from your health insurance coverage. Take a look at the table of benefits in the health insurance policy document, and take an even closer look at the section on exclusions and limitations. For example, your plan may or may not cover dental treatments, alternative medicine, physiotherapy, preventive screening tests etc.