Health Insurance Basics

Important Issues When Choosing a Medical Insurance Provider

March 17, 2015

We get it; when you are sick, you want treatment, not drama. This makes the choice of a health insurance kenya carrier an important decision because it may have a significant influence on the quality of care you receive. If you are currently shopping for a medical cover, or you just want a feel of what is out there, then here are some things that you will do well to bear in mind.

A medical insurer is not a medical services provider

With the exception of companies like AAR that provide medical insurance and also run health centers, a vast majority of medical insurers do not offer any direct health services. They only finance healthcare for their members. This distinction is important to bear in mind for two reasons. First, it may mean the difference between having access to services from a large number of healthcare facilities that have a relationship with your insurer or being restricted to health centers run by your medical insurance provider. Secondly, it may mean that you are tied within an insurer’s network, and you may not be able to access services from certain hospitals. Always take time to ensure that the company you go with actually addresses your needs.  

Related: 3 Pro Secrets of Choosing Health insurance

Reputation does Matter

It is critical to determine the reputation of your preferred health services provider before making commitments. If you can, ask hospitals and clinics what sort of relationship they have with the medical insurer, and find out whether the relations are smooth. Talk to your friends too, and other referrals to get their views on the services provided by that medical services provider. The market reputation of a provider is an indication of how well the company provides services to its members, and is usually a good point of reference when making decisions regarding healthcare insurance.

Consider the Reach of the Health Insurance Carrier

Depending on your lifestyle, it may be important to consider the geographical reach of your carrier. The main points to consider include the following. First, does the health insurance provider have a network of partner hospitals that cover all your main areas of operation? The point here is to ensure that you will have access to a hospital from any of your areas of operation. The second point to consider is whether the health insurance carrier allows you to use the hospitals of your choice. For instance, if you look at the Linda Jamii product from Britam, you will discover that the list of hospitals that participate in it do not include the major private hospitals in Nairobi, ostensibly to keep the costs of healthcare affordable both for the insurer and the insured. Other health insurance companies may insist on copayment plans if you visit the major private hospitals, or if you want to see a doctor outside of their primary network. Consider all these factors as you buy your medical insurance.

ALWAYS compare Costs and Services

Consider the costs of premiums, in the context of the size of cover available for your use. A cheap medical insurance cover does not always mean that it is a better deal. A company may give you an inferior cover at a low cost, which fails to meet your needs. On the other hand, a high cost cover is also not the same as a high quality cover. Examine the cover to ensure that you are getting the most value for your money. One of the best ways of doing this is to fill in our online medical insurance quote form to compare medical insurance quotes from different providers. 

Related: Surprising Benefits of Health Insurance Brokers

Make sure the provider is accessible especially on short notice

One of the most frustrating situations you can find yourself in is not being able to access your medical insurance provider when you need advice, or have an inquiry, especially during emergencies. Before you get into a scheme, call the company to find out how helpful they are when you have an inquiry. You can also experiment with sending an email or an sms to see which medium attracts the quickest and the most comprehensive response. Check out their website to see whether you can find the list of hospitals in their network, then call some of those hospitals to confirm that they actually have a relationship with this potential insurer. This is especially important if you would like to access services from specific hospitals listed in the company’s roll. Some company’s may not update the publicly available information when their relationships change, and you can buy into a cover thinking your preferred hospitals are in the network, only to discover that they are not represented. Do your research well to ensure that you get the best medical insurance cover possible on your current budget. 

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