Browse By

MEDICAL INSURANCE

What is medical insurance (MI)?

Medical insurance is a type of personal insurance that guarantees you in the event of an insured event to receive medical care and reimbursement of expenses for the purchase of medicines at the expense of the insurance company (this type is also called continuous health insurance ).

Medical insurance will help you, your family members or employees of your company are guaranteed to receive fast and high-quality medical care in private and public clinics and hospitals, without queues and at a convenient time for you.

VHI programs are not standard (if it is not corporate employee insurance ) – they are developed individually and can be configured as a designer depending on your needs and requests.

What does the cost of health insurance depend on?

Tariffs and cost of medical insurance depend on the list of risks, the level of programs, the number of insured, the region of service, the state of health of the insured and are determined, as a rule, after passing a medical examination.

Insurers are reluctant to insure the health of individuals, as individual VHI contracts are unprofitable, so they are 20% more expensive than corporate health insurance programs.

How to reduce the cost of voluntary medical insurance programs for individuals and legal entities?

– at the expense of franchises for doctors (20-50% of the cost of the consultation, you can pay for yourself)

– due to the sublimit for drugs (unlimited drug provision is more expensive than with a sublimit of 2000 UAH.)

– with the exception of brand clinics of class A + (Boris, Oberig, Medicom)

– with the exception of private hospitals (as a rule, wards in branded clinics are occupied or reserved, and you still have to deal with departmental hospitals)

– with the exception of dentistry (cheaper than 1000 UAH.)

Corporate health insurance is an effective tool for motivating employees. You can consider the equity participation of the employer and employee (50/50, 60/40 or 70/30), or regulate the cost of the contract by deductibles and sublimits for medicines and services. In addition, you can additionally insure the life and health of the team against critical diseases.

How do we recommend to insure the team?

– to insure employees and their families with a 10-20% deductible and sublimit on medicines (this disciplines employees to be less sick and restrains medical institutions to heal)

– approach selectively to the categories of employees, offering different programs and coverage (basic, standard, elite)

– exclude dentistry (cheaper for 1000 UAH.)

What does voluntary health insurance include?

inpatient care – counseling, research, surgical and therapeutic treatment, payment for hospital stay, provision of medicines.

outpatient care – consultation, call a doctor at home, registration of sick-list, diagnostics.

provision, payment and delivery of medicines and drugs

emergency medical care – departure of the ambulance, examination, emergency care, medication, transportation.

dental care – examination and consultation; therapeutic surgical treatment, x-ray, anesthesia.

A health insurance contract is an agreement between the insured and the insurance organization, according to which the medical organization undertakes to organize and finance the provision of medical care of a certain amount and quality or other services under the voluntary medical insurance programs.

The VHI contract shall be recognized as concluded from the moment of payment of the first insurance premium, unless otherwise provided by the terms of the contract.

 

Useful tips

Health insurance is of great interest to insurers (especially corporate corporate health insurance and children’s health insurance), so we tried to collect in this section the most useful tips, advice and advice on health insurance and choosing the best insurance programs.

Conflict of interest in health insurance

In the insurance market there is a systemic conflict that accompanies the field of health insurance since the beginning of its work in Ukraine.

Customer service for medical insurance. INGO Ukraine experience

Many insurers put the question: “What to do next with the LCA? Keep it in your portfolio, reduce it in your portfolio, or try to make it profitable, profitable and economically viable? ”

Corporate LCA: the secrets of effective interaction

Practical case of OTP Bank and share experience with colleagues in the market who work in the segment of LCA. It is necessary to clearly understand what risks the insurer may exist and how they can be reduced.

MHD should be based on best practices in LCA

After almost five years of silence, the topic of health care reform has recently been actively revived in the project documents of the Cabinet of Ministers of Ukraine.

Balance of service quality and profitability of corporate voluntary medical insurance. Experience Ilyichevskoy

One of the main issues of insurance companies is to achieve a balance of profitability and quality.These two concepts are very closely related.

Control of unprofitability of corporate health insurance contracts. Experience of OTP Bank

The story, which began in 2011 with a tender for the selection of a provider of medical insurance services for OTP Bank employees (more than 2500 people were insured), was very active and later taught us a lot

The availability of a voluntary medical insurance policy will significantly save on medical expenses.

The cost of drugs in Ukraine can be reduced at least 2.5 times with the provision of policies of compulsory or voluntary medical insurance. The presence of medical insurance policy will significantly save the cost of medicines, which make up 60-70% of the cost of treatment. Cross-checking of medical appointments and medical bills by the insurance company will prevent the purchase of unnecessary, often expensive medicines, writes […]

Corporate LCA reduces the number of sick leave

The presence of medical insurance for employees reduces the average annual number of days spent on sick leave in a team by 40%

Corporate health insurance – effective staff motivation

Today in Ukraine only 5% of voluntary medical insurance contracts fall on the retail segment, while the share of corporate insurance is 95%

What to look for when buying a personal health insurance policy?

Experts advise choosing voluntary health insurance policies with limits expressed not in quantitative terms, but in monetary terms.

The demand for medical insurance in Ukraine, despite the flu epidemic, has not grown

There are no separate insurance policies for the swine flu virus as such; however, in some packages of health insurance programs, the “vaccination against flu” option is provided.

Insurance against flu and epidemics is just a marketing ploy.

Some insurance companies have already declared their readiness to sell insurance programs against the flu, but this is just a marketing ploy.

How can I reduce the cost of the LCA policy?

For a relatively healthy person, it is sometimes sufficient to include in the VHI only outpatient care and inpatient treatment, or to choose only “emergency room” and “medicines”

How to choose a voluntary health insurance program with optimal conditions?

Voluntary medical insurance in Ukraine can rise in price by another 20-30%. However, now buy a normal policy for the year for 5 thousand UAH is still real

Corporate health insurance for employees: pros and cons for employee and employer

The main advantage of corporate health insurance is that the company-employer always (or almost always) pays for it.

Cheap and expensive health insurance policies: pros and cons

For young people between the ages of 25-35 years, the VHI package with a limit of at least 50-75 thousand UAH will be the most optimal. and with the ability to be served in renowned private clinics

How can you reduce the cost of an enterprise for a corporate LCA?

The financial crisis has forced insurance companies to take measures aimed not only at expanding the customer base, but also at keeping it – the prolongation of contracts for the next year.

 

Leave a Reply

Your email address will not be published. Required fields are marked *