EnglishFor every one of us, health and our family’s well-being comes before all else. Right?
But if you’re considering purchasing health insurance from an insurance company in Pakistan, there are some things that you should really know about beforehand.
So, let’s get into this!
Why is Health Insurance Important?
You must be familiar with the common phrase “health is wealth”. Well, if you haven’t ever considered this seriously, it’s time to do so!
Let’s be honest, costs of medical treatments have incredibly increased, and they’re likely to go higher in the near future. Which means, if you ever find yourself in a medical emergency, there are high chances of you having to bear the burden of loans just because you weren’t able to afford the treatment required.
In such a scenario, individual health insurance plans that are offered by nearly every insurance company in Pakistan are a must-have!
For those who are availing individual health insurance for the first time, it is important to know about the following surprising benefits which are not commonly known about an individual health insurance plan provided by an insurance company in Pakistan:
How do Out-Of-Pocket Limits Operate?
Your annual out-of-pocket expenses for insured medical treatment are limited by out-of-pocket maximums. However, only around 40% of individuals are aware of what out-of-pocket maximum means, indicating that the majority of people are unaware of how this works.
No matter how much covered treatment you receive; you won’t spend more than Rs 3,000 annually if your coverage includes a Rs 3,000 maximum out-of-pocket limit.
When you reach your spending limit, you cease paying for any covered treatments, so there are no longer any copays or coinsurance fees by an insurance company in Pakistan.
The out-of-pocket maximum only applies to services that your insurer agrees to cover.
Your maximum expenditure does not apply to elective treatments or care that is not covered.
The maximum limit also excludes premiums, so even if you pay a few hundred dollars in premiums each month for your insurance, this won’t affect how much you may spend. But your deductible is included.
Understanding In-Network vs. Out-of-Network Providers
When you purchase health insurance, some healthcare providers are considered “in-network” while others are “out-of-network.” This distinction impacts your medical costs significantly. Surprisingly, many people misunderstand this concept—some think it doesn’t affect expenses at all, while others believe otherwise.
Why Out-of-Network Care is More Expensive:
Out-of-network care typically costs more due to higher out-of-pocket limits or even the absence of any caps. Additionally, insurers often charge increased copays and coinsurance rates for services received outside their network—for example, 50% coinsurance for out-of-network versus 20% for in-network providers.
Tips to Avoid Unexpected Medical Expenses:
To avoid high healthcare costs, always check how broad an insurer’s provider network is before choosing a plan. Ensure your preferred doctor is included in the network. If your employer doesn’t offer extensive coverage, you may need to spend more to stay protected.
Make Informed Decisions When Choosing Insurance:
Carefully compare health insurance policies and understand key terms that affect coverage. It’s important to speak directly with a representative from the insurance company in Pakistan to select a plan that suits your healthcare needs and budget.