Do you claim for your medical expenses to your health insurance company?

Welcome back!

Last year when I talked about life insurance policies, the rather low participation rate gives the impression that very little of my blog audience actually have one. Today’s topic might seem similar but as opposed to a life insurance policy, a medical insurance plan works differently. I just hope that you won’t get bored.

What is it all about?

receipt

If you are working in a private company, you are most probably covered by a medical insurance policy. These are one of the main benefits brought forward when vacancies are advertised. While some employers might contribute 100% of the monthly fee, most sponsor you up to 50% and you need to pay the other half. Depending on your medical insurance plan, the total monthly fee might vary. To give you an approximate idea, the total monthly fees per person might be around Rs1000 ( average value).

And if you chose to include your wife and children to get the similar benefits, their monthly fees will probably be deducted directly from your salary. Of course, you can get subscribed to a similar plan on a personal basis, no need to be employed by a private company ;)

Why should you have a medical insurance plan?

I’m not an agent trying to sell any plans to you, you can be reassured. When I stepped in the job market some 6 years ago, I was automatically enrolled on a medical insurance plan. Every employee had a medical plan, whether through the company’s official medical insurance company or on a personal basis).

Some of the expenses  (sometimes partly) refunded by the health insurance companies are:

  • Outpatient treatment : Visits to doctors and pharmacy bills
  • Inpatient treatment : Stays in clinics
  • Expenses related to hearing problems, ophtamologic and dental care
  • Other expenses related to maternity, fertility problems etc

Unlike the other claims, stays in clinics (Inpatient treatment) are sometimes fully taken in charge by the medical insurance companies. This means that you don’t need to pay the bill when you leave the clinic. Both parties (the clinic and insurance) will settle their accounts among themselves. As for the other claims, sometimes they might be fully refunded or sometimes up to a limit, 80% in most cases I know. Please note that not every type of drug and treatment are refundable.

Why should you claim?

cheques

At the end of the month, when you get hold of your payslip, you realise that the insurance company is enriching itself with your contributions as well as those of all of your colleagues. What are you getting in return? Nothing. Because you are either physically fit with no health problems or you prefer to queue up at public hospitals for free treatment.

Sometimes, it might make sense to go for the hospital for small health issues whose solutions are only “panadol” and “pirithon” but unfortunately many among us wait until there are health complications to get to a private doctor or clinic. Just as you pay tax to use the public health care hospitals, you are also paying monthly fees to your insurance.

medicines

Finally, my piece of advice :

  • Be on your guard when it concerns medical insurance companies.
  • Always make a copy of your original receipts before sending the original ones to the insurance company.
  • They talk about conditions they never informed you of or things they put in tiny prints in some documents which might have probably never reached you.
  • They are sometimes annoying when it comes to give you back your money. But don’t try to play with them at the end of the month. They need to get their money on time!

Money Su*kers!

Medical insurance companies might be hating me for this post, especially mine. I just received 4 refund cheques during the past days lol. And lastly, DON’T HESITATE TO CLAIM FOR YOUR EXPENSES! ;)

Are you in a medical insurance plan? Do you claim for your expenses?

If no, why?

  • http://tinyurl.com/2f7olfl Mike

    I am retired but decided to go for a medical insurance here. I enrolled for a plan through Medibroker in Ebene for myself and wife. We do not have major health problems but decided that we needed to have the coverage just in case we needed to use private health services. Recently my wife got new glasses + frames and we claimed for the full amount. However, we received 75% reimbursement which seems fair. After seeing how the state hospital treats the citizens, having a medical insurance for treatment in the private system is wise.