The Cost Of Primary Health Care, Is Medical Insurance Timely?

The Cost Of Primary Health Care, Is Medical Insurance Timely?

What would you do if your doctor sent an SMS to your phone that he needs you urgently at the hospital? Of course many questions would race your mind and most probably be unsettled until you meet the Doctor. Perhaps do so or reminisce and track all your activities leading to the last checkup. Such scenarios are often not commonly played out in our minds because we believe it just could never happen to us.

If so happened?

The first thing that would come to mind is; it’s very bad but worse still it’s going to cost a fortune. To meet this obligation in return for good health, one needs an insurance of sorts. Perhaps having a good bank balance would help or support a structure of family and friends, may be medical insurance would suffice. Having heard advertisements by insurance companies like UAP, Sanlam Life Insurance, Jubilee among others, it never occurs to some individuals that those messages are directed to them. This time, it may not necessarily be your car, business or job, but your health.

Medical insurance especially in countries like Uganda is a preserve of the rich and employees of formidable corporate bodies and entities. Whereas having such a policy would greatly benefit any individual, many people are averse to taking on  one. Citing cost of premium, ambiguity of coverage and in most cases outright ignorance, many would rather walk into any clinic for quick alleviation of their ailments than trust insurance covers.

Given the ever rapid growing population now at 34.4m (Uganda Bureau of Statistics 2014) amidst the expanding disease bracket that involves the evolving diseases and ailments, there is need to have assured protection. Not forgetting socio- economic challenges of resource competition, inflation and unemployment, this implies that the gap between insurance covers and policy holders is ever wider.

Why medical insurance?

The assumption that any common malady like malaria or typhoid can easily be treated at the local clinic makes many think that is all they could ever catch. However, due to irregular checkups, many people don’t know what other ailment they may be having until its too late. The treatment of the disease drains them financially and emotionally. Some treatments are quite costly and the price of falling sick is enormous in an economy not offering any upturns.

Medical insurance will among other things afford you specialist treatment for chronic diseases, complex medical ailments and accidents, but even cater for your family. Besides, the more complex sickness, it will afford you the luxury of routine checkups, dental and optical care where necessary and the latter are often paediatric concerns.

Maggie, an employee with one of the leading NGO forum in the country has possession of medical cover that includes up to three family members courtesy of her employers with a major insurance company in town. When her two year old son; Kafeero fell sick and was taken for routine checkup at the nearby clinic, the diagnosis was inconclusive. Whatever symptoms the boy showed were consistent with one ailment but the tests showed nothing to prove it. Maggie then took her son to associates hospital backed by her insurance cover and the results showed the boy to have contracted a blood infection. Treatment of which out her own pocket would have cost her upwards of Ugx2million for preliminaries and the consequent costs of care could have ballooned to nearly Ugx3million. Much as the policy could cater for costs up to Ugx1.5million, the difference was much appreciated in her bank account.

Medical insurance ensures financial protection for the policy holder, give one a worthy and healthy life and accord security to family members. As for companies, insurance policies serve to motivate staff and increase productivity. The consequences of medical uncertainty are far reaching and no one can be certain their plan will work. However medical insurance may be the plan that actually sticks with you through that most trying of moments when one’s health is on the line.

Before taking on medical insurance, The cost and coverage of the policy.

A premium for simple ailments may range from Ugx50000 to Ugx150000 per month. Whereas a more comprehensive cover ranges from Ugax650000 and above depending on what is included. For instance with palliative care and cross border treatments may cause increase in premiums paid as this allows for access to evacuation and specialized treatment. Coverage is concerned with the seriousness of the condition or just the desire to close up any loose ends that a disease may sneak past depending on the person.

Length of coverage and terms of an upgrade or renewal.

It’s imperative that the person seeking insurance knows how long the policy will hold. For some it could fall anywhere from short to long term. Depending on the requirements of the person, a policy should be tailored to address the time period within which one may require the services. It further more implies that one should be in position to know the probable costs of upgrading or renewing a policy on expiry of the current one.

Affiliate hospitals and treatment.

To know which hospital you can access and which treatment can be offered is important. Due to the nature of ailments, some covers limit the access one has to certain hospitals and what they can do. Hence such knowledge is crucial in deciding how well your policy will serve you and how often.

Claims settlement.

This is the most challenging department in insurance. It is related with many frauds. Assuming one had emergency treatment that is covered in their policy but in a place other than is stipulated for associative facilities, then there must be a memorandum of understanding as to how best recover those monies spent. Furthermore in due course of doing business, discrepancies will arise. How the company addresses them is important through the channels of communication and feedback.

As it is, call your broker today and work out a way to access the best deal on the medical insurance market and this could someday save you the blushes of having in to see your doctor fearing the medical results as well  the resultant bill.

 SOURCE: SUMMIT BUSINESS.NET/VOL. 08 ISSUE 15 August 2016.