If you do not ask these questions, you could be in for a big surprise when you need to use your Medical Cover.
- What’s the medical plan’s overall global limit (maximum you can claim)?
[Personally, and this is just my opinion, I think your minimum global limit should be US$500,000 – US$1,000,000. It is almost unheard of to exceed US$1,000,000.]
- What’s the limit for in-patient (hospital) and the other sub-limits?
[Hospital Bill are very expensive these days. Read my other article to see why it’s critical to have a high hospital limit and sub-limits.]
- How much cover is there for High Care, Intensive Care, Organ Transplant and Oncology (cancer) treatment?
[I recommend no less than US$200,000]
- Are all pre-existing (past/on-going/current) and related medical conditions covered and up to what limit?
[Warning: very few Health Insurers offer this benefit because it’s very expensive for them to cover.]
- Does the medical plan cover ALL local and regionally (cross border) Air Ambulance costs?
[This benefit is very important to have if you want access to the BEST medical treatment because in many cases, first class treatment and aftercare isn’t readily available locally.]
- Do members have the freedom to seek medical treatment locally at any facility of their choice or are they restricted to a few facilities?
[Very important if you want access to the BEST medical treatment because in many cases, the BEST treatment and aftercare may be available outside the Health Insurers provider network.]
- Even if the treatment is available locally, do members have the freedom to seek medical treatment outside their home country at any facility of their choice or are there restrictions?
[This is a no brainer! Sometimes it’s best to seek treatment outside your home country.]
- When seeking hospital treatment (locally or abroad), will members have to pay-and-claim or put down a deposit or will the Health Insurer pay the bill directly to the service provider?
[Very important if you don’t have immediate access to large sums of money. Some medical facilities will not start treatment until they receive a Guarantee of Payment from the Health Insurer or at least a cash deposit.]
- If hospitalized (locally or abroad), is the medical bill covered in full or will there be shortfalls?
[Very important unless you have access to a large savings fund. If there will be shortfalls, some medical facilities may ask for a deposit to cover the shortfalls before treatment starts.]
- When seeking out-patient treatment (locally or abroad), will the member have to pay-and-claim or put down a deposit or will the medical plan pay the bill directly to the service provider? When seeking out-patient treatment (locally or abroad), is the medical bill covered in full or will there be shortfalls, co-payments or deductibles?
[Only important depending on availability of personal funds.]
- Does the medical plan cover travel and accommodation expenses for someone to travel with the member if the member requires hospital treatment abroad and up to what limit?
[A nice benefit to have as it can save you thousands if someone wants to travel to be with you.]
- What are the waiting periods?
[Very important especially if you are a new member!] They should have a list of waiting periods.
- Does the Health Insurer guarantee renewal? Or will they in any way shape or form ever refuse renewal or cover or benefits on the grounds of age or ill health when renewing?
- What is the age limit for joining?
[Very important! Join before you get too old to join and can’t find cover.]
- Are members covered and up to what limit when traveling outside their home country on holiday or on business; for how long and which areas/countries?
[Not critical but a nice one to have.]
- If joining mid-financial year, will it affect the limits and by how much?
[Very important that you understand this rule and how it can affect your benefits! This can catch you out when you suddenly exceed you limits due to your benefits being pro-rated.]
- How often do the premiums increase, by how much and why?
[A good thing to know so you can budget accordingly.] Because of something called Medical Inflation, annual premiums/subs can go up anything from 5% to 15%. Furthermore, some Health Insurers use age brackets which see your premiums increase when you jump into the next age bracket. You must budget accordingly!
- What are the exclusions?
[Don’t wait until you claim to find out this one. All the Insurers we support have an exclusion section in their Policy Wording/Agreement.
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