Health insurance

12.10.2011

Health insurance


Health insurance

What usually happens when a person gets sick? Ideally, of course, goes to the hospital. But it’s no secret that the overwhelming majority of Ukrainians act differently, and there are plenty of excuses for this: poor-quality service, unqualified specialists, “pre-war” clinics, lack of time, but ultimately health suffers.

Modern medicine in Ukraine, based on the Soviet model of Semashko, is extremely inefficient and needs to be reformed. So, the mortality rate is 2.4 times.than in Europe, and Ukrainians live an average of 6 years less. The way out of this situation could be the health insurance system. And if at the state level compulsory health insurance is still planned, the voluntary medical insurance system is available to every Ukrainian today. However, it is difficult to talk about accessibility.

A little about health insurance

Health insurance is of two types -voluntary(LCA) andmandatory(OMS). Compulsory insurance is maintained at the state level. Expenses are paid from the unified social tax.Compulsory health insurance provides the same opportunities to all citizens, regardless of age, social status or place of residence. Thus, with a relatively small monthly premium, a person receives high-quality medical care. Such an insurance system operates in Russia, but we still have compulsory medical insurance. The estimated amount of the monthly fee is quite affordable - from 30 to 40 hryvnia.

Voluntary medical insurance

If the state guarantees the system of compulsory insurance, thenvoluntary medical insurancehealth care providers are insurance companies. Here, the range of services depends on the company, the selected insurance program, age, health status of the insured and other factors.

There are three health insurance programs: "Economy" (300-3000 hryvnia / year), "Standard" (2500-5000) and "Elite" (4500-185500 hryvnia). However, there are limitations in purchasing a voluntary health insurance policy:

  • disabled people;
  • retirees over 60;
  • alcoholics, drug addicts, drug addicts, who are registered in the mental hospital;
  • cancer patients;
  • tuberculosis patients;
  • patients with sarcoidosis, diabetes mellitus and HIV / AIDS.

These categories of citizens can not take out insurance. Insurance cases do not include particularly dangerous infections, sexually transmitted diseases, mental and occupational diseases, endocrine diseases, transplantation, prosthetics, replacement therapy, congenital anomalies and defects, childbirth, abortion, contraception and chronic diseases.

How much is health today?

The cost of health insurance

The number of people using voluntary medical insurance is only about 2%, since medical insurance is currently only available to Ukrainians with incomes above average.

So, the annual policy with high-quality medical care and a covering of 50 thousand hryvnias will cost the citizen of Ukraine approximately 6 thousand hryvnias a year. The most economical option can be purchased within 400 hryvnia per year, but it will cover only ambulance services, as well as payment for medical products for outpatient and inpatient treatment within 10 thousand hryvnia per annum, not covering dental services and outpatient treatment.

The cost of an insurance policy depends on many factors: the level of programs, the age of the insured, the region, the state of health. Insurance is often preceded by a medical examination.

Who is better?

The choice of insurance companies today is unusually rich, and each of them is ready to present a spectacular portfolio and rich history to the client. However, this is not always true, and therefore it is better to give preference to reputable companies, tested not by sensational advertising, but by the time and trust of customers.

Among the firms that have proven themselves in the domestic market, one can mention “AXA Insurance”, “PZU Ukraine”, TAS, ASKA, “Alpha”, INGO, “Oranta”, “Ukrainian Insurance Group”, “Unica”.

Past the lines in small print ...

Buyingmedical insuranceshould be extremely attentive.

Medical insurance in Ukraine

What you need to pay attention in the first place?

First, insurance contracts often contain a list of exceptions to insurance claims, and therefore the contract must be read very carefully. The spectacular word "franchise" means nothing more than ... payment for treatment at its own expense. For a good policy, the permissible value of the share of the franchise is up to 25%.Thus, insurance companies protect themselves from customer hyperactivity, but a franchise above 25–30% is more likely to indicate a desire to save on health.

Secondly, each policy has a maximum amount of insurance coverage. The higher the price of insurance, the higher the sum insured, as a rule.

Third, companies offer different schemes for reimbursing medical expenses. Experts recommend carefully to beware of firms offering self-payment of treatment with subsequent damages: there is a risk not to return the money spent.

Some insurance companies regulate the time spent in hospital, the cash limit for medicines and the number of visits to medical institutions for the year. Most often this speaks of the company's bad faith.

When choosing an insurance service provider, it is not worth paying attention to the work of the support service. It is important that it was around the clock. It is also important to clarify with which medical institutions the company cooperates. For cheap insurance, it is most often government agencies. At the conclusion of the contract, the insured is assigned to a particular hospital (s),in which he will apply during the term of the insurance contract.

You decide to insure - where to start?

First you need to chooseinsurance provider company. Next is the contract. Today, it is not necessary to go to the office of the company. Most firms offer to conclude an agreement via the Internet, after which the package of documents comes insured by mail.

When an insured event occurs, the client calls the round-the-clock dispatch service, reports personal data, the contract number, the essence of the problem - and the insurance company solves it.

In case of late payment of the insurance premium, the contract does not enter into force. You can terminate the contract on the initiative of any of the parties, which should be notified at least 30 days in advance.

What can you save?

Of course, not on health. However, on health insurance - quite!

Significant discounts (up to 50%) can be obtained for corporate clients. Insurers give preference to group orders (companies), however, family insurance is accompanied by considerable discounts.

Rarely ill people can get the most budget option insurance,which includes emergency care and medicines, although in such cases it is better to purchase accident insurance, which will cost many times less.

Experts recommend choosing policies with a price range of 3-5 thousand per annum with unlimited coverage of the cost of medicines.

Significantly affects the cost of the policy and the type of proposed medical institutions. Thus, public hospitals are often located at medical universities, and therefore this can not only save money, but also get more qualified services.

Should I use the services of voluntary health insurance? You decide! But remember that health is the most precious treasure, and it is very important to learn to appreciate it on time. Health insurance is not a luxury, but the most reasonable and profitable type of investment - investing in health.


Take it to yourself, tell your friends!

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