Should I buy a VHI not to splurge on a treatment and medicine
Educational Program Health / / December 19, 2019
What is LCA and how it works
Voluntary health insurance - is insurance that allows you to receive medical care in clinics, not working on the program of compulsory health insurance. Roughly speaking, with the usual policy apply to the Community Health Center with VHI - in paid.
If compulsory insurance regulated by the law, there is no for an additional separate document. That is, each insurance company sets its own rules and decides which terms to include in the contract.
Typically, the policy - it is a constructor. That is, you are invited to basic services, and to her - a set of additional. Base - a minimum service in the clinic, and a list of possible options is limitless. This doctor on call at home, and emergency care, and dental care, and much more.
In Russia, LCA, as a rule, make out employers, it comes in an attractive part of the social package in employment. But whether to do additional policy, if it is not working and is not expected?
Advantages of voluntary health insurance
Advantages here are the same as that of the treatment paid to free:
- Service in private clinics with a higher level of comfort and technical equipment.
- No queues.
- Quality service. This includes the courteous treatment of staff, and the little things like free shoe covers and other disposable consumables.
In addition, the patient pays for the policy LCA one time, and then the insurance reimburses medical facility. This approach reduces the number of unnecessary tests and assignments that sometimes doctors do in the paid centers: the insurance simply do not approve of holding manipulation, non-standard treatment.
Cons voluntary insurance
Lack of LCA have one, but huge. It is expensive.
VHI - this is not a subscription at a discount to visit the hospital and insurance product.
The insurance company is not profitable, so you spend a lot of hurt and in the hospital all the money given for the policy, so the LCA many restrictions. Final calculations are often not in favor of the patient.
It is sure to be found in the policy
If you are thinking about buying insurance or employment, where employees provide VMI, and want to connect to the program kin, be sure to ask a number of questions:
- The list of diseases and conditions in which the policy will not be issued. In preparing this article, I reread the rules of insurance than a dozen companies. And everywhere refuse to enter into a contract with LCA with HIV and cancer patientsAnd people over 65 and people with chronic diseases of the cardiovascular system. In terms of insurance, it is unprofitable.
- Do's and Don'ts in the medical organization. Under the contract, it may be that before the visit to the clinic need to contact the insurance, and already there the operator will direct you to the doctor. And if this is not done, then the treatment will be at your expense.
- Clinic works with an insurance organization. The less choice and more modest clinic, the more likely that doctors will not be able to carry out a particular examination or manipulation. Then you have to go somewhere else, and spend their money.
Also, be sure to read all the rules of insurance and the contract itself, stating which cases will be insurance, and what - no.
What is not covered by insurance
All insurance different conditions. It is possible that in your contract for a certain price is something that no other agreements. But the standard policy in most cases the same. Besides the already mentioned cases of HIV infection and malignancies, they do not cover the costs of:
- Medications. Buy pills have for their money.
- Preventive visits to the doctor. Let's say you do not bother, but you know what it takes every year, or even twice a year to visit a dentist and a gynecologist. If you take care of yourself, the doctor will confirm that you are healthy. And the appeal will not be considered an insured event. The same can be said about visiting the doctor when you need to put a stamp on the certificate, for example.
- Pregnancy and childbirth. These events are not considered an insured event, and there are some suggestions for medical support pregnancy in insurance and clinics.
- Psychiatric care. About stress, burnout and depression with the therapist will talk for his money.
Simply say, when running a basic policy: when you have something sick, you visit a doctor and treated as outpatients. Everything else, including hospitalization (in a comfortable house) - it is extra chips for the extra money.
How do you know whether to buy VHI
To find out whether or not to buy a policy, you need to do a little bit:
- Calculate how much you spend on treatment.
- Find out what packages you need.
- Check which insurance and for what sum grant policy.
Last year I spent on treatment in commercial clinics are not so many, and sought help from mainly for routine inspections (in the table - rounded data, prices are relevant for my region):
Service | Cost, rub.) |
Admission gynecologist | 2 300 |
Tests and examinations | 3 750 |
Medical procedures and treatment | 4 540 |
Routine inspection dentist | 150 |
Professional teeth cleaning | 3 000 |
Massotherapy | 8 000 |
medical consultation | 550 |
medicines | 4 724 |
in total | 27 014 |
Calculator for one of the insurance companies have counted that the minimum policy, which will include dental services for me will cost 35 000 rubles per year. However, I still and will spend money on treatment, because all prevention, according to security rules, all the way down on my purse. That is, massage, teeth cleaning and the purchase of drugs - the most expensive item on my list - will be out of the insurance.
You can purchase an insurance policy that will cover these costs. But its price will be above the clouds - a hundred thousand.
For interest, I called back in two insurance companies, where honest officials said directly that for individuals VHI unprofitable and if worried because of the risk of injury or illness, it is logical to conclude an insurance contract from an accident or illness: he at times cheaper.
When it makes sense to buy a VHI
Voluntary health insurance is beneficial in several cases:
- With the help of the employer you are connecting to the relatives on favorable terms of insurance program.
- You've been sick and treated in private clinics.
- You have a lot of money and you want to receive medical care with maximum comfort.
If this is not your case, leave the LCA for employers who are thinking of subordinates, want to be attractive steep for professionals and do not lose people, because they are due to the common cold all day long in the queue to protorchali doctor.