Health insurance is a crucial aspect of our overall well-being, providing financial security and access to essential medical services. Understanding the various types of health insurance is vital for making informed decisions about coverage. While the specific types of health insurance plans can vary, the following are the five major features often included in a comprehensive health insurance coverage:
Inpatient cover
Inpatient care generally refers to any medical treatment that requires admission into a hospital or a medical facility. Health insurance companies usually require you to be formally admitted into a hospital for an overnight stay for a service to be considered inpatient. The cost shall be recovered from the members hospitalization benefit.
Health insurance providers will specify what is covered, what is not covered and to what limit.
Outpatient cover
Outpatient refers to medical treatment or consultation that does not require a day admission or an overnight stay at a medical facility. The medical services include doctors’ visits, diagnostic tests and minor procedures. Outpatient coverage ensures that individuals can access a wide range of medical services without the need for hospitalization, promoting a more cost-effective and efficient healthcare system.
Dental cover
Just like the name suggests, dental coverage covers costs related to dental health and care as per specified limits in your policy. Dental insurance plans typically cover preventive services such as dental consultations and cleanings, as well as restorative procedures like fillings, extractions and root canals. It is important to understand what is covered in your dental insurance so you can make the most of your benefits.
Optical cover
This entails the coverage of treatment that is related to the eyes. It takes into consideration the cost of eye consultations and prescribed glasses (frames and contact lenses), all subject to the optical limit.
Some of the exclusions include:
- Replacement of frames unless directly caused by accidental injury to an eye
- Replacement of lenses unless prescribed by a qualified Ophthalmologist as necessary
- Laser eye correction (Lasik) unless otherwise specified
Maternity cover
Maternity insurance in Kenya is offered as a benefit or a rider after purchasing an inpatient cover. It covers several things such as consultations, scans, normal deliveries, c-sections and complications that may arise as a result of medical emergencies such as miscarriages.
It is important to ensure that you have a clear understanding of how your pre and post-natal work under your plan. Check if they are utilized under your maternity limit. This helps you keep the actual maternity cover limit within the package cost of your choice.
In conclusion, a comprehensive health insurance plan like ours includes these five features to provide a well-rounded approach to health care. It is important to note that specific coverage details can vary significantly among different health insurance plans. Individuals should carefully review the terms of their specific policy to understand the extent of coverage for each component and any limitations or exclusions that may apply. By understanding these components, individuals can make informed choices that align with their health and financial goals.
We have experts at CIC ready to help you out with fact finding and help you make the best decisions for all your health insurance needs. Contact us on 0703099120 or email.
