How to choose health insurance?

“… 3 things in life: health, money and love …”

The choice of health insurance , like that of any insurance, is a complex task. Now, it is essential not to be wrong in the election or we could pay it very expensive if necessary. And when we say “pay very expensive” it is literal if the insurance does not cover the intervention or center we need.

Therefore, the comparator Seguros.es is a unique tool to facilitate this work and succeed in 2 of the 3 important things in life. For you to choose health insurance that guarantees your recovery and, of course, at the best price. But, what are the most relevant aspects when selecting health insurance?

1.- Do I really need private health insurance?

In Spain, all those who have access to the public health service can say that they already have health insurance. Moreover, health insurance with highly qualified professionals and very advanced facilities. We could say then that private health insurance is only a second protection, for those occasions when public insurance fails. However, the current saturation of the public system implies that the service is not always of the quality and promptness of action that we would like. For this reason, private health insurances are becoming a tool of primary need, with very high quality offers, with many possible combinations in the service provided and with the most adjusted prices.

2.- How much am I willing to pay for private health insurance?

There are 3 types of health insurance.

Between € 30 and € 70 per person and month are the most common insurance, which are known as “ medical insurance ”. It means that clients have unlimited access to the company’s medical staff (to the group of doctors and centers with which they have signed an agreement), without making any additional disbursement, except for small co-payments that we will talk about later. The service usually covers both medical consultations and diagnostic tests as well as surgical interventions with hospitalization

From € 60 per person per month, the “ medical insurance plan plus reimbursement ” are placed. It means that customers have unlimited access to the company’s medical staff, as well as to any doctor in Spain and the world as long as the customer pays in advance and sends the bills to the company to reimburse the amount (usually between 80% and 90%) Again, coverage usually includes diagnostic consultation and surgical intervention with hospitalization.

Between € 20 and € 35 per person per month, and responding to a market demand, during the last years “ medical insurance that only covers medical consultation and diagnostic tests ” are becoming popular . This is an interesting option for those people who want to receive a rapid diagnosis, but who prefer to undergo surgery in a social security center.

3.- Am I interested in taking insurance with co-payments?

The word “ co-payments ” is not popular since it was proposed to introduce it in social security. However, it is a very interesting option for those people who barely use (or would use) private health insurance, since it allows to significantly reduce the price of insurance in exchange for paying a small amount every time we go to the private doctor. For example, in the case of a company currently available, the option with a co-payment is € 10 cheaper per month and person. In insurance for 3 people are € 30 per month. If the copayment is between € 3 and € 5 per consultation, and we see the doctor less than 6 times a month, the option with a copayment will be less expensive.

Likewise, it is worth noting the appearance of the so-called “baremados medical cadres” or “health clubs”. These initiatives allow the purchase of a product comparable to medical insurance (technically they are not insurance, although in practice they can be difficult to differentiate) for a price between € 3 and € 8 per person per month. In these cases, the price to be paid in a consultation can be € 25, lower than the doctor’s “standard” rate, but much more expensive than the insurance co-payment.

4.- Which insurer includes my usual doctors in the medical chart?

Even for those who are going to take out reimbursement insurance, it is recommended that the doctors we go to frequently are in the private insurance medical chart. These health professionals are the family doctor, the pediatrician for children, the gynecologist for women and a specific specialist that each person, for their health, needs to visit frequently.

5.- What is the fine print that I should read and know about my insurance before hiring it?

Like any contract, health insurance has many limitations. These limitations are usually detailed in the general and / or particular conditions of the policy. The main factors that we must assess are:

  • Total economic limitation per insured and year, that is to say the maximum amount that the insurer will pay for treatments to an insured over a year. The limit is usually between € 100,000 and € 150,000, although there are offers between € 20,000 and € 1,000,000.
  • For reimbursement products, partial economic limitation for specific interventions or inquiries. For example, in highly prestigious centers, consultations and interventions can be so high that the reimbursement is not calculated as a percentage of the total amount but for a maximum reimbursement limitation. Thus, there are insurances that limit the cost of a delivery to € 5,000, although in renowned clinics the price exceeds € 10,000.
  • Temporary deficiencies that imply that the insurance does not cover certain interventions for a period of time from the contracting of the policy. This is a clause to prevent private insurance from being contracted once a disease diagnosis already exists. For example, it is common in birth coverage.
  • Coverage of transplants and prostheses, which are an intervention and very expensive and often excluded elements
  • Family coverage such as assisted reproduction, cryopreservation of umbilical cord cells, IUD implants and vasectomies, etc.
  • Coverage in mental health practices (psychology), sports (physical therapy) or dental coverage.

We hope that with all this information you can calmly choose your health insurance. For now we wish you good luck and good shopping! Because from here we can’t help you with love …