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Health Insurance 101 for First-Time Buyer

by | Aug 19, 2022

After much deliberation, you have finally decided to get yourself (and your loved ones as well) health insurance but you still have some doubt. Here are a few things that can help you fearlessly jump into buying Health Insurance.

 What benefits does health insurance provide?

1. Safety net.

Having health insurance provides you with a safety net. In most cases one fails to see an illness coming and being insured cushions you from the financial blow one can get from falling sick. The safety net brings with it peace of mind because if anything happens, the first thought for you will be ‘I need to get to the nearest hospital’ and not ‘ I need to get money first before I go to hospital’.

2.Extensive panel of providers.

With health insurance at hand, one has a wide variety of healthcare providers, including specialists at their disposal. The insurance companies usually provide you with a list of NHIF accredited hospitals that you can visit and you will not have to pay out of pocket for every visit.

3.Managing illnesses.

Most of the insurance companies include medical check ups in their plans. This allows one to catch certain conditions in their early stages before they become problematic. The medical plan will also lighten the financial burden that may arise from managing chronic illnesses.

4.Saves Medical Costs.

One is able to save on medical costs for medicine, consultation fees, tests, surgeries, accommodation fees etc. that can alternatively be quite expensive if paid out of pocket. It makes it easy for you to handle your medical expenses over time.

 

What factors will determine the cost of Health Insurance? (e.g. age, location, deductibles, etc.)

There are a few major details that determine how far inside your pocket you need to go to get your medical cover;

1.Age.

Your age largely affects the price (premium) of your cover. The older you are, the higher the premium is likely to be. This is due to one having higher health risks as they get older. On the mTek Services app, you are able to digitally compare pricing for different age brackets and better prepare yourself.

Read; How to generate a health insurance quote

2.Number of dependents.

Through the app, one usually picks if the cover is for an individual or a family. When you look at the quotes, you will notice covers for individuals have lower premiums compared to those for the family. The number of dependents (spouse and children) heavily affects how high or low your premium will be.

Read; How to generate a health insurance quote for a family

3.Type of Plan.

Different insurance companies have a variety of plans within their health insurance product. Many classify the plans depending on the limits (the maximum amount an insurer will pay for a particular type of coverage) being offered. Higher limits result in higher premiums. Plans can also be classified depending on benefits and add-ons that come with the cover. Before you pick, you need to know what plan works best for you and is within your budget. With digital insurance, you can easily and quickly make this comparison at the click of a button.

4.Deductibles/Copay

Deductibles in insurance in Kenya are usually represented by the NHIF Rebate. This means that insurance companies will pay less the percentage your NHIF cover caters for. They usually indicate this in their benefits so you are able to see where the rebate applies.

As for co-payment, this is the cost that some insurance companies charge for a visit to a particular medical service provider. They usually indicate the facilities to which the copay applies so one is well aware beforehand. It usually ranges from Ksh.500 to Ksh.2000.

5.Add-Ons.

Having add-ons on your cover also leads to change in your medical premium. Through the mTek services app you are able to see the price for these addons before you make a purchase. 

 

 What are Add Ons? 

In simple terms, an addon is an additional feature that provides extra coverage on your basic premium at an extra cost.

The main health insurance add ons include;

1.Dental  Benefit

Some insurance companies offer dental coverage as an add-on upon purchase of a comprehensive health cover. With this, you are assigned a certain amount that is specifically for dental care and does not affect your inpatient or outpatient limits.

2.Optical Benefit.

Similar to the dental add-on, you are assigned a specific amount just for optical care which includes things like eye tests and prescription glasses.

3.Maternity Benefit,

This also comes in as an add on upon purchasing a health cover inclusive of inpatient and outpatient. This benefit covers costs related to maternity like, consultation fees, prenatal, c- section deliveries, normal deliveries etc. Coverage is dependent on the insurance provider you choose.

 

 When is the best time to buy Health Insurance?

Most insurance consultants encourage individuals to purchase health insurance in their mid twenties. At this stage, one is believed to have less financial pressure hence having the ability to save up for one’s cover. Most plans also tend to be significantly lower for those in this age bracket.

Purchasing health insurance at this age also helps one avoid waiting periods in case they get lifestyle diseases at a later stage in their lives. This also applies for those who intend to start a family. By getting the maternity add-on early enough, one is able to gain fully from the benefit when you are ready to get a child. 

 

 How to compare different Health Insurance plans on mTek

With the mTek Services app, we have made it easier for you to make comparisons in terms of pricing as well as benefits that the various insurance providers on our digital platform have to offer. 

Once you have followed the steps as shown on How to generate an insurance quote, there is a PDF file on every quote that gives a breakdown of the benefits the plan has to offer. This enables you to compare the plans by their  benefits. 

Each quote comes with the pricing so right off the bat you are able to compare the premiums each plan has to offer as well as the limits each premium is getting you. You are able to pick if you want an inpatient option alone or inpatient and outpatient. There is a clear distinction of pricing for the two on the app. Furthermore, you can also make comparisons in terms of pricing for the add ons which you are able to view on the app under every quote. 

 

#besmartwithus today & get yourself a Health Insurance cover!

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