Rus Articles Journal

- two poles of

you did not manage to acquire the health insurance at the end of the last year from the policy and hesitate whether it is worth doing it now? Its purchase has to be thoughtful, especially if crisis concerned your family budget.

we Look for differences

First of all, it is necessary to understand - what a difference: to pay for single medical services or in a complex to the insurer? Centers and policlinics generally the same. Doctors - the same. At the same time the voluntary medical insurance (VMI) has pluses and minuses. Let`s begin with good.

Pluses

  1. Possibility of the choice. In an asset of insurance company - a set of different clinics and centers.
  2. Protection of interests. In conflict situations your interests will be advocated by the specialist of the company interested in extension of the contract both in a year and through two: it is its profit. The attending physician is not pleasant - he will be replaced. The ear in the day off ached - will find the ENT specialist.
  3. Additional services. Any service can be bought separately. For example, alternative ambulance or contract for conducting pregnancy and/or childbirth. Do not consider the contract as a sentence moreover and lifelong. During all term of insurance you have the right to change the doctor, policlinic, to add the list of services.
  4. of Anything superfluous. To you will never appoint doubtful analyses, will not make the unreasonable diagnosis and will not write down on unnecessary consultations with the purpose to fleece from you. On the other hand, it is unprofitable “to gape“ a problem too.

Minuses

  1. Coefficient for hronik. Many difficult chronic diseases at VHI only diagnose. It is necessary to be treated and pay most further. At chronic diseases the cost of the policy is multiplied by solid coefficient. If the chronic disease is known in advance, you should not conceal it - everything will become obvious sooner or later, and in this situation the insurer can refuse to pay treatment. VHI - not a way to cure everything that already hurts, and at the same time to save. It is all the same what to run to make out the COMPREHENSIVE INSURANCE when the car already crashed into a fence.
  2. For children and pensioners of the VHI program cost much, especially for babies.
  3. is cheaper than
  4. , but it is not better. If there are several methods of treatment of an illness, the insurer will choose the cheapest, it is possible not to doubt.

How to choose

the Step № 1. Define the list of services which you expect to receive. The list of your expectations can look, for example, so:
Out-patient service in policlinic + home visiting service + stomatology without prosthetics. Or so:
Out-patient service + departure on the house of doctors - experts + an electrocardiogram and laboratory researches at home + ambulance.

Step № 2. Choose the program. The insurance agent will offer several options. For an additional fee it is possible to add to any practically any services! The individual insurance is always more expensive than corporate.

Step № 3. Determine the price level of the program. Clinics with which the insurer cooperates are divided into several groups and, respectively, levels. Among them also there are old military establishments, and the modern medical centers. The price of a question depends also on the number of medical institutions to which you can address.

Step № 4. Finally decide on the program, all additions and again attentively re-read the contract. Happens, the agent begins “to break the resistance“: only today and only for you - a 5% discount. It is anyway better to think one or two days, to weigh everything and to discuss with house.

the Medical policy is included into a social package of the firms respecting themselves.

Carry out by

field tests

Dmitry Kuznetsov, the CEO of the Interregional union of medical insurers, comments on typical cases.

Situation № 1

“To me is 30 years old, is not married. It is quite healthy, but on spring overcomes pollinoz. I am fond of fitness, I ride a snowboard“.

would advise

Ya the standard program “Policlinic“, only specify whether the allergist is on the staff of the offered clinics. If the risk of injuries is high, it is possible to add the Emergency Stationary Help program with a limit to one hospitalization.

Situation № 2

“To me is 38 years old, two daughters (one - 6 years, another - 8 months), the husband with the beginning prostatitis and the mother-in-law - the hypertensive person. There are osteochondrosis and gynecologic problems, after the delivery there were bad hair and nails“.

“Family insurance“ has doubtful value in Russia so far. There is no standard of “the family doctor“ yet, most often it is the ordinary therapist who is safely undertaking part of functions of the ENT specialist, cardiologist and other doctors - experts.

by

Choose the company - the insurer from among solid, engaged in medical insurance not the first year.

to

In this case to the lady will suit the program “Policlinic“, but functions of the cosmetologist and the trichologist will be carried out, most likely, by the dermatologist. Insurers do not love therapeutic cosmetology because it is difficult to estimate effect of treatment objectively. There is an alternative - the contract with medical institution directly. On money it will be approximately the same.

For other family members - also the program “Policlinic“. Plus for children and the mother-in-law, depending on problems and financial opportunities, - programs “Ambulance“ and “Emergency Stationary Help“.

Situation № 3

“to me 50. I lead active life, tightened, in a tone. However, I smoke, short wind exasperates, is varicose and cholelithiasis (perhaps, operation is required) and a climax began... Yes, still I want to have a denture made“.

to

needs a full set Here: “Policlinic“, “Stomatology“, “Ambulance“, “The emergency and planned stationary help“. The contract directly with commercial center does not make sense - money for it will leave much more. To find the insurer whose stomatologic program includes prosthetics, it is theoretically possible. But it considerably narrows the choice of the company and the program for other parameters and not the fact that will allow to save. The insurer - not the doctor, but the economist.