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Two types of Health Insurance plans on offer

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• HEALTH INSURANCE

Two types of health insurance plans have been available to Vincentians. These are the traditional “Base Plan plus Major Medical” and the “Comprehensive Major Medical”.

• BASE PLAN

The “Base Plan” aims to cover the normal medical expenses that you incur in S.V.G.

These include: In-hospital room, nursing & hospital services; surgery & anaesthetic; doctors consultations, at clinic, home or hospital; prescribed, approved medication; psychiatric treatment; maternity benefits.{{more}}

There are limits on the coverage under each heading so, in some cases, the extra cost is covered under “Major Medical”.

• MAJOR MEDICAL

Major treatments can have major cost, and the Major Medical benefit tries to help you bear that cost. Expect to contribute. Most plans insist that you bear 20 per cent of the cost (co-insurance) as well as paying the first amount (deductible) of such claims – this could be EC$100 or EC$250 etc. since plans vary. Some companies only charge 20 per cent co-insurance up to a limit, so that your actual contribution might not be more than EC$1,000 to EC$5,000 according to which company’s plan.

• SURGERY

If you’re told you need to plan for surgery, you can learn in advance how much your insurance would pay. This can help you to budget for what you have to pay towards the cost.

• “COMPREHENSIVE MAJOR MEDICAL”

This is a different approach, where you decide in advance just how much you can afford to contribute to any major medical costs. This amount you decide on is called your deductible. This means that the insurance does not pay for any costs less than this amount – it could be EC$1000, EC$2500, EC$5000 etc.

So, the insurance only cuts in above your chosen figure, and pays the balance of your costs. It’s simple, but the cost can be higher than other methods, simply because the amount of cover can be very high, e.g. EC$1,000,000 or more.

• INDIVIDUALS, FAMILIES & GROUPS

When, you stock-up your Ju-C or beer, it is always cheaper by the case. “Buying in bulk” has always been cheaper, and it’s no different with insurance. Prices vary according to Benefits, however! To insure yourself alone (“individual”) might cost you from EC$40 to EC$60 per month.

Yourself plus one dependant might cost EC$70 to EC$120 monthly. A family (parent and unmarried children) might cost you from EC$100 to EC$200 monthly, depending on benefits.

• ASK, AND MAKE SURE YOU RECEIVE

Insurance is an “intangible” product – it’s not like buying a car or chair, where you can try it first. Therefore, ask questions, and make sure you get clear answers. Ask to see it in writing. Specimen Policies are available. Obtain independent guidance where available. Don’t let yourself be rushed. It’s a serious decision! Soon we’ll look at some of the aspects which cause problems with claims settlement – look for the next article on our series.

• (contributed by The Insurance Brokers, Hinds Building, Kingstown. 457-1310)

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