Don't Wait to Get Sick. Better Anticipate!

An illness, in addition to weakening your health, can considerably reduce your assets if you are not prepared. So when it comes to making your budget and deciding what to invest your money in, think about taking out insurance to help you take care of it and cover any expenses arising from an illness or medical emergency, and thus keep your finances healthy.

In the market, you can find options such as health insurance and insurance for major medical expenses, but the key is to understand how each one works and hire the one that suits both your needs and your pocket.

Health insurance is often confused with major medical expense insurance, but its characteristics are different. While the former seeks to prevent and restore the health of the insured; the latter seeks to restore their health in the event of suffering an accident or illness that is previously stipulated in the policy, paying all the hospital and medical expenses that are needed to be derived from them.

Its objective is to provide services to prevent or restore the health of the insured directly with its own resources (in its own facilities); through third parties (network of medical service providers); or in a combination of both, through actions carried out for the benefit of the insured. They are ideal for those who require frequent medical consultations, such as children.

You can also contract additional coverage by paying an extra cost for them, such as dental and ophthalmological services, hospitalization expenses, among others. The costs of these policies will depend on the plan managed by each insurer, the coverage contracted, and whether it is individual or family insurance.

Major medical expenses

If what you want is to guarantee that you can cover the expenses caused by an accident or a medical emergency, the ideal is to take out insurance for major medical expenses.

In this type of insurance, it is necessary to pay attention to the sum insured that you wish to contract because it is the maximum amount that the insurer will pay for each claim that arises. This sum is per event (for each accident or illness) and per person and must appear on the title page of your policy. Previously, insurers offered unlimited sums insured, however, as of January of this year, all medical expense insurance must establish some amount3.

Two other aspects that you should consider if you want insurance of this type are the deductible and the coinsurance, which will always be borne by you so that you have co-responsibility in the claim.

The deductible can be a fixed amount or specified in minimum wages, and you must cover it before the insurance begins to pay you any benefits.

Coinsurance is your share of the total cost of the claim. It is calculated after subtracting the deductible and is usually expressed as a percentage. It serves to prevent you from exceeding expenses by contracting services that are outside of those contracted in your policy.

Other factors that determine the cost of insurance are age, gender, hospital level, and residence. They also intervene in the cost if you are a smoker, your occupation, and the scope of the insurance (if it is national or international).

Some of the basic coverages in these insurances are:

Medical fees with and without surgical intervention.

Hospital expenses (room, food, laboratory and office studies, operating room, cures, intensive care, blood transfusions, medications within the hospital, anesthesia equipment, general nursing care).

Rehabilitation therapies (physical, neurological, hydrotherapy, physiotherapy) are necessary as a result of an accident or covered condition, as long as they are prescribed by the treating physician.

Radiotherapy and/or chemotherapy treatments prescribed by the treating physician.

Reconstructive surgery as a result of an accident and covered condition, as long as it is medically necessary.

Laboratory and cabinet studies are essential for the diagnosis or treatment of a covered accident or condition.

You can also contract additional coverage such as emergencies abroad, accidental death, organic losses, travel assistance, elimination of the deductible in the event of an accident, funeral expenses, among others.

Expenses not covered

You should consider that there are some cases and expenses that your insurance does not cover, so you need to keep them in mind when hiring your policy.

Exclusions are those diseases or treatments that the insurer does not cover. The most common are cosmetic surgeries, psychiatric treatments or studies, congenital conditions, homeopathy, accidents, or illnesses due to drug use, among others.

Both health insurance and major medical expenses can be contracted individually, family and group, or collective. The hiring age is from newborn to 64 years old, with renewal up to 69 years old.

What if it's not enough for me?

If after reviewing your budget it is not enough for any of the aforementioned insurances, there are also basic health and medical expenses insurances, which cover the most common risks and have a contract model that allows you to compare the rates of all the institutions that offer these products.