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Medical Insurance

About Cover

Medical or health insurance is one of the most desirable benefits offered to employees. A good medical scheme/plan is one that provides an extensive and reputable network of Hospitals, Clinics, Pharmacies and Laboratories within easy reach of the members and their dependents on 24 hours basis taking into cognizance of the unpredictable nature of sicknesses and/or unforeseen accidents. There are several basic options for setting up a medical insurance scheme.

Medical cover can be

Fully Insured Schemes -Insurance company covers both inpatient and outpatient as fully insured

Self-Funded Schemes -Fund manager manage medical schemes fund

Hybrid Schemes -Partly Insured and partly funded medical schemes

Important considerations when taking cover

Check the various plans offered by different insurers.

Compare prices before committing to a particular provider

Seek for references from your colleagues that have an existing insurance plan for their employees. This will enable you to plan your budget appropriately. It is also good to know how long your reference has dealt with the insurer. The longer the better.

Make sure the insurance company you opt for is financially stable and capable of settling claims.

Make background checks by contacting the providers’ current clients to understand the providers’ service standards and turnaround time.

Types of covers

Individual Cover (M)

An individual seeking medical cover

Family Cover (M+)

A family seeking cover (could be Principal member and spouse with (out) children)

Corporate Cover (Staff)

Company seeking a medical cover for its staff and their dependants (M+)

Medical Schemes

Inpatient Cover

The In-patient cover benefit caters for illnesses requiring hospitalization and will be fully enhanced with pre-existing illnesses, chronic and HIV/aids conditions among other benefits.

Outpatient Cover

The Outpatient schemes deal with cases of illness not requiring admission into a hospital and include examinations, diagnosis and speedy treatment at health clinics and/or hospitals with the aim of preventing any ailment or illness from growing into cases that require hospitalization.

Benefits of the cover

Depending on the financial capability of the sponsor/employer, the medical scheme may be expanded to incorporate the following benefits:-

Funeral cover/ last expense (member / dependent)

Dental

Optical

Maternity

Evacuation

Overseas treatment

Learn how to protect yourself, family, assets and business

Medical Cover Insurance
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