Medical insurance: What should I consider when buying cover on a budget?

Have you ever been added to a WhatsApp group where you are asked to contribute towards someone's medical bill? It is becoming more common nowadays.

I know of families who have had to sell their possessions just to pay off a medical bill ranging from Sh300,000 to Sh10 million.

It is a tough situation to be in and unfortunately, we all know someone who has gone through this.

But there are ways to avoid this financial strain, such as saving for emergencies, but let us be real, how many of us actually do that?

The better option for people on a budget is to buy medical insurance.

Now, I know what you are thinking: "Medical insurance? It's expensive! But hold on to your wallets, my friends, because with a little bit of research, you can find an affordable medical cover that will not break the bank. Trust me, it is easier than finding your exit at Sarit Centre.

Starting point

So where do you start? Well, most insurance companies have brochures that you can request and compare, just like you would when you are trying to find the perfect pair of shoes.

And if that is too much work, you can always go through a licensed agent or an insurance broker who can make things easier for you.

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They know all the ins and outs of the various insurance companies in Kenya, and they will help you navigate through the infamous fine print.

When comparing packages, pay attention to the benefits offered, such as inpatient, outpatient, dental, optical, and maternity coverage.

Inpatient coverage is the most crucial one as it caters to all expenses in case of hospitalisation. Insurance companies offer a range of options, with payouts ranging from Sh50,000 to Sh10 million.

You can find something within your budget, with premiums starting from as low as Sh500 per month.

The premium you pay will depend on various factors, including your age and any waiting periods for pre-existing conditions.

Waiting periods are the time you must wait before you can use your cover due to an illness, such as chronic conditions like diabetes or hypertension or cancer.

Accidents, however, have no waiting periods. The longer the waiting period, the lower the premium you will pay.

Some insurance companies offer tailor-made solutions to suit the type of hospitals you prefer to visit.

If you prefer high-end hospitals, you may have to pay more than someone who chooses budget hospitals.

Co-payment is another factor to consider, where you pay a certain fixed amount before receiving treatment.

This cost-sharing method makes your cover more affordable as the premiums you pay are lower than if the copayment was not there.

Finally, make sure to go through the list of exclusions, which are ailments, conditions, or occurrences not covered by your medical insurance.

This is where the devil is, so go through the list preferably in the morning when you are fresh. It will affect you in the future if you have an ailment or condition that falls under this list.

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With a little bit of patience and research, you can find an affordable medical cover that will give you peace of mind and keep your wallet intact, if not, feel free to reach out to an insurance broker to guide you on the same.

Mr Njue is a senior risk consultant at Zamara. He can be reached via [email protected].