What to look for and what to avoid in health insurance for children

Posted on Sep 11, 2015 by rob.mcbroom

A family health insurance plan will cover medical costs you, your spouse, and your children may be faced with in the event of a medical injury or illness. We’re going to set out a few things that you should always stay aware of, hopefully providing you with a solid background that can help in finding the most suitable plan.  

Keep in mind that the real value in family health insurance is to protect yourself against the worry and often complicated procedures of medical bills, when the focus should be on your family, and getting them the best care.

Your selection

There is a wealth of choice in both the number of insurers and each of the plans that they offer. All plans cover varying degrees of cost for treatment, based on which options you select, and you will have a choice from a range of medical facilities for you to access.

The first thing newer parents may want to know is that some plans are available where payment for only the first child has to be made, where each child beyond the first is covered at no additional cost. Then make sure you know what your plan’s annual limit is, as some insurers offer what is known as a combined annual benefit pool. This means that the more family members on the plan, the higher the increments in the limit go, providing more flexibility.

Another good point is to see whether lifetime renewal is guaranteed for the plan; this means the continued membership with the insurer will be based on your age, regardless of claims made on conditions that arise in the course of your life (or your family member’s). You can also choose to pay your subscription monthly or annually, and depending on the insurer at the time, selecting one over the other can see you saving money.

The benefits

A good family plan will provide annual health checks, and in some cases you are able to select from a range of free wellness services every year after your first renewal, including services such as dental polishing, optical checks, full body health checks, vaccination, and even pre-marital/pre-pregnancy check-ups.

Some family tailored plans provide coverage all over the world, (many excluding the United States) that include Emergency Evacuation. If you intend to take your family on trips around the world whether on holiday or to relocate, international plans offer cover wherever you end up visiting.

A good list to start with is below, as an idea of what you will be able to select on

• Maternity Coverage
• New-born Child Coverage
• Inpatient coverage
• Outpatient coverage
• Vaccinations and Preventative Medicine
• Alternative Therapies and Complementary Medicine
• Dental Coverage
• Pre-existing Condition Coverage
• Chronic Condition Coverage
• Emergency Evacuation

Some specifics

Make sure that the policy is clear on whether it covers pre-existing conditions, and determine how long exactly the moratorium (period of time before the plan takes effect) will be. If you have any doubts about the health of the previous generations in your family, also make sure you know if the plan excludes hereditary conditions. Same advice goes for congenital conditions, or developmental conditions, which may not be included in every family plan out there.

An important thing to know that if you actually have to use the insurance, is how much excess/deductible there is on the plan. Competitors in the industry will offer different levels of excess, always depending on how much you want to initially spend on your insurance, but it is essential to know the figure, as you will need that amount of money ready in order for the plan to start covering.

If you do make a claim, make sure you know if there are going to be any extra charges for claims afterwards. A plan that does not charge you extra after each claim is much better value, and would not force you to cancel when costs are eventually raised too high.

In the hospital

When it comes to the actual treatment and its related costs, make sure to investigate how high or low the caps are on outpatient benefits. Also know if there is a minimum length of hospital stay. Restrictions on certain treatments such as receiving a cast, wound sutures, radiotherapy and chemotherapy, basically treatments that do not require hospital confinement, mean that they may be excluded on your plan.

When it does however come to covering hospital expenses when receiving inpatient treatment, here are a few medical expenses that can be covered for your family:

• Room and Board
• Miscellaneous Hospital Services
• Intensive Care
• Private Nursing
• Surgeon and Attendance Fees
• Anaesthetist's Fees
• Operating Theatre Fees
• Inpatient Physician's Fees
• Inpatient Specialist's Fees
• Cancer Treatment and Kidney Dialysis
• Pre-admission and Post-hospitalisation Outpatient Care
• Emergency Out-patient Benefit for Accidents

An important luxury for many to look for is the covered costs of using an extra bed, or companion bed, for use of a family member of parents if a child is hospitalised.

All of these payments for treatment can work through what is known as Direct Billing, which eases the process of claims and bill payment drastically. Not all plans and hospitals offer this benefit however, and many that pretend to may not actually have an efficient enough network for it to be useful, so make sure to ask specific questions when it comes to your network (hospitals in your area).

At home

A 24/7 health support network is available with most big insurers, to enable access to a team of qualified nurses and healthcare professionals who can provide guidance on your child's health related queries, with the support of doctors. It is essential that this network is readily available to you, which means saving the number in your phone, or sticking it permanently on your fridge.

Many large insurers now have online platforms for their customers. See if the one you are choosing can offer a centre to submit claims. These notify you of a successful process with immediate confirmation to your mobile phone.

If you are looking for a comprehensive family plan, the experts at Pacific Prime Singapore can help you find the ideal plan that will meet your coverage needs and your budget. Contact us today to learn how we can help.