With health insurance, there is no such thing as a ‘one size fits all’ approach. The finer details really do matter.
Finding the right health cover
For most people being in good health is a top priority. When it comes to your health you can’t predict what’s around the corner – but you can make sure you have the right plan in place.
At JW Seagon we offer a full range of health insurance plans. We will guide you through the following questions, review the options and make a recommendation:
In which countries would you want to be treated?
Are you comfortable with the medical facilities in the country you live in? Whilst you might be for routine treatment, if you needed to treat something more serious, would you want the option to travel to access superior facilities and expertise within Africa, in Europe or in the USA? The wider the area of cover you choose the higher the premium you will pay.
What do you want treated?
Do you simply want to know that the treatment of the big, serious illnesses is covered, or do you want to have cover for everyday routine treatments as well? Do you want cover for maternity, health checks or non-emergency dental treatment?
Health plans give you the option to cover either:
in-patient + out-patient treatment
in-patient + out-patient + wellness, optical, and dental benefits
Whichever combination is right for you, we would recommend that you make sure your health plan includes evacuation cover (with some policies it is an option). When the right facilities aren’t available locally, evacuation cover meets the cost of transporting you to another hospital where you can get appropriate treatment. This might be in a nearby town or city, or a completely different country.
Whilst most health plans will not cover any medical conditions you currently have or have had in the past (often referred to as ‘pre-existing conditions’), there are a few that may do so. Africa Wellness Solutions (AWS) is such a plan. Instead of excluding pre-existing conditions, AWS looks to cover them where possible, sometimes for an additional premium to cover the increased risk.
What is your budget?
For most people getting the right health cover in place is a balancing act between the extent of cover and what they can afford. Your premiums will be affected by your choice of which countries to have cover in and what you want to have treated. You can also manage the price and make your plan more affordable by taking an excess or deductible.
To discuss our health insurance options further or to request a quotation, please call JW Seagon on: +254 709 455 300
Area of cover: the geographical region where you can have treatment (travel costs are not covered). The wider the area of cover the higher the premium.
Deductible or excess: the amount you pay each year for eligible treatment before your insurance policy starts to pay any benefit. The higher the deductible the lower the premium.
In-patient treatment: treatment requiring an admission to hospital.
Out-patient treatment: treatment not requiring an admission to hospital, including visits to a doctor, consultations with a specialist, tests to find out what is wrong, as well as prescribed drugs and medicines.
Pre-existing conditions: medical conditions you have, or have had, before buying a healthcare plan.
Provider network: insurance companies have networks of medical providers (hospitals, clinics, doctors etc.) Typically:
If you use a network provider the cost of treatment will be settled directly by the insurer
If you don’t use a network provider you have to pay for treatment and submit a claim for reimbursement