A step-by-step guide to understanding health insurance plans

health insurance plans

Health insurance can sometimes be pretty complicated. We guide you through the top questions to ask before making a final decision on choosing between health insurance plans.

There are a lot of things to take into consideration when it comes to choosing the right health insurance plan – from cover for prescription medication to the claims process. Each factor is as important as the next, and the truth is, it can be a little overwhelming.

Trust us, we get it.

But the good thing about this is that we have also got your back when it comes to making insurance simple. We get that life is complicated, which is why we make sure our insurance isn’t. So, keep reading and at the end of this article, we hope you will be ready to make a well-informed decision on the right health insurance plan and cover for YOU and your health needs.

Right then, here it goes.

What is health insurance?

Great question! Many people are interested in getting health insurance and don’t really know what it is. The simple answer is that health insurance is basically an affordable alternative to medical aid. Giving you instant access to private healthcare, doctors, and hospitals, and at a price you can afford.

Discover: What is the Difference Between Medical Aid and Medical Insurance?

What makes health insurance plans so affordable?

Another good question. With health insurance, we have specified limits to our cover. Unlike medical aid, which is required by law to cover unspecified and often unpredictable medical fees and bills set my doctors and hospitals, we let you know EXACTLY how much cover you have and for what. This means we can offer more affordable premiums as we have limits in place.

The right questions to ask BEFORE choosing between health insurance plans

1.     Does the plan include my doctor?

A typical health insurance plan will work with a network – this means that there is a specified group of doctors you are allowed to go to. Anyone outside this network will not be covered. BUT – and here’s where it gets good – with Oneplan (that’s us), we let you go to ANY private doctor of your choice. Which means you can keep your family doctor with us.

2.     Does the plan cover my chronic medication?

With all health insurers, there will be specific waiting periods in place regarding pre-existing conditions. This means that if you have previously been diagnosed and are currently undergoing treatment for a long-term disease, then you will have to wait for a certain period of time to pass before you can claim for medical fees relating to this condition. This waiting period is typically 12 months.

3.     Does the plan cover prescription medication?

This will depend on your chosen insurer and the plan you want to get. Some health insurance plans cover emergency and hospital issues only. Others include prescription drugs. With Oneplan, we cover scripted and over-the-counter medication in EVERY single one of our 5 plans.

Related: What is covered in health insurance?

4.     How easy is the claiming?

It’s all fine and well having a great health insurance plan with great cover, but when it comes time to claim, you need to make sure you understand exactly how to claim and how complicated this process may or may not be.

Some insurers will require pages of paperwork from you before they even consider your claim. Others, like us, pride ourselves on a claims system that is upfront, easy, and hassle-free. So much so, that we even pay you BEFORE you see your doctor.

How we do this is through our awesome Onecard.

The moment you become a member with us, you will receive your Onecard. When you need to see your medical professional (like your doctor), simply login to our Oneplan App, load your claim, and the funds are then transferred to your card within seconds. You can then use this card to swipe at the doctor’s office as you would a normal debit card.

5.     What tools are available to help me make decisions on my health?

This is an important question that many people forget to ask. Before making your final decision, ask your insurer what kind of smart tools they have in place. Some of our smart tools include:

  • An interactive chat function in our app when you can chat with a team of nurses about any health concerns you may have.
  • Easy and paperless claims (as we already mentioned above).
  • A 24-hour helpline with emergency services available if needed.

We hope that this information was helpful in guiding you to making a well-informed decision.

Expert tip: Another important thing to keep in mind is that cheaper does NOT mean better. You should never choose a health insurance plan based on price alone. Some plans may seem like the best option because of their price, but this often means that your cover is limited.

Ensure you ALWAYS read the terms and conditions of your contract so that you are never left in the dark when it comes time to claim. Do your research and make sure you choose a plan and an insurer you feel comfortable with and one that covers you for your needs. If you are still a little confused, then one of our team members will be happy to help you with any questions.

Your Health Insurance Family,

Oneplan

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