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4 tips for getting the most out of your employee health insurance

April 15, 2017

As an expat working in a country away from home, it’s likely that you’ll have an employee health insurance plan. Amidst the ever-increasing cost of healthcare, it’s no wonder why employer-provided health insurance is often hailed the “crown jewels” of the benefits administration sector.

What a lot of people make the mistake of doing is taking their employee benefits packet home and storing it away without properly having a look at what’s included in their plan. This is definitely not a good idea, as every employee health insurance plan is different and some plans may cover more benefits than others.

To help you take advantage of your employee health insurance plan, this article by insurance broker Pacific Prime Singapore lets you in on the following tips for getting the most out of your employee health plan.

1. Be sure to sign up during the open enrollment period

Typically speaking, when a company implements a new employee health insurance plan or switches insurance providers, there will be an open enrollment period during which employees will join the corporate health plan. If joining the health plan is optional, then it’s a good idea to sign up before the open enrollment period is over.

The reason to join before the deadline is so that you don’t experience any delays when you join the employee health plan. Also, insurance providers will usually organize informative sessions to educate employees on the benefits covered by their plan, how to submit claims, etc. If you join after, you may not be able to get this session. In some cases, failure to meet the deadline may even result in loss of insurance coverage for not just yourself, but your family too (if they’re eligible for coverage under your plan).

2. Include your spouse and kids

Due to the rising cost of health insurance and consistently thin operating margins, a lot of companies have started to trim benefits. As such, it has become increasingly common for employers to implement health plans that only cover the employee themselves, and not their dependents, e.g. your spouse and children. If that is the case, you’ll likely need to obtain a family health insurance plan and add your children onto it.

On the other hand, if your employee health plan does offer coverage for your dependents, then it can be a very valuable asset in offsetting your family’s healthcare costs. One thing to be aware of here is that restrictions may apply, e.g. there may be a restriction on the number of dependents that can be included in your plan. Also, if your spouse already has a health plan provided to them by their employer, then it is likely your employer-provided health insurance won’t cover them.

3. Know what’s covered in your plan

A lot of people think that just because they have health insurance, all or most of their healthcare costs will be covered. More often than not this is not the case, as each plan is different and the comprehensiveness of what is covered varies. Therefore, it’s definitely a good idea to know what your plan covers. Geared with this information, you’ll be able to make better use of your plan to receive the medical care you need.

For starters, it’s a good idea to be aware of the level of coverage your employee health insurance offers. Generally speaking, the levels of coverage are:

  • Inpatient only: As the most basic type of health insurance, inpatient only plans cover the costs related to healthcare that involve a stay at the hospital. Usually, you will have to be admitted by a doctor. This type of plan won’t cover outpatient treatment, e.g. visits to your GP.
  • Inpatient and outpatient: This plan is more comprehensive than inpatient only plans, as it covers both inpatient and outpatient treatment.
  • Full coverage: Full coverage plans are the most comprehensive, and are comprised of both inpatient and outpatient coverage as well as add-on benefits such as dental and maternity insurance.

Another thing to be aware of is which healthcare facility will accept your health insurance. Insurers often impose a “preferred network of providers” as a way to restrict coverage, meaning that it will only cover the facilities that have been contracted with the health plan. Be sure to visit the facilities that are within this network, because if you make a claim for care at an out-of-network provider, you may only receive a partial reimbursement, and sometimes even end up with your claim outright rejected.

4. Also know what’s not covered in your plan

Let’s face it, most people tend not to apply the same degree of due diligence on health insurance provided by their employers as they would on plans they have purchased themselves. The important thing to be aware of though is not only what is covered, but what’s not covered.

Historically, a lot of employee health insurance plans include what insurers refer to as a Medical History Disregarded (MHD) clause. This means any medical condition that the employee has prior to joining the plan (their pre-existing conditions) are covered. However, an increasing number of employee health plans exclude cover for pre-existing conditions, as treatment for these conditions tend to be very expensive.

5. Look out for additional perks

One of the top trends among HR teams is the introduction of wellness plans, which is often comprised of health insurance and other additional perks that are aimed at improving the overall of their employees. As such, it’s definitely a good idea to check whether you’ve got access to any additional health-related perks. Examples of these perks include:

  • A yearly health check-up
  • Discounts to fitness classes
  • Gym/ health club memberships
  • Counselling

6. Identify whether there are any gaps in coverage

By knowing what’s covered and what’s not covered, you may have identified various gaps in coverage. For example, if your employee health plan does not cover maternity insurance, but your or your spouse are planning to have a child, then you may want to find a top-up plan. By supplementing the gaps in coverage on your existing plan, top-up plans can really help save you a lot of money in the event that you require treatment that is not covered by your health plan.

It can be hard navigating through all the insurance jargon in your plan’s policy wording, which is why it often pays to get in touch with an experienced broker like Pacific Prime Singapore for impartial advice on your insurance needs.

by AI Singapore. Find out more about AI Singapore here.

Categories: Medical Insurance