Small print can cost you big time!
It is crucial to read the small print on a health insurance policy because it contains essential details about what the policy covers and what it does not. By thoroughly reading the policy, individuals can avoid unpleasant surprises and ensure that they understand their coverage and their financial responsibilities.
Some of the main things that catch people out and cause dissatisfaction for insured persons are:
Exclusions: Health insurance policies often exclude certain treatments, medications, or conditions. For example, a policy may not cover cosmetic surgery or pre-existing medical conditions. It is important to read the small print to understand what is excluded from the policy.
Deductibles and co-payments: Policies may have deductibles and co-payments, which are the amounts that individuals are required to pay out of pocket before the insurance kicks in. The small print will specify these amounts and how they are applied.
Limits and caps: Health insurance policies often have limits and caps on coverage, which means there is a maximum amount that the policy will pay out for certain treatments or conditions. For example, a policy may have a limit on the number of physical therapy sessions that it will cover. Understanding these limits and caps is important to avoid unexpected expenses.
Network restrictions: Many health insurance policies have network restrictions, which means that they only cover treatments from specific healthcare providers or facilities. It is important to read the small print to understand if there are any restrictions on which doctors or hospitals you can use.
Renewal and cancellation policies: Health insurance policies may have specific renewal and cancellation policies. Understanding these policies is important to avoid gaps in coverage or unexpected costs.
Policy wording can reflect the attitudes and thinking of an insurer, and it is important to understand that all insurers have different terms and conditions, and the way policy wording is written can differ greatly. Levels of clarity can vary and unfortunately some ambiguity and caveats may even be deliberately built-in to the detriment of the insured. Wording should be completely clear and unequivocal, and one should never accept a single term or any wording that cannot be understood.
Wording should be comprehensive enough so all questions or scenarios cannot be suitably answered and covered. Moreover, if one finds themself asking lots of questions after reading a policy’s wording alarm bells should start ringing. These documents can and should be clear enough for a non-insurance professional to understand and complete and comprehensive enough to ensure this does not happen.
More or longer words and more complicated and technical terms do not ensure a policy’s wording is any better or more accurate. Wording should be as succinct, and customer focused and user friendly as possible. Even when external regulations and laws must be incorporated, if due amounts or care, attention and effort are taken for the wording this is still achievable. An example would be the DHA compliant versions of our GlobalCare products range sold in Dubai, UAE, which use some of the clearest, most succinct, and yet still complete and user-friendly wordings in the market. This makes the polices easier to sell and administer, minimises misunderstanding and disputes, increases member confidence and certainty, and therefore leads to high quality customer experiences and satisfaction.
Reading the small print on a health insurance policy is critical to understanding what is covered and what is not. By understanding the exclusions, deductibles, limits, network restrictions, and renewal/cancellation policies, individuals can make informed decisions about their healthcare coverage and avoid unexpected costs.