Understanding Health Insurance Coverage in Pakistan
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Understanding Health Insurance Coverage in Pakistan

October 10, 2024

Health insurance plays a vital role in providing individuals and families with financial protection against unexpected medical expenses. In Pakistan, health insurance is increasingly being recognized as an essential tool for managing healthcare costs. With rising medical inflation and the complexity of modern treatments, having a solid health insurance plan ensures you have access to the best medical services without worrying about the financial burden. The United Insurance offers comprehensive health insurance plans that cater to the diverse needs of individuals, families, and corporate employees.

This blog will take you through the various aspects of health insurance coverage, what’s included, and who can benefit from these plans.

What’s covered under Health Insurance?

OPD (Outpatient Department) Benefits

Outpatient services are a critical part of health coverage, as they involve treatments that don’t require hospitalization. Here’s what The United Insurance offers:

  • Consultation Fees: The insurance plan covers both General Practitioner (GP) and specialist consultation fees.
  • Prescribed Medicines: All medicines prescribed by licensed medical practitioners are covered.
  • Laboratory Investigations: Routine lab tests, X-rays, ECGs, and ultrasounds are included.
  • Dental Care: Basic dental services are covered, ensuring you and your family can access dental consultations and treatments for acute dental issues.
  • Alternative Medicine Consultation: Apart from traditional healthcare, consultations with registered Hakims and practicing alternative medicine specialists are also covered.

Hospitalization Coverage

In case of hospitalization, The United Insurance covers a wide range of expenses, ensuring that you can focus on recovery rather than financial constraints:

  • Hospital Expenses Per Person: Coverage includes room rent and nursing expenses. This applies to each confinement per ailment (excluding pregnancy and dreaded diseases).
  • Surgical Expenses: If surgery is required, costs related to anesthesia, operating theatre (OT) charges, consultation fees, and nursing charges are covered.
  • Pre & Post-Hospitalization Expenses: The policy also takes care of expenses incurred before and after hospitalization, making it a comprehensive plan.

It’s important to note that a minimum of 24-hour in-patient confinement is required for claims.

Specialized Investigations

Specialized investigations are often necessary for diagnosing complex health issues. The United Insurance covers these investigations on an outpatient basis, provided they are recommended by a specialist:

  • Tests Covered: CAT-SCAN, MRI, Nuclear Scans, Angiographies, EEG, EMG, ETT, and ECHO.

Dreaded Diseases

The United Insurance plan provides coverage for several life-threatening and dreaded diseases, ensuring you receive the best possible treatment:

  • Heart Attack Management
  • By-pass Surgery
  • Cancer Treatment
  • Stroke (CVA)
  • Kidney Failure and Transplants
  • Major Organ Transplants
  • AIDS
  • Major Burns
  • Knee and Hip Joint Replacement
  • Chemotherapy
  • Multiple Fractures

These diseases often come with high treatment costs, and having coverage for them ensures peace of mind during difficult times.

Dental Cover

Dental health is essential for overall well-being, and The United Insurance offers coverage under the OPD limit:

  • Dental Care Coverage: Includes consultations, treatments for acute dental conditions, and gum disease treatments. However, orthodontic procedures, scaling, polishing, and prosthesis placements like dentures are not covered.
  • Limit on Dental Claims: Total dental expenses are capped at 40% of the total OPD limit per family.

Maternity Benefits

Maternity coverage is an integral part of any family health insurance plan. The United Insurance provides a wide range of maternity benefits:

  • Gynaecologist and Anaesthetic Fees
  • Diagnostic Tests
  • Miscarriage-Related Expenses
  • Medications and Nursing Care for the Baby
  • Labour Room and Operation Theatre Charges

This ensures that both the mother and baby are well taken care of, from consultation to delivery.

Who’s Covered?

  1. Corporate Sector Employees
    The United Insurance health plans are designed to cover corporate sector employees up to the age of 65. Special packages for businesses ensure that employees and their families have access to comprehensive healthcare services.
  2. Dependent Parents
    Special modules are available for dependent parents, allowing corporate employees to extend their health insurance coverage to their elderly parents.
  3. Children
  • Daughter: Coverage is extended to daughters until marriage, ensuring her health is taken care of during the formative years.
  • Son: Sons can remain covered under the health insurance plan up to the age of 25.

Why Choose The United Insurance?

The United Insurance is committed to offering tailored health insurance solutions that meet the evolving needs of individuals, families, and businesses in Pakistan. Here’s why you should choose our plans:

  • Comprehensive Coverage: From OPD to dread diseases, dental care to maternity benefits, our plans cover a wide range of medical services.
  • Corporate Plans: Special modules designed for businesses, covering employees and their dependents, make our plans ideal for the corporate sector.
  • Affordable Premiums: We offer competitive pricing for our health insurance plans, ensuring you get the best value for money.
  • Nationwide Network: With a wide network of hospitals and medical specialists across Pakistan, The United Insurance ensures you can access quality healthcare whenever and wherever needed.

Conclusion

Health insurance is no longer a luxury but a necessity in today’s fast-paced world. With the rising costs of medical treatments and the increasing complexity of healthcare needs, having a comprehensive health insurance plan can make all the difference. The United Insurance is here to provide you with peace of mind by covering you and your family’s medical expenses, ensuring that health is never compromised due to financial constraints.

For more information or to get a personalized health insurance quote, contact The United Insurance today!