The basics of choosing the best health insurance

According to the World Health Organization (WHO), "health is a state of complete physical, mental, and social well-being." This definition emphasizes that a healthy person leads a happy and fulfilling life in every way, which is why it's so important to take care of your health at every stage of life.

Health insurance is there to support you on this journey, and more and more people are choosing it as a way to access high-quality, personalized care without the long waits. These policies offer comprehensive coverage for any situation that could affect your health or that of your family.

If you're thinking about taking this step, this article will walk you through all the important details about these products to help you make your choice

Start by figuring out which type of health insurance best fits your needs, because there’s more than one kind. The most common option is healthcare assistance insurance, which gives you access to a network of medical professionals and hospitals, either owned by your insurance company or part of its approved network. The provider network is usually listed on the company’s website or mobile app.

If you prefer to visit a private doctor or hospital center of your choice, expense reimbursement insurance is the right choice for you. With this type of policy, you pay for care upfront, and then your insurance company will reimburse you for the full amount or a percentage of the expenses, as stipulated in your contract. Make sure to check the reimbursement rates and limits, as well as the steps you'll need to follow to submit your invoices.

Another option is dental insurance, which provides access to dentist and clinic services, often at no cost or with significantly reduced deductibles, for example, in orthodontic or cosmetic dentistry treatments. And finally, there’s daily compensation insurance, which provides a set payment for each day you're unable to work due to hospitalization, illness, or similar situations. This insurance is thus ideal for entrepreneurs.

Health insurance covers a wide range of medical services and care. Although the list of coverages may vary between insurers and the type of insurance, there are certain benefits common to practically all policies:

• Access to primary medical care (general, pediatrics and nursing) and all manner of specialties (gynecology, cardiology, traumatology, dermatology, ophthalmology, neurology and allergology, among others). Reflecting changing times, many insurance companies now include virtual medical consultations as standard.

• Surgical procedures (general and outpatient) and hospitalization.

• Diagnostic tests: X-rays, scans, ultrasounds, and analysis.

• Preventive medicine: vaccines, regular checkups, health advice or health education programs and rehabilitation.

• Emergency and emergency medical transport.

• Travel healthcare assistance.

If you’ve decided to take out a health insurance policy, you’ll have to fill out a questionnaire when you apply for it, which mainly collects information about your habits, medical history, and current health status.  

Don't forget to disclose any pre-existing conditions—any illnesses or medical issues you had before you applied. It's not only required, but also essential for the insurance company to be able to offer you a policy that truly meets your needs.  

You have to be transparent about your medical conditions when applying for this type of insurance, as it will help you avoid any future coverage issues. 

It’s also important to understand the waiting periods of your future policy, which is the amount of time you’ll need to wait after you purchase the product before you can access certain services, which are usually diagnostic tests or complex treatments. For example, when it comes to pregnancy, a waiting period of around eight months is typically required from the start of your policy. For treatments like radiotherapy or chemotherapy, it can be up to 10 months. 

With healthcare assistance insurance, you often have the option of choosing a policy with or without a copay. This determines whether you pay a small fee for using the services.  

A copay plan is a way for insured parties to share costs with the insurance company, which helps lower monthly premiums. Check your policy to learn about all the details and the cost of each service.  

We hope this glossary has helped you better understand some of the key terms related to health insurance. At MAPFRE, we offer a complete range of medical insurance plans with extensive coverage. You can choose the one that best fits your needs, whether you want healthcare assistance insurance with or without copays or reimbursement-based insurance for medical and hospital expenses. All of our plans come with a wide array of coverages and services. 

Plus, with your health insurance, you’ll have access to the MAPFRE Salud app. With just one click, you can view your medical history, schedule appointments online, manage authorizations and reimbursements, access telemedicine services and video consultations for adults and children, chat with doctors, and enjoy many other features designed to provide the best possible experience. 

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