How to calculate the price of health insurance

What are the factors that make the price of health insurance what it is.

When someone is interested in health insurance usually compare the different options by searching the internet and usually talk to their acquaintances and friends who already have one hired in order to know what offers at the level of coverage and what they pay for it . This gives a reference, but it is still a reference, because not all people pay the same for their insurance.

It is clear that we do not talk about the same thing, that a car is not a person, but the operation when calculating the price of insurance has many similarities: asking a friend how much he pays for the insurance of his car does not give us a A clear reference, unless we have the same car and a similar vital situation (parking to leave the car, same years of license, kilometers we make per year, number of parts, etc.).

We mean by this that just as a car insurance depends on these and other factors, health insurance also varies depending on the characteristics of the person, the insurance that contracts and various situations that we discuss below so that You can know what it is that makes health insurance the price it has.

What the price of insurance depends on

When determining the price of insurance are many factors that intervene. These factors are studied in the actuarial department of insurers, which is specialized in the evaluation of risks and costs through the application of statistical and mathematical models. The result of this evaluation will give the price to pay to be insured with the particular conditions agreed.

Some of the factors that are taken into account are the following:

Type of insurance: If it is a reimbursement insurance, where the person goes to the professionals he or she wishes, he personally pays the bill and then the company returns a previously negotiated percentage, or a medical chart, which is the one in which the person visits centers And professionals attached to the company.

Age: Here, to continue with the car insurance analogy, the question goes backwards. In a car insurance you pay more when you are young, because of the inexperience and possible risk behaviors, whereas in a medical insurance the probability of getting sick increases with age, so the policy of a young person is usually cheaper than An elderly person or a baby.

City of residence: Depending on the province in which a person lives the cost may vary because it is a function of the cost of the medical providers.

Individual or family: It is not the same in terms of cost to buy insurance for a single person as if we are talking about insurance for several members of a family. In that case, in Sanitas there is a discount of 8% if there is more than one insured.

Corporate or collective policies: Similarly, if we talk about a policy that includes many people, such as workers in a company, the price is negotiated with the insurance company.

Coverage: A third party insurance in the car is much cheaper than one to all risk because they do not cover the same thing, because at the same level of health. Health insurance coverages also make it vary enormously. It is not the same basic coverage that one that covers medications, major interventions, hospitalization, dental services, etc.

There are more factors, but the comments are some of the most representative to give an idea of ​​why insurance may be different between some people and others. As a curiosity, to comment that there are things that are not taken into account, like the sex of the person, that does not vary the price, nor any genetic question (that the person has a predisposition to have some disease).

Is the price always the same?

Once the price is known and the insurance is contracted, the price is usually established until one year of the contract or until the end of the calendar year. Once that time arrives, the price is usually revised to adjust to the new circumstances, if any (increase of the CPI, health situation of the insured, if it belongs to a working group whose need for medical attention is increasing, etc.). In such a case, the insurer should advise the insured well in advance so that it decides if he wants to go ahead with his health insurance.

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Why your insurance premium increases every year

In another entry we explain how the price of health insurance is calculated in order to make known what are and what are not the circumstances and factors that are taken into account when insuring the insurance company .

That is, the conclusion drawn by the company after analyzing the situation of the person who wants to take out health insurance.

Today we are going to give a further thread on this issue, because once the person contracts insurance the price can vary. What? Varying? Is not it always the same? These are questions that many people ask because they think the starting price is what they will always pay. However, this is not the case, the price may vary because from year to year the circumstances of a person change, or those of the society, or those of the collective in which he works, or ... we will see, therefore, why the premium of your Insurance increases every year.

How long have the contracted conditions been maintained?

When an insurance is contracted the agreed conditions are maintained during the time established in the contract. There are agreements for 12 months from the time it is contracted and others that end on December 31. That is, you can hire insurance in October, for example, and on December 31, because it is when the calendar year ends, a rise in premium.

This, of course, does not work well in those cases where there is an offer or if a discount has been negotiated for a certain time. It would be something like the promotions that say "during the first 6 months you will have a quota of X euros". In these cases, even if the calendar year changes, the premium remains the same. Of course, at the end of those 6 months, there may be a change from the conditions that were previously set if, as we say, we are in the following year (or not, if the conditions have been negotiated previously with the insurer).

Why does the premium increase from year to year?

If you have noticed the entry that I have told you at the beginning, which explains how the insurance premium is calculated, you will have seen that the calculation depends on many factors and is quite complex to control. Well, every 12 months, or every December 31, companies make a new calculation for whether the person's life situation has changed or if the market has changed.

All of the factors we discussed, such as age (many companies operate by age group and a client may go from one stretch to another), pathologies (it is not the same to be completely healthy at the same time. (If we talk about collective insurance and it turns out that this group has more accidents), etc., and add more variables, such as the CPI , The price of medical services and, in short, all the factors that the actuarial department studies again based on the risk and the cost to establish the new premium.

In short, it is as if every 12 months the contract was terminated and re-insured with the company for 12 more months.

How much can the premium raise?

I wish this question could be answered, but it is materially impossible. If nothing changed, the premium would remain exactly the same, or at most there would be some variation per CPI issue and if the medical services also increase the cost. But since this (that nothing changes) does not always happen with all users, it is impossible to determine what the increase will be made 12 months after the initial signature. Come on, they are not preset. No company will say "for 12 months you will pay so much and from then on you will pay so much for another".

But, do they notify you of this rise?

Of course, or at least they should. It is a grace if not, that finding a charge in the account for an amount that you did not expect does not please anybody, and when you hire health insurance you do it because you trust the services they will offer you and the last thing you He wants to start feeling distrust.

Each company can do it in its own way, but usually a minimum of two months in advance will be sent to the customer a letter that will be clearly informed of what the new insurance conditions will be and therefore , Which includes the price of the premium that will pay. At that time the person who receives the letter can choose to do nothing, and in that case the company understands that it agrees and the contract is automatically extended twelve more months, or disagree with the increase and choose to rescind the Contract and unsubscribe from the company.

For this step, to know what to do to unsubscribe from a health insurance you can read the entry in which we talk about it: How to unsubscribe from health insurance.

What documentation is needed to get health insurance?

It is important that before contracting a health insurance we are very clear the necessary documentation that we must contribute or that we can demand the insurance company.

We must not forget that health insurance has increased massively in recent years and although they can be hired quickly and easily, it is still a contract and a series of documentation is needed to carry it out.
If you are thinking about taking out health insurance it is necessary that before you hire it you are informed about the different types of policies that the insurance companies offer you, as well as the different coverages or restrictions that they may have.

Therefore, the contracting of health insurance implies some responsibility both by the party that contracts the insurance and by the insurance company.
It is precisely for this reason that any insurer can demand a series of documents to be able to contract the health policy.
The purpose of having to provide a series of data and documentation to the insurance company is so that it can meet the client, to ensure the best protection possible.

The documentation required for the contracting of health insurance is as for the performance of any other contract, such as our personal data, but we must take into account that more specifically a health insurance contract may require a statement of Health or medical history. Since there are health insurance companies that can propose exclusions or limitations with certain health problems.

That is why it is important that we are very clear that documentation can require us to be able to take out health insurance.
As a summary, when it comes to taking out health insurance the documentation that we may require from the insurance company is:

Personal information
Statement of health or medical history.
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Once you have obtained your health insurance budget through an insurance comparator, you have several ways to formalize your contract. Currently there are several possibilities, in addition to the phone call or go to an office of the insurance company in question, there is the possibility of contracting the health insurance through the Internet, where you can carry out all the formalities for hiring the same.

What is medical insurance for expatriates?

Your health and that of your family are very important, especially if you live and work for long periods of time abroad.

In order to protect your health and that of your family, there are medical insurance for expatriates, these are aimed at those who are working or living abroad. It is an insurance product designed to offer medical protection anywhere in the world.
And more and more people are getting health insurance for expatriates, because the difficult situation that our country is currently suffering, due to the economic crisis, is forcing many people to emigrate to other countries, either to work or to To carry out some type of training. The figures show, since the beginning of the crisis in 2008, has grown 70% the number of people who have left our country to work.

If you are thinking of going abroad to work or study for a long period of time, you should know that healthcare abroad is not covered by Social Security, in the case of traveling to any country of the European Union or Switzerland we can Receive health benefits for two years with the European Health Card, if it is for a temporary stay for work or tourism.

Because the risk of falling ill or suffering some mishap we can not predict, so it is necessary to prevent and contract health insurance. With the comparator of health insurance, you can compare between the main insurance companies and find the health insurance to suit you.

The main coverage of medical insurance for expatriates is:

Protection for hospital stays.
Basic medical treatments.
Coverage of payment of medical consultation fees and surgery.
Accommodation in hospitals.
Hospital and outpatient treatments.
Routine care in maternity.
Visits to the doctor and recipes.
Some companies may also include dental and vision coverage within their guarantees.
Not all insurance companies offer the same coverages, so it is important to analyze our needs in advance and hire the policy that best fits our needs.
Some important points before hiring expatriate health insurance are:

If the policy is refund know what type and percentage.
The scope of coverage.
If you pay the health insurance directly.
The time of coverage of the policy abroad.
Therefore, when making an employee move abroad, one of the topics most requested by companies is to have health insurance.
Since it is possible to guarantee health care for those who travel for work, study or tourism abroad, it becomes fundamental, since not all countries have health care with the characteristics to which we are accustomed in Spain , That is, health care can vary greatly from one country to another.

That is why insurance companies have long been offering insurance companies to cover the medical needs of those workers who travel abroad.

10 tips for Health Insurance

It is becoming more common to have health insurance that supplements the health services of the Social Security. However there are almost as many insurers and types of insurance as people and, therefore, choosing among so many options is not easy. If you want to hire a new health insurance, take note of these tips to find the one that best suits your needs.

1. What coverage do you need?
To start looking for your insurance you should first think about some issues like deciding if you are going to include your family within your policy. You should also keep in mind that your age will significantly influence the price of your insurance. In fact, from a certain age, it might be impossible to hire him.

2. Choose the mode that best suits you
Usually, insurers make available to clients a medical chart with a wide catalog of specialties, ranging from primary care to hospitalization. Another option is the so-called free choice, which allows you to choose any professional anywhere in the world.

These specialists are not always part of the company's medical staff. The usual thing in these cases is that you have to pay the bills yourself and the company will refund you a percentage based on your policy. In addition, there are mixed modes that combine the two above but it is a decision to take into account since they are usually much more expensive.

3. What is the copayment?
The copayment is a formula to lower the insurance premium. In exchange for paying something less in your monthly payments, you will have to face part of the cost of certain medical care. In this way, companies make sure that users do not abuse the services and, in turn, users who use less insurance can pay less. It's all about making numbers and figuring out what works best!

4. What are the grace periods?
The grace period is the time that passes from the insured's discharge until he can request a series of health services such as interventions or diagnoses. This must be taken into account in the case of suffering an illness or being pregnant since it may be that after some time you may not be able to benefit from some services that you need for your situation. This point is one of the most important when it comes to insurance.

5. Values ​​the center and its professionals
In the case of health prevention is better than cure, so take some time to check the medical chart offered by the insurer. Check that you have professionals and specialists of quality and that you can have at your disposal well-equipped medical center near your residence.

6. Special covers
Not all insurances include it, you will need to assess whether you are interested in receiving special coverage of oral, psychological, assisted reproduction or overseas travel assistance.

7. Authorized services
In almost all companies there are a number of services such as hospitalizations, high-tech diagnostics and prosthetics. Which require prior authorization. That is why it is essential to have an efficient telephone service that can resolve this type of action quickly and know what services are necessary for these authorizations.

8. What are the consequences of using these services frequently?
In some health insurance premiums may increase from year to year and one of the reasons may be frequent use of the health services that have been contracted. For this reason it is very important to inquire about these types of issues since it could be very expensive to renew our insurance.

9. Read the fine print
As always whenever a service is contracted it is important to conscientiously review the clauses of the policy you have chosen. It is important that you clarify the duration of the contract, the form of payment, the cancellation deadlines and that you do with some way to contact a customer service before signing.

10. Save whenever you can.
It is important that there is a balance between the coverage and the price of your insurance. However, whenever you talk about health it seems a little risky to talk about saving, that is why, you can find other advantages when you hire your health insurance. For example, if you live in Aragon, Balearic or Cantabria and you meet a number of conditions, you can get rid of 5 to 15% of the premiums you have paid in your health insurance when making the declaration of property.

Besides the price, you can also find insurance that will offer other benefits if you hire them. For example, with the Travel Insurance Agency, by hiring your policy you can add many points to transform travel and gifts. Specifically, if you contract your health insurance with Caser before January 31, you will add 7,500 points.