Large insurance companies are in no hurry to sell voluntary medical insurance policies to Ukrainians. What is the reason?
Of the ten largest insurance companies, only five directly sell voluntary medical insurance policies to Ukrainians. The rest work only through the employer within the framework of corporate insurance programs for employees.
It is individually unprofitable to work with individuals, insurers note. Due to the weak development of the insurance culture, citizens usually apply for insurance after they have been diagnosed with a specific disease.
The average cost of an individual policy starts from 5000 UAH per year. For this money, insurance companies promise to cover the treatment of a client in the amount of up to UAH 50,000 both in public and private clinics.
Usually, there are serious exceptions to medical insurance contracts – insurance does not cover all medical services. A policy with plus or minus full service will cost 800-1000 UAH per month.
Insurers do not expect a surge of interest in voluntary health insurance even after the launch of the medical reform and the transition to family medicine. The overall growth of the market, although it will remain at the level of 15-20% per year, but only due to corporate programs, insurance market participants surveyed by LIGA.net predict.
Who goes to insurers?
According to the National Financial Services Commission, in the first half of the year, insurers sold voluntary medical insurance policies for UAH 1.618 billion, which is UAH 309 million more than in January-June 2017. The main share is occupied by employers who offer employees insurance as part of the social package in addition to wages. Ordinary Ukrainians account for a little more than a third of the total amount – UAH 318.02 million.
“If an employer needs to additionally motivate an employee, a salary increase of UAH 600 per month is unlikely to matter,” says Sergey Maistrenko, head of the personal insurance department at INGO Ukraine. “Besides, the salary fund is limited, so companies tend to choose additional bonuses in the form DMS”.
The average price of a corporate policy is UAH 5,000-7,000 per year, Maistrenko adds. Individuals usually have to pay more to get full-fledged insurance – from UAH 8,000 to UAH 15,000, says Raisa Atamanenko, director for personal types of insurance at Krajina Insurance Company.
Many insurance companies, including large ones, deliberately refuse to work with individuals, cooperating only with corporate clients who insure at least 10-15 employees. The reason is the high unprofitability of servicing individual clients, Maistrenko explains.
“So far, among individuals, medical policies are bought either by those who already have a positive experience of insurance at enterprises, or those who need treatment; another category is families with small children,” Maistrenko says. “The corporate segment is more stable and predictable, it gives at least and a slight, but still increase in the volume of collected premiums.
The majority of VHI corporate clients are companies with foreign capital, notes Olga Sidoruk, Director of Insurance Products at PZU Ukraine. Demand among local companies is low, but in recent years, their interest in employee insurance has been increasing, adds Atamanenko.
The basic VHI insurance program for corporate clients includes typical options: emergency (first aid), emergency and planned hospitalization, outpatient consultation, and provision of medicines, Sidoruk lists. Also, such packages often include dental care, says Atamanenko.
Where to buy a policy
It is more difficult for individuals to choose the best insurance policy than for large companies that purchase insurance for their employees. Not all leading insurers work with such clients. In addition, low-cost policies often contain a number of exceptions. In these cases, treatment (for example, the purchase of medicines) has to be fully or partially paid for by the insurer himself.
A LIGA.net correspondent, under the guise of a client, contacted the managers of the ten largest insurance companies in terms of voluntary medical insurance, according to the Forinsurer resource. Only five of them serve individual insurers. What are the results?
The cost of the policy depends on the content of the services – the cheapest options for 1050-1080 UAH per year include only emergency assistance with the involvement of an ambulance and hospitalization. Some tests and procedures (for example, fluorography, MRI, blood tests) are not covered by the UK at all.
Critical cases such as heart attack or stroke must be insured separately – as a rule, they are not considered part of the VHI, falling under the criteria for risk insurance. Oncological diseases, hepatitis, tuberculosis and other intractable diseases are not included in the insurance, clarifies Maistrenko from INGO Ukraine. Dental services are usually covered, but in relatively small amounts.
The most expensive policies cover almost all types of medical services, including massage and dentistry. The cost of insurance also determines which clinics will serve the client: public or private. Policies of the middle price range (UAH 8,000–10,000) include both options at the same time.
Only natural persons of “non-retirement age” can insure their health: the most loyal age limit of insurers is 65 years, the toughest is 55 years.
The policy fee is usually paid in one lump sum, but insurers usually allow you to break it down into three payments. In such cases, the total cost of insurance may increase. Another nuance is that the policy does not take effect immediately, but 7 days after the conclusion of the contract. Not all insurance companies have the option to apply for an online policy.
“At the request of the insured, the contract may include a variety of options,” says Atamanenko from SK Kraina, “These are vaccinations, vitaminization, a swimming pool / gym, preventive examinations, medical insurance abroad, etc.”
How health insurance works
The organization of medical care is completely taken over by the insurance company, which searches for the necessary specialist, appoints a consultation, delivers medicines, provides hospitalization, etc., Maistrenko from INGO Ukraine lists.
“You call the call center of the UK, you are connected to the doctor on duty, you describe your symptoms to him or tell him which doctor you want to see and why,” explained the manager of one of the insurance companies. “Then they make an appointment for you at a convenient time and place.” .
It is not necessary for the client to visit the same doctor – for consultations, you can go both to private clinics and to public ones. Consultations of leading specialists of medical institutions of the UK are partially paid.
Insurance amounts over UAH 150,000 are almost never used in full, managers of two insurance companies told LIGA.net .
If the insurer considers the individual client unprofitable, he may refuse to renew the insurance, one of the companies noted.