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september 2015 year
september 2015 year
exclusively for Capital

Ukraine Health Insurance: How to Choose Between Medical Institutions Covered by Your Policy

exclusively for Capital

We are glad to continue the series of articles devoted to health care in Ukraine in terms of health insurance policies and to explain how they actually work. 

Our Clients often ask us why their visit to the doctor is arranged without being offered a chance to choose between the private clinics or other medical institutions located close to their house. Let’s start from the very beginning. 

Once you’ve received from your employer the copy of the policy insuring your health care in Ukraine, make sure to familiarize yourselves with the program overview and the list of medical institutions covered by it.  This information is available both in the insurance policy and in the Client area on the insurer’s website. Don’t neglect to inquire about the deductible amount as well. Sometimes HR department prepares memory cards for their employees which include all the key parameters. If that’s your case, ask for the list of clinics additionally. When insuring health care in Ukraine it’s worth remembering that sometimes programs do not cover consults of leading specialists or cover them only subject to deductible amount. This refers mostly to VIP-Clients’ policies or those including the best brands of medical care in Ukraine.

Once you understood the limits of coverage go ahead and call insurer’s assistance to require the consult in the medical institution of your choice.

Desires vs. Options

Sometimes it makes sense to call the Ukraine’s health care institution yourself to be sure whether or not they have the resources to provide you with medical assistance.
Sometimes it makes sense to call the Ukraine’s health care institution yourself to be sure whether or not they have the resources to provide you with medical assistance. Very often private clinics cannot or do not want to take responsibility for handling emergency cases such as heart attacks or strokes. In this case it’s wise to agree on the second best option and look for the better clinic later. In Ukraine health insurance is quite flexible. Usually a coordinator doctor offers you an alternative if the medical institution of your choice is not available. If it suits you well, you can accept it without a doubt. However sometimes it is reasonable to call the clinic yourself to double check whether they in fact cannot provide you with the service you need. If they turn out to be happy to assist you, though, don’t hesitate to make an appointment yourself and then call the assistance back to make sure the insurer is willing to guarantee the payment. 

Clinic of your choice is not covered by your insurance program

In Ukraine health care system is not fully suitable to co-operate with insurance companies on the large scale basis. In some cases you might encounter a situation when the required clinic is not listed among the medical institutions covered by your insurance policy. In rare cases this institution does not provide services within Ukraine’s health insurance market at all.  However you can still arrange for your visit to such clinic to be paid by the insurer. Just don’t forget to let your assistance know about your plans to go to a particular medical institution and send them the documents confirming all the payments you had to make yourself in order to be indemnified under your health insurance policy. Feel free to ask your HR department or insurance broker about detailed instructions on how to proceed in such cases.

There are some aspects though which it’s worth pointing out:

  1. You must inform your insurance company that you are going to visit a doctor in the clinic not covered by your insurance program.
  2. Make sure that your problem falls within the category of the insured events. 
  3. Read all the fiscal documents issued by the clinic closely. Make sure not to have “charity” marks in any of the payment receipts as they will not be covered by the insurance company!

In terms of health care Ukraine’s market is quite flexible. The list of the medical institutions covered by the policy can be changed in the course of the year. Make sure to check it from time to time. If you are a person responsible for signing the agreement on behalf of company employees, it’s reasonable to stipulate in the policy that all the amendments be negotiated by both parties.

Last but not the least. If you have a simple cold, feel free to choose the clinic based on its class, quality service and your personal comfort. However if unfortunately your illness is a serious one, it’s best to look for the best doctor first, and only then choose between the clinics in which you are able to receive his consult. Always remember that there are plenty of options available under your health insurance policy and you have a right to use them all.