Medical insurance in Kazakhstan at low prices, medical insurance in Almaty

Voluntary medical insurance, or medical insurance — VMI

Voluntary medical insurance in Kazakhstan is one of the most popular types of insurance in the country. Medical insurance in Almaty, Astana and throughout Kazakhstan began to develop actively immediately after foreign investment arrived. This was linked to the growing activity of foreign capital, in whose insurance culture medical insurance became established not only as a way to improve conditions for employees but also as a necessity and an integral part of conducting business in a civilized way.

Low prices for medical insurance and high quality of medical services are not always compatible. Medical insurance is for the most part a low-profitability line: this is due to its limited reach, that is, the small involvement of individuals in this product. If the article has not answered your questions, see similar materials.

Who buys medical insurance

  1. Medical insurance for legal entities. Most often it is legal entities that buy medical insurance in Kazakhstan. The reason is very simple:
    • social protection of their employees;
    • attractiveness to new employees;
    • company employees do not spend valuable working time on recovering their health.
  2. Medical insurance for individuals. Not all insurance companies insure individuals. Because of its low popularity and purchase "out of necessity", medical insurance for individuals leads to high losses, and the risk, that is, the likelihood of loss for an individual, is hard to calculate. Individuals most often conclude a medical insurance contract when they already have an illness that requires constant or periodic treatment, and this leads to even greater unpredictable losses.

Medical insurance contract

In Kazakhstan a medical insurance contract can be concluded with almost any insurance company, but, as everywhere, there are industry leaders. To select a suitable medical insurance company, contact Polis Re.

Before concluding a medical insurance contract, you must first agree the medical insurance program. We recommend building the program individually, taking into account the company's needs. In the contract, pay particular attention to the exclusions — what is not subject to insurance.

Stages of a medical insurance contract:

  1. agreeing the program;
  2. application for insurance;
  3. discussing the contract terms;
  4. signing the contract;
  5. payment.

How medical insurance works

Medical insurance is the only type of insurance in which the insured event occurs with an almost 100 percent probability: people will certainly use at least one option — have their teeth treated, buy medicines, consult a doctor.

The procedure for seeking help under a medical insurance policy is almost the same in all insurance companies. You need to remember that you will be served by the insurance company's assistance service (assistance):

  1. first the call center, which clarifies the specifics of the illness and books the patient with a doctor or a specialist;
  2. if a dentist is needed, you can go directly to the clinic;
  3. in the case of an emergency visit or an ambulance call, the insurance company's assistance service is notified after the visit.

Prices and cost of medical insurance

Medical insurance, like all voluntary types of insurance, is not regulated by law as to its terms: all the terms of the contract are agreed by agreement of the parties and are limited by knowledge of the insurance market and the qualifications of the insurance company's representative. The cost is affected by the composition of the program, limits by block, the level of clinics, the size and age structure of the group, and the claims history under previous contracts.

VMI and compulsory social medical insurance: what is the difference

Kazakhstan has a system of compulsory social medical insurance (CSMI), through which citizens receive a package of medical care funded by contributions and payments. Voluntary medical insurance does not replace CSMI but supplements it: it gives access to selected private clinics, shortens waiting times for appointments, widens the list of services and includes an assistance service. An employer that has arranged VMI is not released from its CSMI obligations.

What a VMI program includes

A program is built from blocks, each with its own limit:

  • outpatient care — appointments with a general practitioner and specialists, diagnostics, tests;
  • inpatient care — emergency and planned hospitalization;
  • ambulance and emergency care;
  • dentistry — treatment, sometimes prevention; prosthetics and implants are usually excluded or limited;
  • medicines prescribed by a doctor, within the limit;
  • additionally — vaccination, medical check-ups, rehabilitation, care at home.

Typical exclusions

Each company has its own list of exclusions, but most often the following are not covered or are covered to a limited extent: treatment of illnesses known before the contract was concluded; a number of chronic and serious diseases; cosmetology and plastic surgery; pregnancy care; treatment of the consequences of alcohol or drug intoxication; sanatorium and resort treatment; services not prescribed by a doctor. Before signing the contract, it is worth checking the program line by line against the employees' needs.

How to choose a program and an insurer

  1. Define the goal: retaining staff, reducing sick leave, caring for key employees.
  2. Check which clinics are in the network and whether they are in the cities where your employees work.
  3. Compare the limits by block, not just the overall sum insured.
  4. Clarify how the assistance service works: whether it is available around the clock, whether there is online booking, how quickly services are approved.
  5. Discuss the possibility of including employees' family members in the program.
  6. Find out the terms for adding and removing employees during the contract term.

Common mistakes

  • choosing a program on price alone without analyzing the clinic network;
  • the same program for everyone, regardless of employees' age and needs;
  • employees do not know how to use the policy and go to a clinic bypassing the assistance service — in which case the costs may not be reimbursed;
  • the contract is not renewed on time, and employees are left without protection for a transitional period.

In summary: medical insurance is a sufficient tool for reducing medical costs. Prices for medical insurance are acceptable, and anyone who wishes can find a suitable program. For more on the options, see the medical insurance and employee insurance sections. To select a program for your company's needs, you can get a consultation.