Health Fitness

How to avoid overpriced hospitalization insurance at the pension

More than four million Belgians benefit from hospitalization insurance through their employer. It covers hospital costs which are not reimbursed by health insurance.

In most of the cases, the employer pays the premium. However, a study by the human resources services company Mercer shows that an evolution is looming and that more and more companies are asking for a contribution to their workers. In 2015, 7% of companies requested a contribution and, five years later, this figure has already reached 14%. Note that around 45% of companies offering hospitalization insurance allow free affiliation of the partner and children.

Franchise

Depending on the contract and the premium you pay, you may or may not be faced with a deductible. This is the amount that you have to bear yourself and for which the insurance does not intervene. According to Mercer, the so-called “differentiated franchise“. With more and more insurers, the deductible for a single room is much higher only when you opt for a double or shared room.

“In this way, insurers avoid the well-known problem of fees – which weigh heavily on the final bill in the case of single rooms – and they manage to control their claims statistics and the resulting premiums “, explains Benjamin Rutten, Employee Benefits expert at Mercer.” According to our research, a little bit more than three quarters of policies apply the uniform deductible, and therefore the same deductible for a single room as for a common room. “

Higher premium

Normally, affiliation to a group hospital insurance plan is done without the need to complete a medical questionnaire. In other words, no distinction is made on the basis of age or state of health. People who subscribe to a hospital insurance will however have to complete a survey.

When you retire, you can continue individually the collective hospitalization of your employer. To do this, you will not have to undergo a medical examination and there is no waiting period (it is the waiting period which precedes the effective date of the cover). One condition, however: you must be insured for at least two years, without interruption, and you must request it within 30 days of loss of coverage.

But from now on you will have to pay a significantly higher premium. For individual hospitalization insurances, the age of the insured plays a role. The older you are, the higher the premium will be. “The premium for collective hospitalization insurance varies approximately between 10 and 25 euros, depending on the coverage chosen, the size and composition of the group and the claims statistics “, specifies Marc Van kerckhoven, Director Employee Benefits at Vanbreda Risk & Benefits.

The premium for individual hospitalization insurance for a 30-year-old quickly reaches more than double the collective premium. A person who joins at age 55 pays on average twice as much as a person who does at 30. “And those who join at 65 already pay on average 3 times more than those who do so at 30”, adds Marc Van Kerckhoven. Depending on the product and the insurer chosen, the premium for individual hospitalization insurance will be either “fixed” on the age of entry in hospitalization insurance (+ indexation), either it will evolve depending on the age reached.

Police waiting

To avoid higher premiums, you can take out a waiting policy. This is an additional contract by which you “pre-finance” your subsequent individual hospitalization insurance. When you leave your group hospitalization insurance, you pay a premium based on the age you were when you took out your waiting policy.

“It is better to start the pre-financing as soon as possible“, underlines Karolien Goethals, Employee Benefits advisor at Vanbreda Risk & Benefits.” Indeed, the premium for the pre-financing and for the future individual hospitalization plan is determined according to the age at the start of the pre-financing. “

Of course, it is always possible to start pre-financing at an older age, but the benefit will then be smaller. The size of the benefit, of course, depends not only on the age at which you start to pre-finance, but also from your lifetime and therefore the age up to which the individual hospitalization insurance will cover you. “

In a number of cases, it is the employer who prefinances the individual hospitalization insurance. However, a study by the human resources services company Mercer showed that only 15% of policies offer such pre-financing. As with individual pre-financing, it will be possible to take out insurance at a lower premium later, when the worker leaves the company or retires.

THESE EXTRAS OFFERED BY EMPLOYERS

Hospitalization insurance and group insurance are fairly common extralegal benefits. However, employers sometimes take out additional insurance for their workers.

Supplementary insurance against accidents at work

As indicated by the word “complementary”, it is about a cover which can be taken out in addition to the legal cover covering accidents at work. Indeed, the legislator has capped the basis for calculating compensation at a legal salary ceiling of 44,817 euros per year.

If an employee suffers from a long-term incapacity for work, for example following a serious surgery or an accident, guaranteed income insurance can ensure that this person’s loss of income remains limited. The legal benefit decreases over time, which has significant financial consequences for the worker concerned. Additional insurance can compensate for this problem. During the period of incapacity for work, a pension is paid in addition to the intervention of the health insurance fund. The employer can, for example, continue to guarantee workers 70% of the salary during their long-term absence.

Sometimes the dividing line between work and private life is fine. What if your worker is hit by a vehicle on a business trip while jogging around the hotel just before a meeting? You can also insure the situations in which your employees are victims of accidents in their private life. Moreover, this insurance goes well beyond those cases which are on the borderline between work and private life. It covers all possible accidents of a domestic, leisure or sporting nature, even during holidays. However, it must be an “accident”, implying the presence of a bodily injury which occurs on the occasion of a “sudden event”.

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