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private health insurance again

private health insurance again

Old Dec 1st 2023, 5:23 pm
  #16  
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Default Re: private health insurance again

Originally Posted by bons
Did you get a quote?
I received the quotes from Medal yesterday.
There are several plans, all with their own plusses and minuses, and differing prices that are all dependant on age.

Medis is a no for us because they cancel you at age 70 if you join after you're 55.

MGEN is cheaper than Allianz A plan but more expensive than Allianz B plan, and the main benefit (inpatient ceiling) is right between too.
Allianz B; 50,000
MGEN ideal; 100,000
Alianz A; 150,000

MGen excludes claims from car and motorcycle accidents (what about pushbikes and tractors? no idea), that makes it quite unattractive for us.
Not that I have a lot of road accidents (yet), but if I/we do then it can be a major expense. Remember it's not just emergency care (which would likely be INEM carrying one to the public hospital anyway), but all follow-up therapy and procedures resulting.

Allianz excludes HIV, pandemics, congenital conditions, and obesity. So the choice depends on what conditions you have, or are afraid of having.

Co-pay on consultations and exams are not all that much compared to the huge premium, and I think that the small amount they pay out for meds and glasses is silly too, it probably costs as much in admin as they pay out.

Allianz has dropped the 15,000 co-pay ceiling back to 1.500 (or it was a typo in the first place). So at least if you do choose to pay for private health insurance, you'll be able to afford to use it if things really do go south.

It's big money for sure; after our experience of the PT public health, we consider it an essential expense.
Rather drive an old car and wear old clothes, shop at the discount market, don't go out for meals or drinks, and go to the private hospital when we need health care.

Because it's not a question of IF, but rather of WHEN.

Your experience may differ.

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Old Dec 1st 2023, 5:45 pm
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Default Re: private health insurance again

Originally Posted by NataHH
UK trained?? 😠
Doctor's receptionist seem the same the world over to me.
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Old Dec 1st 2023, 5:50 pm
  #18  
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Default Re: private health insurance again

Originally Posted by liveaboard
I received the quotes from Medal yesterday.
There are several plans, all with their own plusses and minuses, and differing prices that are all dependant on age.

Medis is a no for us because they cancel you at age 70 if you join after you're 55.

MGEN is cheaper than Allianz A plan but more expensive than Allianz B plan, and the main benefit (inpatient ceiling) is right between too.
Allianz B; 50,000
MGEN ideal; 100,000
Alianz A; 150,000

MGen excludes claims from car and motorcycle accidents (what about pushbikes and tractors? no idea), that makes it quite unattractive for us.
Not that I have a lot of road accidents (yet), but if I/we do then it can be a major expense. Remember it's not just emergency care (which would likely be INEM carrying one to the public hospital anyway), but all follow-up therapy and procedures resulting.

Allianz excludes HIV, pandemics, congenital conditions, and obesity. So the choice depends on what conditions you have, or are afraid of having.

Co-pay on consultations and exams are not all that much compared to the huge premium, and I think that the small amount they pay out for meds and glasses is silly too, it probably costs as much in admin as they pay out.

Allianz has dropped the 15,000 co-pay ceiling back to 1.500 (or it was a typo in the first place). So at least if you do choose to pay for private health insurance, you'll be able to afford to use it if things really do go south.

It's big money for sure; after our experience of the PT public health, we consider it an essential expense.
Rather drive an old car and wear old clothes, shop at the discount market, don't go out for meals or drinks, and go to the private hospital when we need health care.

Because it's not a question of IF, but rather of WHEN.

Your experience may differ.
I've been looking at Private healthcare for two years and I'm still don't know which to go for.
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Old Dec 2nd 2023, 11:46 am
  #19  
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Default Re: private health insurance again

It depends on your situation; firstly, whether the public hospital / medical service near you is ok.
Assuming it is not (or you wouldn't be looking to go private), then I think a group plan is best.
The group gives your broker some leverage when it comes time to get your claims settled.

I'm not sure if the offers through the banks are group deals, or if they're just acting as an agent and selling you an individual plan.
When I look at the website of my bank, information is scarce. That puts me off.

So that brings us back to the Medal / AFPOP plan; it's been working well for us for 15 years already. sometimes the insurance company refused a claim, but usually Medal got it out of them.

I think most people probably spend their last days in hospital, maybe in the ICU; that costs a lot.

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Old Dec 2nd 2023, 5:56 pm
  #20  
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Default Re: private health insurance again

Liveabroad, I'm a bit confused by all of this. From what you have said, it sounds like the private healthcare system in Portugal is very different from the one in Spain. You talk about making claims via a broker and copay (excess?).

We are with Adeslas in Spain and we each have a credit card type membership card that we present at the clinic of our choice - we have a directory of all the health clinics that accept Adeslas insurance. As soon as we enter a clinic for an appointment, the receptionist takes the card and checks the database to make sure we are up to date with our premiums. We only pay €4.00 excess per appointment or treatment. The only time we would need to make a claim is if we had treatment outside Spain.

It's a completely separate, standalone system that completely bypasses the state healthcare system.

Sorry but please can you explain how the Portuguese system works?
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Old Dec 2nd 2023, 6:59 pm
  #21  
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Default Re: private health insurance again

Originally Posted by Lou71
Liveabroad, I'm a bit confused by all of this. From what you have said, it sounds like the private healthcare system in Portugal is very different from the one in Spain. You talk about making claims via a broker and copay (excess?).

We are with Adeslas in Spain and we each have a credit card type membership card that we present at the clinic of our choice - we have a directory of all the health clinics that accept Adeslas insurance. As soon as we enter a clinic for an appointment, the receptionist takes the card and checks the database to make sure we are up to date with our premiums. We only pay €4.00 excess per appointment or treatment. The only time we would need to make a claim is if we had treatment outside Spain.

It's a completely separate, standalone system that completely bypasses the state healthcare system.

Sorry but please can you explain how the Portuguese system works?
Works in exactly the same way. The only varient is if you make a claim as you have visited a doctor/clinic not registered withn your providor. In that situation you need to present an invoice and wiil only receive a %age of the cost. Otherwise the same, present your card and pay the fee established with the insurance providor.
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Old Dec 3rd 2023, 10:27 am
  #22  
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Default Re: private health insurance again

Originally Posted by Loafing Along
Works in exactly the same way. The only varient is if you make a claim as you have visited a doctor/clinic not registered withn your providor. In that situation you need to present an invoice and wiil only receive a %age of the cost. Otherwise the same, present your card and pay the fee established with the insurance providor.
Thanks for clarifying, that's very useful information.
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Old Dec 3rd 2023, 3:17 pm
  #23  
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Default Re: private health insurance again

Originally Posted by liveaboard
I received the quotes from Medal yesterday.
There are several plans, all with their own plusses and minuses, and differing prices that are all dependant on age.

Medis is a no for us because they cancel you at age 70 if you join after you're 55.

MGEN is cheaper than Allianz A plan but more expensive than Allianz B plan, and the main benefit (inpatient ceiling) is right between too.
Allianz B; 50,000
MGEN ideal; 100,000
Alianz A; 150,000

MGen excludes claims from car and motorcycle accidents (what about pushbikes and tractors? no idea), that makes it quite unattractive for us.
Not that I have a lot of road accidents (yet), but if I/we do then it can be a major expense. Remember it's not just emergency care (which would likely be INEM carrying one to the public hospital anyway), but all follow-up therapy and procedures resulting.

Allianz excludes HIV, pandemics, congenital conditions, and obesity. So the choice depends on what conditions you have, or are afraid of having.

Co-pay on consultations and exams are not all that much compared to the huge premium, and I think that the small amount they pay out for meds and glasses is silly too, it probably costs as much in admin as they pay out.

Allianz has dropped the 15,000 co-pay ceiling back to 1.500 (or it was a typo in the first place). So at least if you do choose to pay for private health insurance, you'll be able to afford to use it if things really do go south.

It's big money for sure; after our experience of the PT public health, we consider it an essential expense.
Rather drive an old car and wear old clothes, shop at the discount market, don't go out for meals or drinks, and go to the private hospital when we need health care.

Because it's not a question of IF, but rather of WHEN.

Your experience may differ.
There is also an MGEN Essential which is 60,000.

In my MGEN policy (May this year) I can't see any exclusion for car/motorcycle accidents, where did you see it?
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Old Dec 4th 2023, 7:55 am
  #24  
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Default Re: private health insurance again

It's in the comparison chart that Medal sent out; it could be buried in the fine print of your policy (or not). You should ask your agent about it.
It could be that the exclusion is particular to this group plan, a trade off for a better price.

It's a really horrible thing when you need medical care, and then find out that you're not covered.
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Old Dec 20th 2023, 9:40 am
  #25  
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Default Re: private health insurance again

Our bank has a Medis light insurance offer. Anyone used Medis. Still confused by it all.
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Old Dec 20th 2023, 11:14 pm
  #26  
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Default Re: private health insurance again

My bank also offers something; but there is practically no information on the website (just grinning healthy and smug looking people) so I thought of going to the bank to ask.
But then I decided that it's unlikely that the bank staff are also experts on health insurance.

There are too many variables and pitfalls; exclusions, limits, and even age based cutoff dates (just when you need it, some policies end at age 70).
You really need expert advice I think.
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Old Dec 21st 2023, 6:13 am
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Default Re: private health insurance again

Originally Posted by liveaboard
My bank also offers something; but there is practically no information on the website (just grinning healthy and smug looking people) so I thought of going to the bank to ask.
But then I decided that it's unlikely that the bank staff are also experts on health insurance.

There are too many variables and pitfalls; exclusions, limits, and even age based cutoff dates (just when you need it, some policies end at age 70).
You really need expert advice I think.
Agreed. Medal made a good attempt at comparing policies and then it was up to us to to decude what was best for us. Good private health insurance is expensive. Anything else is limited in its cover. We are staying with Allianz for one more year as we are well over 70, and are therefore postponing the decision for another year. I am also experimenting with the SNS system for my minor problems and will use it for emergencies again as and when they occur.
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Old Dec 21st 2023, 10:36 am
  #28  
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Default Re: private health insurance again

Originally Posted by bons
Doctor's receptionist seem the same the world over to me.
I've been reading this thread and feel for most of you experiencing health care insurance related problems.
Not living in Portugal I have no positive advise to those experiencing these issues, and certainly understand the frustration that comes across in many of your posts.
Fwiw, regarding the above quoted comment, I can confirm that, fortunately, doctor's receptionists are not "the same the world over". My current doctor here in France used to have a delightfully young and very charming receptionist, it was almost a pleasure to check in there for an appointment. I guess she was a temp and she was replaced by a middle-aged secretary with a wonderfully pleasing manner who makes every possible effort to fit one in for an appointment - especially when it's urgent.
In Nov and again this month I have been given several appointments within two days of requesting. The only 'negative' with the doctor is that one can always expect to be kept waiting at least an hour and a half, as his appointments are never on time. A small price to pay in health-related circumstances.
France though like many other countries is experiencing a critical shortage of GP's and it is worsening with so many more practitioners retiring and unable to find replacements. These days the best general advise to all folks - especially seniors now wishing to move to France is, ensure that your preferred location is not a flood-prone zone and find a department that is not known as a medical desert!
I hope most of you can ultimately find more suitable health insurance plans.
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Old Dec 21st 2023, 5:10 pm
  #29  
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Default Re: private health insurance again

That's a good point; the Algarve where most "expats" choose to move to, is a medical desert.
Most have paid during their working lifetime and now have these benefits due to them; health services in other EU countries (and the UK) have reciprocal agreements so health cover for retirees can be accessed here.
But only through the Portuguese health service, SNS.

We have also decided to stay with Allianz, even though the cost is a big hit that will tip our annual budget into the red and start eating at savings.
After experiencing the horror of our underfunded understaffed overworked not-so-local hospital, we've come to the conclusion that we have to pay or move.
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Old Jan 5th 2024, 12:40 pm
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Default Re: private health insurance again

I was in the same situation. I had skin cancer several times before and I discovered a new one. The GP said I need to see a dermatologist. He would arrange that. I would receive a letter from SNS with an appointment. I waited and waited ........ After several months I went to a private dermatologist who told me it is cancer and needs to be removed as soon as possible (face). Without a private health insurance, I decided to do it in the private clinic. I was curious when I would receive the letter from the dermatologist. I never received anything! 3 years after that, I decided to return to France.
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