How to Choose a 'Personal' Health Insurance Policy: A Guide for Those Who Pay for Themselves

? “This is about health insurance. I have worked as an employee my whole life, and my employer has always purchased the health policy for me. But now, at retirement age, I have neither an employer nor hope that one will appear in the near future. For now, I am using the policy that my last employer purchased for me, but this insurance will also expire after a while, and obviously, I will have to buy a policy with my own money.

Could industry specialists answer the following questions:

How is such insurance purchased?
How can I determine which specific health insurance I need?
Is there a way to compare offers in one place, or do I need to call all insurance companies before choosing one to buy a policy from?
Are there any discounts on health insurance for certain categories of residents — for example, for pensioners, the unemployed, low-income individuals, people nearing retirement age, etc.
What should I pay special attention to when purchasing an insurance policy? I ask because I have heard that contracts often contain important details that one might overlook since they are written in small print.

Sandija Shaicāne, representative of the Latvian Association of Insurers (LAA)

In Latvia, health insurance policies can be purchased from three insurance companies, specifically their Latvian branches – ERGO Life Insurance SE, If P&C Insurance AS, and Compensa Life Vienna Insurance Group SE.

Individual Programs

There is no such thing as 'different' health insurance – it is a specific type of insurance. The coverage amount can only vary depending on the chosen program. The insurance company may offer various programs - for example, only a basic program, or a basic and additional programs - such as dentistry, rehabilitation, vaccination. However, the more programs there are and the broader their coverage, the more expensive the insurance will be.

There is no standard platform for comparison: health insurance is a type of insurance where the offer is made individually, and accordingly, the insurance premium (the cost of the policy) is calculated. Therefore, a person wishing to purchase a policy needs to contact each insurance company separately. A representative of the insurance company will ask to fill out a health questionnaire, and based on this, an individual offer will be prepared.

The Higher the Risks — the More Expensive

There are also no discounts for specific categories of people (pensioners, the unemployed, etc.); as mentioned above, health insurance is a type of insurance where the risks are assessed individually for each client, and the insurance premium is calculated accordingly. The greater the potential risks (that is, the more health problems a person has), the higher the premium will be.

Important Point: When filling out the questionnaire when purchasing an insurance policy, one must never hide anything about their health status or, even more so, deceive; if it is later discovered during a claim submission that the client initially misled the insurance company regarding their health, the insurer may refuse to pay compensation.

Read the Contract!

And finally, regarding the conclusion of the contract. Although insurance rules usually take several pages, they should still be read in full. If reading the entire contract seems too complicated for the client, they should at least familiarize themselves with the product information document — this is a brief description of the main terms of the contract, which usually takes about one and a half A4 pages.

Particular attention should be paid to the insurance programs you are purchasing – their descriptions are usually attached to the policy. The program descriptions indicate which paid services the insurer covers and to what extent. For example, if it states that a consultation with a specialist doctor is covered up to 45 euros, and the consultation needed by the client costs 55 euros, then the insurer will reimburse 45 euros, but the client will have to pay the remaining 10 euros themselves.

Also, before receiving a medical service, it should be clarified whether a referral from a family doctor or specialist is required; this is usually indicated in the insurance program. If surgery or inpatient treatment is planned, it should be determined in advance whether approval from the insurer is required. It is also essential to familiarize oneself with the exclusions — cases that the insurance does NOT cover. And in all cases, if there are any uncertainties, one should contact a representative of the insurance company and clarify everything BEFORE receiving the service.