03 April 2014
Residents here have accused health insurance companies of providing inadequate, expensive and delayed coverage for medical services.
"Health insurance is a form of security and it is very important for every individual to know that health care is available if needed," said Abdul Samad, a Jeddah resident.
"The grading of medical insurance for VIP, Class A, B and C varies depending on the class or category of the insured person. The lowest category has the least amounts for services. If a person exceeds the prescribed limit, he will have to wait until the insurance company sends its approval. This could even be for medicine."
Many say insurance companies are constantly trying to find ways to reject claims. Even if a service is approved, it is likely to be rejected because the cost exceeds the amount set by the insurance company.
Moreover, the medical insurance companies, to maximize their profits, have increased medical fees by 10 to 20 percent for B and C grades. "Such insurance coverage is of no value if we are paying more than before for every single procedure at hospitals. It is especially difficult for the low grade insurance card holders to pay for every little test even after having insurance coverage," said Hamza Zahrani, a resident.
He added that "companies don't cooperate on this issue. If we lodge a complaint with our company's human resources department, they get back to us late, even in urgent cases."
Many say that they end up paying for services if the polyclinic or hospital is not covered under their insurance scheme. Others say that they often cannot claim money back for emergencies, including when they fall sick while traveling, even though they have international health coverage.
Zubair Sayeed, another resident, said: "The system needs to be overhauled and there should be a portal for poor health insurance coverage arranged by the government so that anyone can lodge complaints or give suggestions like in other countries."
He said many companies do not provide medical insurance for their employees and urged the Ministry of Health to address this problem, especially with costs soaring.
Sohail Rahman, a human resources manager at a multinational company, rejected these accusations: "We are empowering the community with these cards from insurance companies, which allows all employees and their family members to choose any hospital for treatment. However, we cannot ignore the rules set by these insurance firms. We expect employees to respect and have patience with procedures rather than becoming aggressive, because every process takes time."
Mohammed Waleed, a manager at an insurance company, said: "The main thing about insurance is that we want something to drive the quality of health care and the insurance card provided is a way to ensure that people get benefits. We are trying to improve, deal with various complaints and collaborate with the Ministry of Health to hopefully introduce health care programs."
Many Saudis are also complaining about the poor coverage of their health providers, including less facilities providing free treatment.
Residents here have accused health insurance companies of providing inadequate, expensive and delayed coverage for medical services.
"Health insurance is a form of security and it is very important for every individual to know that health care is available if needed," said Abdul Samad, a Jeddah resident.
"The grading of medical insurance for VIP, Class A, B and C varies depending on the class or category of the insured person. The lowest category has the least amounts for services. If a person exceeds the prescribed limit, he will have to wait until the insurance company sends its approval. This could even be for medicine."
Many say insurance companies are constantly trying to find ways to reject claims. Even if a service is approved, it is likely to be rejected because the cost exceeds the amount set by the insurance company.
Moreover, the medical insurance companies, to maximize their profits, have increased medical fees by 10 to 20 percent for B and C grades. "Such insurance coverage is of no value if we are paying more than before for every single procedure at hospitals. It is especially difficult for the low grade insurance card holders to pay for every little test even after having insurance coverage," said Hamza Zahrani, a resident.
He added that "companies don't cooperate on this issue. If we lodge a complaint with our company's human resources department, they get back to us late, even in urgent cases."
Many say that they end up paying for services if the polyclinic or hospital is not covered under their insurance scheme. Others say that they often cannot claim money back for emergencies, including when they fall sick while traveling, even though they have international health coverage.
Zubair Sayeed, another resident, said: "The system needs to be overhauled and there should be a portal for poor health insurance coverage arranged by the government so that anyone can lodge complaints or give suggestions like in other countries."
He said many companies do not provide medical insurance for their employees and urged the Ministry of Health to address this problem, especially with costs soaring.
Sohail Rahman, a human resources manager at a multinational company, rejected these accusations: "We are empowering the community with these cards from insurance companies, which allows all employees and their family members to choose any hospital for treatment. However, we cannot ignore the rules set by these insurance firms. We expect employees to respect and have patience with procedures rather than becoming aggressive, because every process takes time."
Mohammed Waleed, a manager at an insurance company, said: "The main thing about insurance is that we want something to drive the quality of health care and the insurance card provided is a way to ensure that people get benefits. We are trying to improve, deal with various complaints and collaborate with the Ministry of Health to hopefully introduce health care programs."
Many Saudis are also complaining about the poor coverage of their health providers, including less facilities providing free treatment.
© Arab News 2014
