Health is very important for all people who never forget that illness can set in and affect them more or less throughout their lives, sometimes decisively influencing their daily activities. Thus, an essential role began to be played by health insurance, which becomes, practically, a method by which people acquire the mental comfort they greatly need in this regard, even when they do not yet have any medical problems. If in the past Romanians’ interest in concluding such insurances was low, things have changed completely. The need to be safe, to protect oneself from risks is ever greater, which has led to the conclusion of health insurance to be able to benefit from adequate support in case of illness or accident, when you have to perform certain surgeries or when hospitalization is considered.

In the article below you will discover what state health insurance covers versus private health insurance, what are the advantages and disadvantages of each type, why it is recommended to access such private health insurance, what services are included in the two types of policies, as well as some useful tips and advice to choose the best insurance.

1. What does state health insurance cover vs private health insurance

Health insurance is a policy by which the insurer takes over the medical expenses generated by the insured from the hospital institutions with which it has a direct settlement contract or through subsequent settlement if they generate them outside the network of partners. Before choosing a health insurance it is advisable to do a little research on it so that the policy covers as many medical services as possible.

Thus, it is important to understand exactly what government health insurance covers and what private health insurance covers, noting the advantages and disadvantages of each. It is good to know that some of them may cover the treatment of a very serious illness or hospitalization abroad, outpatient investigations or dental treatments. Correct information is the key to success in choosing the right health policy for each person’s needs.

1.1. The advantages and disadvantages of private health insurance

Private medical insurance is not mandatory. Many Romanians opt for this policy, because it covers many more types of medical services, even private firms and companies, which choose such insurance, discovering in it a real tool for motivating employees.

The advantages of private health insurance include:

• covers some shortcomings observed in the public health system;
• allows the person concluding it to enjoy all the excellent treatment conditions of private hospitals;
• provides complete analysis packages;
• has higher medical coverage compared to the subscription;
• includes almost all medical services, from analyzes to surgical interventions, etc.

One of the important disadvantages of this type of health insurance is the fact that it will be somewhat more expensive, but the higher the costs, the higher the quality of the medical document.

1.2. The advantages and disadvantages of state health insurance

State medical insurance (CASS) is mandatory, according to the provisions of the law. Thus, a person employed with an employment contract will benefit from health insurance in the public system, the obligation to declare and pay social contributions falling to the employer who withholds at source every month. The insured person pays a 10% monthly contribution of the gross minimum wage per economy, which allows him to have access to certain free medical services.

Among the advantages of state health insurance, the following can be mentioned:

• it benefits Romanian citizens, citizens of the EU, EEA states and the Swiss Confederation (they must not hold another health insurance concluded on the territory of another member state that produces effects on the territory of Romania), persons from these states mentioned above, who carry out salaried or independent activity in Romania;
• there are also people who can benefit from this insurance free of charge (children, young people up to 26 years old who are students, husband, wife and parents without their own income, disabled people, women pregnant and lactating women, persons on accommodation leave, Romanian citizens victims of human trafficking, etc.);
• it is paid by the employer, so the employee does not have to worry about this aspect;
• offers many types of medical services.

Disadvantages can be mentioned: the guarantee of services only if the family doctor supports the need for these services by granting a referral, the right to be insured ceases with the loss of the right of residence or long-term residence in Romania, in case of death or if they have passed 3 months after paying the last contribution, medical services accessed with the help of this policy are not always of high quality, many insured people complaining about this aspect, etc.

1.3. Why it is recommended to access the best private health insurance

Private health insurance can be taken out for adults, but also for children, it covers various risks and works on several levels, such as prevention, consultation, investigation, diagnosis, hospitalization, postoperative recovery, etc. Among the reasons that lead a person to access such insurance are:

• The state medical system comes with numerous problems, with time lost in endless queues and a lot of bureaucracy;
• When it comes to a medical emergency, private health insurance facilitates quick and easy access to various top medical centers, the waiting time being much reduced, and the appointments are kept exactly;</li >
• This policy can be customized according to the needs of the insured person, covering a wide range of risks;
• There are private health insurances that provide access to hospitals and medical centers abroad;
• The medical services of such a policy are of premium type, the insured enjoying all the comfort he needs;
• Emergency medical services are optimal, so that regardless of the situation the insured person knows that he will receive the help he needs so much in due time.

2. Services included in state health insurance vs private health insurance

The services included in the insurance are very important, so an insured must definitely consider this aspect and choose in full knowledge of the case. As for private health insurance, it brings added security to those who already have state insurance, since the latter does not cover all the medical services that a person might need, especially when it comes to expensive treatments and long term.

2.1. Services included in state health insurance

The medical services included in the state health insurance are numerous, some of them are listed below:

• Primary medicine services, provided by the family doctor. Different types of packages are included here: the minimum package of primary care services for uninsured people, the basic package of primary care services for insured people registered with a family doctor, the package of primary care services for patients from the EU, the European Economic Area and the Swiss Confederation;
• Hospital medical services (inpatient, medical-surgical emergencies);
• Paraclinical medical services (laboratory medical analyses). Pregnant women and children can benefit from these services free of charge;
• Dental medicine services (preventive, dental treatments, emergencies, compensated and free medicines, medical devices, medical services provided to insured persons on the territory of other states, etc.);
• Emergency medical services on the territory of any other European state.

2.2. Services included in private health insurance

A private health insurance is an excellent complement to the state one, because it provides high-quality medical services. Among the services included in this type of policy are:

• laboratory analyses;
• consultations;
• imaging investigations;
• radiology;
• hospitalization expenses;
• surgical interventions.

To choose the best insurance, the future insured must see if it fits his needs and budget. An excellent choice is private international medical insurance which provides access to medical treatments, services and investigations, hospitalization in Romania, Europe, USA and the rest of the world, allows the freedom to choose the place of treatment, provides round-the-clock support, telemedicine service, costs of hospitalization and outpatient treatments, access to second opinion, covers comprehensive cancer treatment anywhere in the world, support to the damage.

3. Useful tips and recommendations for choosing private health insurance

In order to make the best choice, it is necessary to do a little research in detail, to take into account the recommendations of specialists, the opinions of other customers satisfied with the services received through this policy, but also other important aspects. Regardless of what type of insurance a person wants, it is mandatory to collect useful information, in order to make the right, personalized choice according to needs.

• The company chosen to conclude the policy must be serious, guarantee the medical services for which the insured pays;
• A suitable choice is the flexible policy, which adapts to needs and budget;
• The cheaper the policy, the less the included medical services;
• The concluded contract must be read very carefully, to be able to know which risks are covered;
• If one wants to take out private health insurance, it would be better not to wait until the person falls ill, because the existence of a serious illness may cause the insurer not to pay or refuse to sign;
• The older the person, the higher the insurance price will be. There is a logic to this, namely that the risk of disease increases exponentially with age;
• The price of private insurance can be acceptable, but it can increase to several thousand euros per month depending on its customization;
• A person can have state and private insurance at the same time;
• An employee with a work card is withheld monthly the mandatory contribution, called CASS, which is 10 percent of the gross salary, this amount going to the state budget;
• In order to benefit from state insurance, one only needs to register on the list of a family doctor;
• As a rule, before concluding the insurance, the future insured must complete a questionnaire in which personal data and answers to some important, specific questions will be included, through which the insurer will notice what the style of life of the person concerned. It is possible to even request some analyses, depending on the desired medical services;
• Insurance in the public health system is a right guaranteed by the Constitution;
• Even if someone does not pay CASS, they will still be entitled to access a minimum healthcare package;
• A private health insurance can be taken out with any insurance company of your choice, as it is optional;
• Not everyone can take out a private policy. Exceptions are made for people with a high degree of disability, diagnosed with a serious and permanent illness, with alcoholism or drug addiction;
• Optimal medical insurance must focus on all three components of health care: prevention, diagnosis, treatment.

In conclusion, no one can control their future, but they can very well build an effective strategy to ensure that they get the necessary medical services. With the help of this health policy, unforeseen situations will be managed much more easily, so that there are no financial imbalances that would put the whole family in difficulty.

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