Insurance model stands up to pandemic by keeping health debt incidence to absolute minimum
Despite successive waves of the pandemic, the Insured with TU Zdrowie continue to benefit from all medical services offered. Thanks to contractually guaranteed access to physicians and specialist examinations, TU Zdrowie customers will not have to face the health debt incurred by those patients who resign from direct consultations with physicians or whose appointments and examinations are postponed to subsequent months.
This is a real threat to the health and life of every person requiring continuous medical care, preventive examinations and regular contact with specialists. First of all, postponed appointments mean serious consequences of interrupted treatment for the patient, but they are also troublesome for medical facilities which, once the progress of the pandemic is stopped, will have to face rapidly growing queues of patients.
An analysis of the number of medical services performed in 2020 shows that TU Zdrowie customers limited contact with doctors only at the very beginning of the pandemic. From June to the end of December last year, medical access was delivered at a similar level as in 2019. This proves that in the insurance model, the patient has no problems related to the delivery of benefits contracted even during the difficulties associated with Covid-19.
“With the registration of the first cases of coronavirus in Poland and the first lockdown, we saw a decrease in delivered medical services. In March, the figure stood at 67% of the 2019 figure, and in April, it was only 36%. However, already in May, the trend reversed to equal the corresponding state of 2019 in June. By the end of December, we saw a steady increase in the use of medical packages, and this was despite the difficult situation during the fall. If we add up the results for the whole of 2020, the average realized benefits will be 99% of the state of the previous year,” says Teresa Domańska, Director of the Health Insurance Office of TU Zdrowie.
Such high delivery of services is due to the combination of unique features of TU Zdrowie’s insurance portfolio: a contractually defined guarantee of access to medical services, freedom of access to any medical facility and the option to seek reimbursement, and to enjoy reimbursements as well as telemedicine and IT solutions that allow for efficient contact with a selected doctor via e-consultation.
The high efficiency of the system is evidenced by the total number of inpatient, telemedicine and electronic platform consultations. Despite a significant decrease in the number of consultations between March and May 2020, the annual average was 2.5% higher than for the whole of 2019. E-consultations launched by TU Zdrowie in March as a tool to make it easier for patients to stay in touch with their doctor proved undoubtedly successful. The peak of this type of service delivery coincided with April and amounted to nearly 40% of all consultations. However, it is important to note that both e-consultation and telemedicine are complementary to stationary visits, and it is up to the Insured to decide which form of service they prefer.
“We do not report situations, in which our Insured would complain about the lack of doctors’ availability. The Insured enjoy absolute freedom to decide whether they prefer a telemedicine or stationary consultation, regardless of the region of Poland they live in or their current location. The contract guarantees finding a medical facility within a radius of up to 40 km, and if this condition cannot be met, TU Zdrowie reimburses 100% of the incurred costs,” says Dariusz Grądziel, Sales Director at TU Zdrowie.
The data analyzed shows that the average use of medical services in 2020 is similar to the previous year. As of June 2020, the number of services requiring a physical appearance at a medical facility was on average several percent higher than in the same period of 2019. This trend is evident in specific subgroups of services such as laboratory testing, diagnostic imaging, rehabilitation and dentistry. Insureds compensated for the three-month decline - caused by the onset of the pandemic - with higher benefit delivery rates later in the year, reducing the potential for health debt.
TU Zdrowie is proving that the insurance model it offers is very well suited to such a difficult time. The service delivery guarantee combined with the freedom to use medical facilities provides the Insured with comfortable and, above all, uninterrupted access to healthcare.
