Performing due diligence while buying a Health Insurance policy can help in reducing the chances of distress to minimal.
A Health Insurance cover is meant to cover your medical treatment at the best of hospitals and keep you stress-free from the financial strain aspect. However, one may encounter some distress due to health insurance issues and such situations are difficult.
More so, if you have been duly paying your health insurance premiums and at some point of time you don’t get the desired support, it could lead to mental and financial distress. You can avoid this situation if you are aware of the reasons for such distress in advance and plan your health insurance in a more prudent way.
Let’s check out how you can avoid health insurance distress.
Not Getting Cashless Claim
People opt for a Health Insurance policy expecting they won’t be required to pay money under medical emergency. This being true to some extent, there are certain caveats attached to the cashless facility one should be aware of. You are allowed to claim cashless hospitalisation benefit if you get the treatment in the network hospital, which is mentioned in the policy document list.
Also, there are situations when the insurer may not be able to identify the insured on time, and the hospital may ask the insured to settle the bill from his/her own pocket. In this case, an exorbitant hospital bill can cause considerable stress.
To avoid such situation s, you must check whether the hospital is listed in the policy document for a cashless facility or not. It is always advisable to get a pre-approval from the insurance company to avoid any authorisation delay. Even after taking all precautions you are unable to avail a cashless facility shouldn’t be a big worry.
You can always get the money reimbursed by completing the procedure prescribed by the insurance company. Normally the money is reimbursed in 15 to 30 days of filing the request.
The premium may increase due to change in the age slab or due to changes in the cost structure of the insurance company. After continuing the health policy for a long period if the insurance support arises but the premium has increased manifold, the cause of distress could considerably go up.
Normally, the insurance regulator restricts the insurance companies from spiking the insurance premium exorbitantly. However, even a moderate increase could be a burden on the insured person. In such a scenario, you can use the porting option and switch the policy to another insurance company which offers similar cover and charge a lower premium. Normally, all the benefits such as no claim bonus and passed time to get cover for pre-existing diseases continue with the switched policy.
Change In Terms And Condition
Sometimes health insurance companies change the terms and conditions in their policy document. It may include or exclude particular disease from the list or add or remove a hospital from the network list.
If you find it difficult to accept the change in the terms and condition, then you can switch the insurance company by using the porting option. Sometimes, insurance companies include the cover to disease s which were not allowed earlier, but at the same time increase the premium to that extent. In such a situation you must compare the policy once again with others available in the market and decide based on available merits and demerits.
Cover Not Allowed Due To Pre-existing Clause
Pre-existing ailments are not covered for a specified number of years. If the insured person forgets this clause, then they may need to pay all the treatment cost for such pre-existing diseases from their own pocket.
It is important that you clearly mention the pre-existing ailments at the time of purchasing the health policy. If you are buying health policy after an age of 45 years, then it is better to attach the health screening report with the application to avoid dispute in claim settlement in the future.
Paying From Pocket Despite Health Insurance Cover
Exclusion list may vary from one insurance company to another. If you have switched the insurance policy from one company to another through porting option, then your exclusion list may change as well. Suppose, your earlier insurance company may have allowed treatment of dental problem after a waiting period of 2 years, but after porting, the new insurance company may not allow dental treatment at all.
You must check the exclusion list before porting the policy and always check the exclusion list of the existing policy before you renew it.
Hence, performing due diligence before buying a health policy can help in reducing the chances of distress to minimal.