Most are aware of the standard benefits that come with a Health Insurance plan but there are a whole lot of other benefits that you should know before you zero in on a plan.
Getting a Health Insurance plan for yourself and your family is a no-brainer. Whether you want to opt for an individual plan or a family cover is entirely up to you although you’re likely to save more on premiums when you opt for a family cover. If both you and your spouse are working, you both probably get Health Insurance from your employers. While that may be a great employment benefit, it is certainly not a good idea to solely depend on it for all your Health Insurance needs. Company-offered Health Insurance plans will not be valid if you’re out of work or are laid off. That’s why it’s better to get yourself and your family a personal Health Insurance plan.
While most Health Insurance plans come with a host of standard benefits like hospitalisation expenses, cashless admission in ‘listed’ hospitals, tax deduction benefits etc., there are a ton of others that are pretty compelling in themselves and can be of great advantage if you know how to use them well. Let’s take a look at them one by one.
Benefits beyond allopathic treatments:
Insurance watch-dog IRDA has mandated that health plans can also cover alternative treatments like Ayurveda, Unani, Siddha, and Homeopathy (AYUSH). Since this new regulation came into force, many Health Insurance providers have started including these treatments as long as they are availed from a government hospital or any institute recognised by the Quality Council of India and National Accreditation Board of Hospitals and Healthcare. While most insurers offer coverage for these treatments under the primary coverage plan, some keep it under sub-limit treatment. If you or your family members usually undergo alternative medicine treatments, check if your Health Insurance plan will provide you coverage for it.
Some Health Insurance plans offer the benefits of no claim-bonus. A no-claim bonus is offered when a policyholder doesn’t file a claim during the policy’s year-long tenure. Sometimes the bonus could be a higher Sum Assured or a discount on the premium you have to pay at the time of policy renewal. Some insurers may even offer a cumulative bonus instead of giving a bonus every no-claim year.
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Health insurers also offer cover for treatments that are done at home for disease or injury under medical supervision. Sometimes, a patient’s condition is so feeble that he/she may not be fit enough for hospitalisation or a hospital bed/room may be unavailable. Under these circumstances, insurers may offer this benefit for a limited number of days and for a limited amount. Some Health Insurance companies may cover as many as 500 days of domiciliary treatment.
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Check if your policy can be renewed for a lifetime if you’ve been making regular and timely payments of your premiums.
Daily cash benefit/daily hospital cash allowance:
Other than covering expenses associated with the main treatment, insurers might also offer additional coverage for expenses that you have to make towards food and hospital visits in the form of a daily cash allowance. You might be entitled to a good sum in the event of ICU and accidental hospitalisation. Check if your insurance plan offers this benefit or not.
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Sum assured restoration benefit:
Some insurers offer a restoration benefit if the policyholder has exhausted the entire sum within the policy’s annual term. The insurer restores the entire sum assured if it’s been used up from earlier claims. The restored sum assured is for future claims unrelated to claims that have already been made. Many insurers offer unlimited restorations during a policy year.
Some insurers also cover outpatient expenses such as doctor’s consultation fees, pathological tests, pharmacy-related expenses that you don’t need to be hospitalised for in order to claim.
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Most Health Insurance policies are specifically designed to cover maternity expenses incurred for hospitalisation during delivery, pre-natal expenses like tests, emergency ambulance services, etc.
Pre-hospitalisation expenses include expenses related to procedures and tests that you may have to undergo before you get hospitalised for treatment. Insurers cover these expenses for anywhere between 30 and 90 days prior to hospitalisation. Some of these tests include a urine test, X-rays, blood tests, etc. that doctors usually ask for to check if the patient is fit enough to undergo surgery. Post-hospitalisation expenses include costs that are incurred in follow-up treatments for the condition for which one was hospitalised. These could include diagnostic charges, consulting fees, and medical costs that insurers cover between 45 and 90 days after discharge from the hospital. In case your Health Insurance plan covers outpatient department (OPD) expenses, physiotherapy expenses can also be reimbursed. In order to claim pre- and post-hospitalisation expenses, you’ll need to submit original receipts and relevant copies of doctor’s certificate and discharge summary to your insurer.
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In case of emergency hospitalisation, it may not be always possible to admit your loved one in a nearby hospital that is empanelled in your Health Insurance plan. You can still, however, get those hospital expenses reimbursed by submitting the appropriate bills and paperwork with your insurer.
If you’re looking to get a new Health Insurance plan, it’s a good idea to check for some of these benefits and get yourself a plan that is comprehensive and your money’s worth.
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