Things Which Make A Health Insurance Plan Great

By | December 25, 2018

Health Insurance on your mind? Check out these essential tips before you sign up for one.

Things Which Make A Health Insurance Plan Great

Health Insurance is one of those few necessities of modern life that we simply can’t live without. Blame it on the rising medical costs or the changing lifestyle, getting a Health Insurance cover has become a priority in most Indian households.

What Is Health Insurance?

A Health Insurance policy is basically a contract between the insurance company and the policyholder which covers the cost of an insured individual’s medical and surgical expenses. Depending on the type of insurance, you either receive a reimbursement for the medical cost incurred or the insurer pays the incurred amount directly to the hospital.

Medical insurance plans in India can be broadly classified into two types: reimbursement or indemnity-based policies and fixed benefit hospitalisation plans.

Additional Reading: 7 Helpful Tips To Choose The Best Health Insurance Plan

Reimbursement/Indemnity-Based Policies:

Commonly known as mediclaim, this type of Health Insurance covers medical expenses incurred during hospitalisation, diagnosis, and pre and post-hospitalisation period. However, you may be required to pay out of your pocket until you have raised a claim.

Tip: If you are opting for a mediclaim, try choosing a cashless service. It will save you plenty of time by reducing the paperwork and it will also ensure an instant reimbursement in case of an emergency.

Fixed Benefit Hospitalisation Plans:

If you choose a fixed benefit hospitalisation plan, you will receive a lump-sum payout equal to the sum insured under the policy irrespective of the total treatment cost. The fixed plan works out well, especially for the younger lot, since it provides the much-needed financial relief in the event of a medical emergency.

Additional Reading:  Little-Known Features Of Health Insurance Plans

Are You Too Young To Get Health Insurance?

When it comes to Health Insurance, the earlier you start the better it is. Health complications multiply as you grow older, so insurance companies charge lower premiums from the young and higher premiums from the not-so-young. If you are below 30 years of age, you should try to get a Health Insurance right away because the premium costs tend to rise rapidly once you are on the wiser side of 30.

All that being said, choosing the right Health Insurance cover for you and your family can be tough and confusing. Here are some essential tips to help you clear the muddle and make an informed choice:

#1 What You Should Know About ‘Co-Pay’

Co-pay is a fixed percentage of the hospital bill you mandatorily pay out of your own pocket. For e.g. If your policy has a 10% co-pay clause, it means for a Rs 1,000 claim, you have to pay Rs 100 while the insurer will pay the remaining Rs 900.

Tip: Opt for a “no co-pay” plan so that you don’t have to shell out cash from your own pocket.

#2 Duration Of The Coverage

Most people don’t require a lot of medical assistance until they hit 40. Knowing that health is a depreciating asset, always go for a plan that provides lifelong coverage. That way, you will keep the finance worries at bay when your health begins to deteriorate in your twilight years.

#3 Waiting Period

If you have a pre-existing disease, be aware that it’ll not be covered from day one of buying the policy. In such a scenario, you will have to wait for a specific period. Before you sign up for a Health Insurance plan, make sure to check the amount of time taken by that insurance provider to cover the ailment you are suffering from.

#4 Room Rent

The kind of room you take during hospitalisation matters incredibly as far as claim settlement on your Health Insurance is concerned. Check out the sub-limit on the room rent and try to stick within the allotted limit. If you exceed the room-rent limit, the insurer will end up reducing the reimbursement sub-limits for all other associated medical expenses on a pro-rata basis.

Additional Reading:  Understanding sub-limits in Health Insurance

#5 Pre & Post-Hospitalisation Expenses

Pre-hospitalisation expenses are medical costs incurred by the insured before getting admitted to a hospital. This will include the series of medical tests which form the preliminary part of diagnosis before a patient is admitted to the hospital. In most cases, charges incurred by an individual 30 days prior to his or her admission to any hospital fall within the ambit of pre-hospitalisation expenses.

Post-hospitalisation expenses include all expenses or charges incurred by an individual after he or she is hospitalised. In most cases, charges incurred by an individual for 60 days from the discharge date comes under the purview of post-hospitalisation expenses.

Know Your Policy Inside Out

Needless to say, the better you know your policy, the bigger your chances of claiming benefits from your insurer. Before you sign up, read the conditions carefully, check for the list of exclusions, compare a bunch of policies offering similar benefits and make a conscious move.

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Category: Health Insurance Insurance UCN

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