I think Insurers can help by taking the lead, do some good for their customers, by listing hospitals (with classification) that provide Covid19 treatment.
5/n
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Patient hospitalized for 6 days
Insurer pays for 2 days - says no "active treatment" after 2nd day.
Doctor shares logic for the 6-day treatment.
Insurer still disagrees.
Should patients consult insurers before taking medical decisions?
Why do patients suffer for lack of medical regulations?
First, let's understand why this happens.
So, health insurance as per the contract will pay only in case when the hospitalization is
a) "Necessary" and
b) " requires active treatment"
Ok - so what is "Necessary" treatment?
It is when patient can only be treated at a hospital and not at home or in OPD.
For instance, say I meet with an accident, and break my hand.
Now, the doctor needs to apply plaster on my hand.
But say the doctor asks me to get hospitalized for a day - This won't be covered under health insurance.
"What if I skip Health Insurance and build a fund to cover my family’s healthcare."
Fine print + claim hassles have forced all of us to think in this line.
Before you go down that road, here’s a thread on what you need to know
👇🏻👇🏻
Health insurance, despite its flaws, offers some powerful benefits that you should understand before taking such calls.
Let’s break down these powerful benefits of health insurance:
⦿ Lifetime Hospitalization Cover
Once you clear the initial waiting periods, health insurance can practically cover all your hospitalization costs for a lifetime — yours and your family’s.
Regulation does not allow insurers to stop coverage, unless they prove a fraud.
Most of the changes are applicable from immediate effect - unless there is a specific target date mentioned for the change.
Thread time 👇🏻
INCLUSIVENESS:
IRDAI has asked insurers to make available products for 1. All age groups 2. People with medical conditions, including chronic. 3. All types of treatment - including OPD!! 4. All occupations, regions, categories.
All kinds of hospitals including affordable ones.
No denial of coverage in case of emergency situations.