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Hospitalisation can burn a hole in your pocket and derail your finances. It will become even tough, if the person who brings in the money, is now in a hospital bed. All this can be avoided by just paying a small annual premium towards health insurance
#healthinsurance #hospital
#healthinsurance #hospital
There are some loop holes in these insurance policies which may again end up leaving a hole in your pocket. So let's shed light on a few things you should be aware of before purchasing insurance.
#HealthForAll #healthinsurance #hospitalised #hospitals
#HealthForAll #healthinsurance #hospitalised #hospitals
1) What type of health plan it is?
There are various types of health insurance plans -
Individual Health Insurance
Family
Senior Citizen
Surgery & Critical Illness,etc
Go thoroughly through the benefits of each plan and then choose the one that best caters to your requirement.
There are various types of health insurance plans -
Individual Health Insurance
Family
Senior Citizen
Surgery & Critical Illness,etc
Go thoroughly through the benefits of each plan and then choose the one that best caters to your requirement.
3)What does the policy cover (inclusions)?
Check if it covers :
Hospitalization charges, pre and post hospitalization charges, ambulance services, lab tests, prescription drugs, organ donor charges, maternity benefit, small medical procedures (DAY CARE PROCEDURES)
#insurance
Check if it covers :
Hospitalization charges, pre and post hospitalization charges, ambulance services, lab tests, prescription drugs, organ donor charges, maternity benefit, small medical procedures (DAY CARE PROCEDURES)
#insurance
DAY CARE PROCEDURES) like cataracts, tonsillectomy, nasal sinus aspiration, cancer chemotherapy, cancer radiotherapy, etc.. You must read the policy document carefully to understand the exact coverage on offer. Being unaware of the exclusions can lead to claim rejection.
3)What the policy does not cover(exclusions)?
Some insurance policies do not cover the treatment of certain diseases in the first year but after a waiting period. Being unaware of the exclusions can lead to claim rejection.
4)What is a waiting period?
Some insurance policies do not cover the treatment of certain diseases in the first year but after a waiting period. Being unaware of the exclusions can lead to claim rejection.
4)What is a waiting period?
The Waiting Period Clause : applies to pre-existing illnesses- health condition that you already have had symptoms of or have been treated for within 48 months before you got your health insurance policy ( thyroid, blood pressure, diabetes, asthma,etc )
In many plans, coverage for piles, fistula, hernia, etc., is available only after the first 2 policy years. These ailments are called specific diseases. Reach out to the insurance company if you are unsure about this coverage being offered.
So if you are diagnosed with these disease in 24-48months of purchase of insurance, the insurance will consider it as pre-existing disease & will not cover the treatment costs until waiting period completion.
You can look for policies with minimum waiting period (1year)
You can look for policies with minimum waiting period (1year)
Some insurers will give you the option to reduce your waiting period to 2,3, or 4 years, and instead, they will charge you a higher premium accordingly.
#healthinsurance #healthsector #hospital #Doctors #HealthForAll #medicine
#healthinsurance #healthsector #hospital #Doctors #HealthForAll #medicine
5) Check if your insurance covers preventive health check-ups for cardiovascular diseases, cancer screenings, MRIs
6)What is the hospital room rent limit on the health insurance plan?
A hospital’s room rent may sound like a trivial charge, but it can be exorbitant.
6)What is the hospital room rent limit on the health insurance plan?
A hospital’s room rent may sound like a trivial charge, but it can be exorbitant.
The treatment cost can go high if the patient is admitted to a room that costs more than the allowed limit,then you would have to proportionately share the load of hospital bill. The room rent limit in insurance specifies the maximum room rent coverage allowed under the policy.
For example, if your rent charges are capped at 1% of your sum insured of ₹5 lakhs, your insurance will cover the same up to ₹5,000.
However, some insurance companies have no room rent capping as a benefit as long as your total claim amount doesn’t exceed your sum insured.
However, some insurance companies have no room rent capping as a benefit as long as your total claim amount doesn’t exceed your sum insured.
7) How much does the plan cost?
The cost of the plan is the amount you pay per month to your insurer to keep your health cover active.(premium)
Depending on age(higher age, higher premium), pre-existing illnesses, type of plan & amount of coverage, the premium varies.
The cost of the plan is the amount you pay per month to your insurer to keep your health cover active.(premium)
Depending on age(higher age, higher premium), pre-existing illnesses, type of plan & amount of coverage, the premium varies.
8) What is Sum Insured (SI)?
It is the maximum amount your insurer will be able to cover for you in 1yr in case of medical claims.
A lower SI can result in a lower premium, but when medical bills exceed this amount, you will have to pay the extra cost out of your own pocket.
It is the maximum amount your insurer will be able to cover for you in 1yr in case of medical claims.
A lower SI can result in a lower premium, but when medical bills exceed this amount, you will have to pay the extra cost out of your own pocket.
9) Does your policy have NO CLAIM BONUS(NCB)?
• NCB refers to the discount offered by the insurance company for all the years that you have not filed a claim. Basically your coverage amount is increased at the time of subsequent policy renewals for all claim-free years.
• NCB refers to the discount offered by the insurance company for all the years that you have not filed a claim. Basically your coverage amount is increased at the time of subsequent policy renewals for all claim-free years.
Eg:
health insurance plan of Rs. 5 lakh and the insurer offers 10% NCB for every claim-free year up to a maximum of 50%.
1st claim-free year₹ 5,50,000
2nd claim-free year₹ 6,00,000 and so on.
The maximum sum insured capping here is Rs. 7.5 lakh ( 50% of Rs. 5 lakh).
health insurance plan of Rs. 5 lakh and the insurer offers 10% NCB for every claim-free year up to a maximum of 50%.
1st claim-free year₹ 5,50,000
2nd claim-free year₹ 6,00,000 and so on.
The maximum sum insured capping here is Rs. 7.5 lakh ( 50% of Rs. 5 lakh).
10)Any additional clauses like co-payment, deductibles, sub-limits?
Health insurance comes with certain out-of-pocket costs like deductible & coinsurance. This amount is what you will have to pay out of your pocket when you receive medical care.
Let's decode these terms
Health insurance comes with certain out-of-pocket costs like deductible & coinsurance. This amount is what you will have to pay out of your pocket when you receive medical care.
Let's decode these terms
What is co-payment?
*It is basically the percentage of the amount that you would need to pay at the time of claim and the rest will be paid by the insurer. Both you & the will pay. Insurer pays for a large portion of the bill, & smaller part of it would have to be paid by you.
*It is basically the percentage of the amount that you would need to pay at the time of claim and the rest will be paid by the insurer. Both you & the will pay. Insurer pays for a large portion of the bill, & smaller part of it would have to be paid by you.
Example, if you have a 15% co-pay, your insurer will bear 85% of the claim amount, while you pay the rest.)
Such policies cost less but also offer less compensation as you have to pay a considerable part of the hospital bill.
Such policies cost less but also offer less compensation as you have to pay a considerable part of the hospital bill.
What is deductible?
*Some health insurance plans include a deductible. This is when you need to pay a part of the insurance claim from your pocket before the insurer can cover the rest for you. This amount is usually decided by you while buying your health insurance policy.
*Some health insurance plans include a deductible. This is when you need to pay a part of the insurance claim from your pocket before the insurer can cover the rest for you. This amount is usually decided by you while buying your health insurance policy.
For example, if your healthcare claim is ₹35,000, and you have a deductible amount of ₹10,000, your insurance company will be liable to pay ₹25,000. The ₹10,000 deductibles will have to be borne by you.
There are 2 types of deductibles:
COMPULSARY & VOLUNTARY.
There are 2 types of deductibles:
COMPULSARY & VOLUNTARY.
Compulsory deductible - the amount is fixed by the insurance company. The amount is set by the insurer, the amount cannot be lowered and will not change the premium. In case of a claim, you will pay only the compulsory deductible amount set by the insurance company.
Voluntary deductible- the amount is fixed by you. The higher your deductible amount is, the lower your premium will be but in case of a claim, you will have to pay the voluntary deductible, as well as any compulsory deductible, out of pocket.
What is sub-limit?
• A sub-limit is a pre-determined cap that is placed on parts of your claim amount by the insurer. These sub-limits won’t be applicable to the entire bill amount, but rather to certain conditions.
• A sub-limit is a pre-determined cap that is placed on parts of your claim amount by the insurer. These sub-limits won’t be applicable to the entire bill amount, but rather to certain conditions.
The 3 main types of sub-limits are placed on:
1)Hospital room rent (1–2% of the sum insured)
2)Treatment of certain diseases – common & pre-planned procedures such as kidney stones, cataracts, piles, gallstones, hernias, tonsils, or sinus
3)Pre- & post-hospitalization charges.
1)Hospital room rent (1–2% of the sum insured)
2)Treatment of certain diseases – common & pre-planned procedures such as kidney stones, cataracts, piles, gallstones, hernias, tonsils, or sinus
3)Pre- & post-hospitalization charges.
What is Maternity benefit?
Usually, there is a waiting period of 2 to 4 years before you can claim the benefits. For instance, if you are planning to get married or are planning a family let’s say after three years then a plan with a waiting period of 2-years will work for you.
Usually, there is a waiting period of 2 to 4 years before you can claim the benefits. For instance, if you are planning to get married or are planning a family let’s say after three years then a plan with a waiting period of 2-years will work for you.
Choose a plan that also covers newborn baby medical expenses apart from the delivery cost. Also, do not forget to check the limitations that are attached to it.
#HealthForAll #hospital #healthinsurance #insuranceindustry #doctors #medicine
#HealthForAll #hospital #healthinsurance #insuranceindustry #doctors #medicine
11)Will you be able to avail of treatment from your preferred doctor?
If you have a preferred doctor or hospital, check the list of network hospitals to ensure that you can avail their services or not since an out of network provider can turn out to be very expensive.
If you have a preferred doctor or hospital, check the list of network hospitals to ensure that you can avail their services or not since an out of network provider can turn out to be very expensive.
12)What is the process for filing a claim?
You must understand the claim process & the documents you will require for claim initiation. Good customer support is an additional advantage one should look for.
2 types : Cashless claim & Reimbursement claim.
You must understand the claim process & the documents you will require for claim initiation. Good customer support is an additional advantage one should look for.
2 types : Cashless claim & Reimbursement claim.
A network hospital (hospitals which accept your policy) can provide a cashless claim, whereas the policyholder will have to follow the reimbursement claim process if admitted to a non-network hospital.
In a cashless claim, the insurance company pays most of the hospital bills during hospitalisation.
In a reimbursement claim, the policyholder pays the entire bill and then raises a claim with the insurance company.
In a reimbursement claim, the policyholder pays the entire bill and then raises a claim with the insurance company.
12)What is the maximum number of claims you can make in a year?
There is no limit to the number of claims in a year, provided it does not exceed the sum assured of your policy. You must ask your insurer about your claim limit beforehand.
#HealthForAll #Hospital #doctors
#Medicine
There is no limit to the number of claims in a year, provided it does not exceed the sum assured of your policy. You must ask your insurer about your claim limit beforehand.
#HealthForAll #Hospital #doctors
#Medicine
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