Medical exigencies are often sudden and unpredictable, and a sudden healthcare need often makes it tough for us to handle, as can be realized with the outbreak of the COVID-19 pandemic.
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Health insurance functions as a protective shield at those times, to cover vast medical expenditures, pre, and post-hospitalization services, annual check-ups, to provide benefits and discounts, etc. This is to get you all covered!
8 essential things to consider while purchasing a health insurance policy
Let’s cover all the essential know-how before you get an insurance policy!
1. Inclusions of the Plan
Every health insurance plan comes with a set of inclusions, which the insurer will cover for you. Check them out!
● In-patient Hospitalisation: During hospitalizations, you can now directly get admitted to hospitals (as an in-patient), availing healthcare, accommodation, on-boarding expenditures, intensive care, doctor’s fees, etc.
●Post and Pre-Hospitalisation: The plan accommodates both post-hospitalization and pre-hospitalization costs.
● Health Check-ups: Most plans provide a free health check-up (annually)
●No-Claim-Bonus (NCB): No-Claim-Bonuses are bonuses provided by insurers if you do not file any claim for an entire year.
●Daycare Service: These are services like dialysis, chemotherapy, physiotherapy, cataract surgery, etc., that don’t require 24-hour hospitalization.
- Exclusions of the Plan
To get a 360° view, you should know the exclusions that your insurer does not cover, alongside the services that you get.
● Any pre-existing disease acquired before purchasing an insurance plan. Learn more about the “waiting period” covered below!
● Cosmetic surgery and hygiene-based therapy
● Dental Care or Auditory Treatment: sometimes covered to a certain percentage. Read more about “sun insured” below!
● Self-inflicted Harm or Suicide Attempts
● Certain Specific Illnesses like hernia, STDs, etc.
● Charges on Diagnostics or Routine Doctor Visits
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- Purchasing Health Insurance Early
Why should you purchase your health insurance early? Here are the top 5 reasons why.
● Reason 1: You enjoy lower insurance premiums at a younger age. If the premium cost is Rs 8000/- when you are in your 50’s, the same plan would cost a premium of Rs 5000/- when you are 25.
● Reason 2: You get a comprehensive deal. You have a lower chance of acquiring diseases when young; hence, any diseases acquired later will automatically be covered!
● Reason 3: Enjoy lucrative benefits and NCBs! NCBs and benefits are offered to those who do not avail of any claim for a year. When young, you will have less chance of hospitalization. You can hence enjoy lucrative NCBs, royalty, and benefits and claim them later on.
● Reason 4: Better financial management for yourself!
● Reason 5: Staying ahead of the game. With an increased risk of acquiring lifestyle disorders or to protect against sudden disease outbreaks like the COVID-19 pandemic, it is always best to plan early and be the early bird!
- Sum Insured
This is the total amount that a health insurer will provide you during the term of your health insurance plan for all the healthcare expenditures and services.
For example, suppose you have a standard Arogya Sanjeevani Policy plan, which offers 3 lakhs sum insured, and your hospitalization cost comes to around 3.15 lakhs. In that case, the insurer will provide three lakhs while Rs 15,000/- will be borne by you.
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- Waiting Period
Worry no more if you are uncertain about what a “waiting period” is, what it covers or what its duration is. Keep reading to get your questions answered!
The waiting period indicates the duration you need to wait to enjoy the policy's benefits from its starting date. They are of various types depending on the type of disease and specific scenarios like – Initial Waiting Period, Pre-existing-Diseases (PED) Waiting Period, Maternity and Baby Cover Waiting Period, Accidental Hospitalisation, Specific Diseases, etc., to name a few.
- Network Hospitals for Cashless Facility
Network hospitals are those that have agreements with a health insurance company so as to provide cashless medical facilities to the policyholders. Upon hospitalization, your cost expenditures will get settled directly by your insurer in a cashless manner.
- Room Rent Capping
There is a limit to the cost covered by insurance providers on the hospital room price of policyholders. This is called Room Rent Capping. The insurer either mentions a percentage of the sum insured or mentions a specific amount for paying the room rent.
- The simplicity of Filing the Claim
Filing a health insurance claim is pretty simple and can be done by either of the two processes.
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● Cashless: For this, you must avail treatment at any of the network hospitals. You need to seek authorization for cashless treatment, read the entire policy document, and follow the steps for cashless treatment as prescribed by your insurer.
● Reimbursement: You need to read all the clauses and familiarise yourself with the documents and processes required to place the claim. Inform your insurer once the claim arises.
Thus, to sum it up, you need to start planning for a health insurance policy early on, to acquire all the benefits, NCBs, and loyalties that insurance companies have on their platter. In case you are applying for an insurance policy for the first time, go with a simple yet trustable policy plan like the Arogya Sanjeevani Policy plan, which provides a simple yet standard plan offered by almost all insurance companies in India.
It provides an insured sum ranging from 3 lakhs to 2 crores, covering post and pre-hospitalization costs, room rent, new-age treatments, and even ICU services. To simplify, you can opt for either an individual or a family floater plan suiting your needs!
So, start early, plan well and live to tell!
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