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Health Insurance 360 views January 22, 2021
Health Insurance covers your medical treatment expenses and ensures financial harmony for you when faced with such contingency times. The process of claiming health insurance is simple too. Just show your health insurance card to the hospital desk, fill the pre-authorization form and start receiving medical treatment for FREE at network hospitals. In case the admission is made to a non-network hospital, you will need to spend first and get that reimbursed from your health insurance company later. To get these claims, you need to pay your insurer a premium at regular intervals. This is how a health insurance policy works.
So simple yet some of us choose a policy that does not serve them much! In some cases, claims get rejected too, piling on the agony for those facing such problems. The reasons for such undesirable circumstances can vary from one case to another. However, a good look at the Dos and Don’ts can help you figure out the approach to selecting a health insurance policy. So what are you waiting for? Let’s glance at the Dos and Don’ts to keep in mind.
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The Dos revolve around the practices to follow when choosing a health insurance policy. The practices could be regarding coverage, premium, exclusions, and much more. So, without waiting any further, let’s check out all of them here!
Stuff which is good for someone may not replicate in your case! Similarly, a health insurance policy chosen by someone may not serve your purpose. With that, it is obvious that you should compare policies much more diligently. Look at your needs before comparing policies. In case you are taking a policy for family members, the sum assured amount should remain high to suffice your needs. In that case, the premium amount will go up. So while comparing, check which policies have a maximum sum insured for you and your family members at least premium. Also, see which policies offer coverage for maximum diseases or ailments before choosing the one for you.
It’s easy to get influenced by words like extended coverages in the promo. But insurers could set certain limits on room rent and other medical expenses associated with hospitalization. Expenses are incurred before and after hospitalization too, but these are also covered with some capping. The coverage will be there for a fixed number of days that you could see in the fineprint. So, read policy coverages and their limits carefully before choosing the one for you. Following this selection principle will ensure a seamless health insurance journey for you.
Choosing the right plan will require awareness not only regarding coverages but also exclusions. So, choosing the plan without checking or being aware of the latter will only make you feel bad when you won’t get a claim from the insurance company in case the disease or illness does not merit a cover. But exclusions may not be lifelong; you could find companies offering cover for diseases or illnesses after the policy runs for a specified time. For example, pre-existing diseases (Diseases that you have before the commencement of a health insurance policy) will get covered after 2-4 years from the policy inception date. Besides, you could see some permanent exclusions in the policy document. That only reinforces the need to read the policy wordings thoroughly and stay away from any speculation.
An important point to consider, but most of us don’t prioritize it much given that you can get health insurance claims even for the treatment undertaken at a non-network hospital by way of reimbursement. But what, when you don’t have savings for the treatment? Don’t think, you would like to be in such a situation! So knowing the list of network hospitals is important for you to undergo a cashless treatment and stay away from problems that you may face otherwise. If network hospitals are near to your home or office, it will be even better!
Failing to intimate the insurer about health claims on time is one thing, not knowing the exact time for intimation is another. So all your money paid towards the premium won’t come to use if you don’t know when to intimate the insurance company. Now the intimation time would depend on the state of hospitalization. If there’s an emergency hospitalization at a network hospital, intimate the insurer within 24 hours. In the case of planned admission, you need to intimate the insurer 48 hours before the hospitalization. With that, the cashless treatment will happen without any hassle. Even for reimbursement claims, you will need to intimate the insurer and that too within 24 hours of hospitalization.
The intimation time shown above is the case among most insurers, if not all. It means the intimation norm can vary from one insurer to another. That makes reading the policy wordings even more important for you!
As told above, you will need to spend towards your medical treatment if you choose the reimbursement method. To get that reimbursed from the company successfully, you will need to submit discharge papers, medicine bills and several other medical documents to the insurance company. The company will check these documents thoroughly and approve the claim only after successful verification. After a few days from approval, you will get the claim amount in your bank account.
Don’ts mean the mistakes you should not commit regarding a health insurance plan. But what are the mistakes you could commit, maybe unknowingly? We have explained that below. Take a look!
The medical history of individuals remains under intense scrutiny during the underwriting process of insurers as they check such details minutely. Yes, some insurance companies can deny you a health insurance policy in case you have a history of diseases. But the rejection for this won’t hurt you much compared to when your claim gets rejected later on the grounds of you hiding your medical history at the time of policy inception. So, disclose all your health details to the insurer at inception. You might face rejection from some insurers if your medical history is bad, but some could give you the nod too!
The best part about health insurance is lower premium rates when you start early. But if you delay, the premium will notch up. Health insurance companies come with different slabs of premium rates according to the age of an individual. As you move from one slab to another with your increasing age, the premium will start to increase.
Besides premium, you could even raise your sum insured greatly if you start early. One generally remains fit and healthy in the young days. So if you maintain the same, you won’t have to claim. You might wonder, what is the benefit then? Well, the benefit will come in the form of a hike in the sum insured amount. Yes, for every claim-free year, you will get a No Claim Bonus (NCB) that will raise the base sum insured by 5-25% on average. The bonus can go up to even 100%. It means you will have more to deal with the rising healthcare expenses going forward.
The fact that health insurance comes into play when you require hospitalization could make you feel it as a waste if you remain healthy and stay away from health hazards. So, you could think of not continuing the policy by not paying the premium at renewal. If you do, the policy will lapse after some point.
But can you predict how your health will shape up over time? In case you do meet with a health emergency later and there remains no health insurance at that time, you could only feel the pinch! So, stick with a health insurance plan by paying your premium at renewal to get uninterrupted cover.
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