Health Insurance 324 views April 15, 2021

Managing finances while paying a hefty sum towards treatment costs can be tricky for most. So, people choose health insurance to protect their finances during a medical crisis. A health insurance plan provides coverage against different medical expenses. But when can you claim your health insurance?

Here, WHEN means ‘Situations’ when your health insurance plan can save your hard-earned savings from going towards medical expenses. If you want to know about such situations, read this page further as we will be discussing the same here. So, without any further delay, let’s get started!.

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Different Situations When You Can Claim Health Insurance

Health insurance plans provide coverage against different medical expenses in different situations. We are talking about each of them below. Please check!

In-patient Hospitalization

You can also claim your health insurance when you need to get hospitalized for the treatment of a medical condition or illness. However, to claim for in-patient hospitalization expenses, your hospitalization period should be a minimum of 24 hours. Also, you can get any coverage after the completion of the initial waiting period that ranges from 30 days to 90 days.

Pre-and Post-hospitalization Expenses

It is possible that you spend before and after the admission to a hospital. Such expenses come under the pre-and post-hospitalization expenses and range from 30 to 90 days (may change from one insurer to another). You can claim for pre-and post-hospitalization expenses via a reimbursement claim method where you need to submit a few documents. The insurer will assess them and approve your claim accordingly.

Accidental Hospitalization

In case you need emergency hospitalization due to an accident, you can claim your health insurance to receive coverage against expenses incurred during treatment. One of the best things about accidental hospitalization coverage is that you can get it right from the day when you purchase the plan. It means you don’t need to serve any waiting period.

Daycare Treatment

Your health insurance can also come to your rescue in case of daycare treatments — Treatments that do not require a minimum 24-hour hospitalization and can be done in a few hours. Some common daycare treatments are cataract surgery, radiotherapy, bone fracture & joint-related surgeries, etc.

Outpatient Department (OPD) Treatment

You can claim your health insurance in case of OPD treatments too. Any consultation, diagnosis, and treatment that does not require hospitalization are known as OPD treatments. With health insurance plans, you can also get coverage against expenses incurred on such treatments. Some of the examples are Root Canal treatment, minor surgeries, bone fracture treatment, etc.

Domiciliary Treatment

Treatments taken at home due to unavailability of bed or when you cannot be transferred to a hospital are considered domiciliary treatments. You can also claim health insurance in such cases.

Critical Illness Coverage

You can claim health insurance if you need to undergo treatment for life-threatening diseases (critical illness) such as cancer, heart attack, kidney failure, organ transplantation, etc. Such treatments can be covered once the waiting period is over. Do remember that the waiting period for critical illness tends to vary from one policy to another.

Organ Donor Cover

With the help of health insurance, you can claim for organ donor expenses incurred by you in case a critical health issue needs organ transplantation. Different organ transplantation expenses are compatibility test expenses, pre-and post-hospitalization expenses, hospitalization expenses, organ transplantation surgery, follow-up tests, etc.

Maternity & Newborn Coverage

Expenses incurred towards maternity and newborn childbirth defects can prove costly considering the present treatment costs. Insurers provide specialized plans for maternity and newborn children. With the right health insurance plan, you can get coverage against such expenses after a waiting period that ranges from 9 to 36 months.

Daily Cash Benefit

You can claim your health insurance to receive a fixed amount every day over the hospitalization period. This amount can help people manage the additional expenses covered under health insurance. However, you should check whether your health insurance plan provides this benefit or not.

Emergency Ambulance Charges

Your health insurance plan can also save your finances if you need to be transported to the nearest hospital via ambulance on an urgent basis. However, the coverage amount will be up to a limit of the overall sum insured and can be claimed up to a limited number of times in a policy year.

Periodic Health Check-ups

Your health insurance plan can also be claimed against the expenses incurred on periodic health checkups every year. These health check-ups help insurers detect diseases at an early stage and can be treated accordingly. Some insurers also ask policyholders (above 45 years) to undergo a pre-policy medical checkup to check if they have any pre-existing illnesses. You can claim your health insurance to reimburse the costs incurred on such checkups.

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