Insurance Finder and Tips

Before I begin, let me be clear as to, what this article does not talk about. It does not explain what health insurance is and neither does it coax you into buying it, if you have not opted for it already.

This article answers certain questions that are pertinent and affect your decision whether to buy Health insurance or not to buy health insurance.

Your neighbor who has just got his entire family insured for health, keeps on pestering you to buy it too and at the slightest opportunity bombards you with the positives and benefits of getting health insurance for yourself and your family. In this article, I keep myself from being your pesky neighbor, and simply keep the facts in front of you and leave it to you to decide.

Here, although I assume that your basics pertaining to health insurance are in place, yet,for the uninitiated,

      Here is a quick look at what we mean when we say, “Health insurance”..

Firstly, when you think of health insurance, you are clearly not thinking about life insurance. These are two distinctly different things, in the sense that while health insurance covers the expenses you might incur as a matter of hospitalization, in case you are affected by a disease, life insurance protects your family (or dependents) from financial loss that may arise in the event of your untimely death/or if something happens to you.

Also, in case of life insurance, the payout is made only after the death of the insured or at the maturity of the policy. In Health Insurance there is no payout made at maturity and the policy needs to be renewed annually.

Now let’s look at some of the most commonly and important questions associated with health insurance. Note that this is not an exhaustive list.

What are the minimum and maximum policy durations?

Health insurance comes under the General Insurance, and all health insurance policies are issued for a period of one year only. The maximum period can be two years, if a company issues a two year policy. But it is important to keep renewing your policy at the end of the period, either one or two years.

Because if the policy is not renewed in time, it may lapse, and you will have to wait for another four years for your claims to be redeemed, when you opt for another health insurance policy with a different company.

      Does health insurance cover diagnostic charges like X- ray, MRI or ultrasound?

Health Insurance covers the charges for all tests, medical expenses and treatments, if they are incurred as a result of the patient’s stay in the hospital for at least one night. Health insurance in India mainly connotes, hospitalization, hence, diagnostic tests like X- ray, MRI, blood tests etc are paid only if they have been done in the hospital during the patient’s stay there.

But it is important to know that tests are not covered unless they lead to hospitalization or unless recommended by a doctor as a part of the treatment, and all tests before hospitalization can be charged in Pre hospitalization expenses.

      Can there possibly be any situation in which my health related expenses may not be covered?

Until 30 days from the date on which the health insurance policy is issued to you, your claims will not be payable. However, if you undergo emergency hospitalization as a result of an accident, then the 30 day waiting period is waived off and your expenses will be reimbursed. All the more, this 30 day waiting period is applicable at the start of the policy only, and not at times of policy renewal. Besides, if you claim as a result of a pre existing disease, then you will have to wait until the time your pre-existing disease is covered (which can be either 2 years or four years depending on Policy wordings), to get your claim reimbursed.

      Can I get my money back in case I choose to cancel the policy after some time of buying it?

 To cancel the policy is your decision, and you may do so at any time after buying the policy. However, when you decide to cancel your health insurance policy, the company may incur cancellation charges –  which differ from company to company. To know more about Health Insurance made Simple

Compare & Buy Best Health Insurance Policy

Kartik Iyer, 24, an advertising professional was advised to buy a health insurance policy by his friend. Kartik did not take this advice seriously; he had a list of reasons for not buying health insurance policy.

He felt that he is young and healthy and therefore he will not contract any illness. Even if he is hospitalized, he thought that he could always handle the bills himself. He had the impression that claims in a health insurance policy are always rejected or you have to go from pillar to post to get them settled.

Sometime later he met with an accident and was hospitalized for 20 days. Kartik could not afford to pay his bills and his father had to pay the hospital charges for him. Even though Kartik is young and earning pretty well for his age, he had to depend on his father.

If only Kartik had taken a health insurance policy, his bills would have been taken care of by the health insurance company! And he would have remained trouble free, at least in the matter of finance.

Young people refrain from buying a health insurance policy as they feel it needs to be taken only when they grow older as they do not need insurance in their prime. They don’t understand that health insurance is a cover against uncertainties in life for which you might not be prepared. So like Kartik you may be young and healthy or feel that you can handle your hospital bills but no future is guaranteed. Today, the cost of medical treatment is on the rise and even a small accident or disease can suddenly wipe out your bank balance So, you need something that will provide security against expenses due to hospitalization costs.  So it is smarter to bank on a health insurance policy that will take care of those expenditures. 

Why Health Insurance?

The very concept of Health Insurance began as a result of the idea that even a lower economic strata individual can avail quality treatment as health comes first, by paying an affordable premium.

Today, what began as a simple idea has grown into a well established not to mention organized industry that strives to give you affordability of the kind of treatment that you need, without you having to worry about the cost. It is constructed with specific clauses and conditions so that the facility cannot be misused and the end user gets all the benefits he deserves.

In India it is also known as “Mediclaim” because the first health insurance policy which was launched in India was called Mediclaim.

What is Health Insurance?

Health Insurance gives you many benefits like providing you cover against hospitalization costs arising from treatment of disease or accidental injuries. So, it is necessary for every individual, of any age group, to get one’s self and family insured as it enables obtaining the best treatment without being bothered about the costs of the same.

How does it work?

When you buy a health Insurance policy you need to pay an annual fee to the company known as ‘premium’. The amount of coverage or ‘cover amount’ or ‘sum assured’ that you want will primarily decide the premium which you need to pay. Higher the coverage amount higher the premium. In the event of a claim, the maximum amount which the health insurance company pays you will be this coverage amount.

For example, you choose a coverage amount of Rs 4 lakhs for the year. Then throughout the year you can avail insurance coverage up to the amount of 4 lakhs, either in multiple claims or one whole claim should one hospitalization cost exceed 4 lakhs. Once you have reached the coverage limit you can no longer claim reimbursement for your hospitalization costs until your policy is renewed.

What is not covered?

Health insurance policy usually does not cover routine medical expenses; it is only a cover against hospitalization. Any health insurance policy has got a list of exclusions like pre- existing diseases, non- accidental dental care etc. The Health Insurance policy covers all or a part of the medical costs incurred in treating the disease or injury including the doctor’s consultation charges, medicine and nursing costs as per the terms and conditions of the policy.

How can you claim?

If, like Kartik, you also believe that claims in a health insurance policy are always rejected or that you have to go pillar to post to get it settled, you are mistaken. If you have all the proof and the right documents with you, your claim gets approved without any hassles.   

 Claims can be made in two ways:

Cashless settlement: If the treatment is sought in a network hospital of the insurance provider the insurance company pays the hospital directly through their Third Party Administrator. This type of settlement is called as “Cashless settlement”.Reimbursement: If the treatment is done at some other hospital, you can file a claim for reimbursement with the health insurance company’s Third Party Administrator after you have paid your bills. Then the TPA will pay you back the amount after examining your claim.

What are the types of Health Insurance policies?

The policies can either be an individual policy, a family policy or a group policy. The other variations are Critical Illness Policy, Senior Citizen policy, Student Medical insurance and Overseas Mediclaim Policy.

Individual Mediclaim Policy – Health insurance policy for an individual person providing that person cover for the expenses incurred due to treatment of disease or injury is called as Individual Mediclaim policy.Floater Policy- A floater health insurance policy covers your entire family under one policy with one sum insured and one premium. It covers all the expenses just as covered under individual mediclaim except that the cover is now extended to the family instead of one person. Under this, insurance will reimburse the cost of hospitalization of any family member covered, but the total reimbursement during the policy year is restricted to the sum insured. Critical Illness Policy – If you have a Critical Illness policy, the insurance company will pay you a lump sum amount if you are diagnosed with a critical illness as defined by the insurance company.Senior Citizen Policy – It is generally for people above the age of 60 and has a shorter waiting period. The entry age as well as renewable age (age up to which renewal is available)is higher.Overseas Mediclaim Policy - An Overseas Mediclaim Policy provides cover for medical expenses incurred abroad for treatment of illness and diseases contracted or injury sustained during the period of insured’s of overseas travel.  Student Medical Insurance – The cost of health care while studying abroad is covered by Students Medical Insurance. It is an essential requirement with many foreign universities for their overseas students.

To know more about Dummy’s Guide to health Insurance

Compare & Buy Best Health Insurance Policy

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Step 1

How to Get a Free Instant Online Insurance Quote

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Step 2

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Step 3

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