Types of health insurance
Mediclaim is a type of health insurance policy that covers you and your family members against sudden medical contingencies. The policy provides medical benefits like medical tests, drugs, etc. The policy also covers expenses incurred for hospitalization for certain injuries, illnesses or diseases. The policy also offers cashless settlement according to which the policy holder gets admission in any hospital without any initial payment..
In hospital cash plan, the policyholder is paid a cash amount for each day he needs treatment in a hospital. The hospitalization may be due to sickness or accident. A hospital cash plan is not a substitute for health insurance, but is taken additionally to existing health insurance covers.
Critical illness cover insures the policy holder against any critical diseases. Once the policy holder gets the policy and starts paying the premium amounts then he will be paid a certain amount of cash if he is suddenly struck by some life-threatening illness. Critical illness plan covers diseases like cancer, heart attack, etc. The insurance company pays you the benefit amount once the disease is diagnosed.
What is the need of health insurance?
A health insurance policy offers protection in case of a sudden illness or accident to you and your family.
What documents are needed for getting a health insurance policy?
You have to fill up an Application form with details of medical history of your family. The insurance company may get a medical test done according to the company policy.
Is it possible to get health insurance for family by paying one premium amount?
Yes. It is possible to do. You need to contact a health insurance company to know about the details.
Does policy holder get an identification card?
Yes. The health insurance company issues an identification card to the policy holder. The card entitles the policy holder to avail of cashless hospitalization facility at any of the network hospitals.
Do I have to take a medical check-up?
Yes. At the time of buying the health insurance policy, you have to go through a medical check-up organized by the insurance company. The check-ups are conducted within 5 days of paying the first premium.
What kind of medical tests I need to go through?
The following are common medical tests that you may have to go through, depending on the life insurance company:
Complete blood count
Fasting blood sugar
Medical examination with BP recordings
Does health insurance cover pre-existing diseases?
Yes. They are covered but only subject to limits and waiting period. They are covered after 3-4 years only if the policy is renewed for that period.
What should be the proper cover amount?
The factors of age, pre-existing diseases and medical history should be considered while going for a health insurance policy.
Will I be given preferential treatment in hospitalization if I have high cover?
No. A higher cover does not entitle you to preferential treatment. The treatment given to you by a hospital depends on quality of service offered by the hospital.
When can I avail of the cover after taking a policy?
You can do it immediately. Though, for the first 30 days after your policy is activated you would not be entitled for any cover for sickness.
Can senior citizens be covered under life insurance policies?
Yes. Senior citizens of age of 65 can be covered. Even the policy can be renewed up to 70 years of age.
Does health insurance cover dental treatment charges?
Yes. Dental treatment expenses are also covered under outpatient treatment. However, it should be on medical prescription. It also varies depending on the insurance provider.
Does health insurance cover maternity charges?
No. Maternity is not normally covered under an individual health care policy. However, if you and your wife are covered under a group plan by your employer, then maternity charges may be covered. You can check about it from the company you are working at.
What happens if I do not disclose my true medical condition?
You should not hide your true medical condition from the insurance company. The insurer may not be liable to pay any claims if you have hidden some facts from it.
Does health insurance cover treatment at home?
Yes. It is covered only the patient can not be moved to a hospital or there is no bed in hospital. By the way, the treatment is reimbursable under the health plan only if the treatment is comparable to that provided at a hospital.
What is the limit to stay in hospital?
There is no limit to the number of days a policy holder can stay in hospital. However, there is certainly limit on amount an insurance company can pay to you.
How to claim?
You can use your insurance ID card to avail of cashless service at any network hospital in case of a planned hospitalization.
What documents are needed for filing a claim?
You need the following documents for filing a claim:
Doctor’s prescription, surgeon’s bill and receipt detailing operation performed.
Original bills, receipts and discharge certificate card from the hospital
Original bills from chemists
What time it takes to settle the bills?
The bills are settled within 15 days of receiving the relevant documents.
Will I need to pay for hospitalization?
You don’t need to pay for hospitalization if you are admitted in any of the network hospitals. They offer you cashless facility. Insurance firms directly reimburse all the expenses to the hospital. However, you have to pay for hospitalization if you get admitted in a non-network hospital. In that case, you need to pay at the time of discharge, and the same amount is reimbursed to you by the insurance company.