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Health Insurance Checklist: Know What Your Policy Must Cover

20 July, 2017

With the rising concern for health issues, it is inevitable that you have some form of protection for your health, a personal health plan or an employer offered one. If not, you will end up shelling a lot of money when a medical emergency strikes.

While you do not have much control over your employer’s health benefit, when it comes to buying a personal health insurance, you do. Therefore, make sure you utilize this control by buying a health insurance plan which has the following must-have features. Take a look -

 

Cover for Pre-existing diseases

When you buy a health policy, you will be asked to list out any pre-existing diseases you suffer from. Insurance firms do not cover these diseases from day one and have a waiting period for them. The period ranges from two to four years and during this time, the insurer will not entertain any claims with regard to pre-existing illnesses or diseases. Try and look for insurance firms which have a minimal waiting period.

 

Day care procedures

A lot of health insurers require hospitalization for at least 24 hours before accepting a claim. However, thanks to progress in medical technology, many procedures are completed within a few hours and do not require hospitalization. It is in your best interest to find an insurer who covers the maximum number of day care procedures.

 

No Claim Bonus(NCB)

No claim bonus is the bonus offered, if the insured person has not filed any claims in the previous years. Simply put, for every claim free year, the insurer rewards you with a No Claim Bonus. The NCB can range from 10% to and go up to 100% over a period of time. Look for insurance providers which offer the highest NCB for a claim free year.

 

Network Hospitals

Network Hospitals have a tie up with insurers. In the case of hospitalization or medical emergencies, at these hospitals, you can avail for a cashless claim where the insurer directly settles the medical bill with the hospital. Therefore, when you are buying a health insurance plan, go for insurers with a large number of network hospitals.

 

Pre and Post Hospitalization Charges

This feature of a health insurance policy takes care of both pre and post hospitalization expenses. Medical expenses incurred before and after hospitalization are known as pre and post hospitalization charges. Most insurance firms offer 30 days for pre and 60 days for post hospitalization charges. However, search and find a health plan which covers more days. The hospitalization expenses include nursing charges, medical practitioner’s fees, intensive care unit charges, room rent, diagnostic procedure charges, boarding expenses, blood transfusion charges, anesthesia, blood, oxygen, operation theatre charges, etc.

 

Ambulance Charges:

This is yet another most important thing you need to consider before buying a health insurance policy. Your health insurance policy must cover the expenses for ambulance service. With this coverage, the person is free from the burden of paying transportation fee as insurance company takes care of it. Therefore, your health insurance policy must have this feature. Insurance companies offer emergency ambulance cover of up to 10,000.

 

Vaccination in case of animal bite:

Several health insurance plans cover vaccination costs in case of animal bite which includes dog bites, bee stings, etc. Therefore, you must check whether your health insurance plan has this feature or not before buying the policy. Mostly insurance companies cover vaccination expenses of up to 7,500 in case of animal bite.

 

AYUSH treatment:

AYUSH, which stands for Ayurveda, Yoga, Unani, Siddha, and Homeopathy is also an important feature that your health insurance policy must have. This medical treatment provides in-patient hospitalization cover up to the sum assured in case of government hospitals and up to 50,000 in case of other hospitals.

 

Health checkups:

General health checkups are covered by some health insurance companies. These are usually annual health checkups that are offered to all the insured people who are above the age of 18 years. This includes complete blood count, ESR, fasting blood sugar, kidney function test, ECG, Urine routine, complete physical examination by physician, lipid profile, creatinine, stress test, etc.

 

Domiciliary hospitalization Charges:

Some insurance companies cover domiciliary hospitalization charges as well. Domiciliary hospitalization is a type of medical treatment in which an ailment or illness or injury that would normally require medical care in the hospital but, is taken care while at home under the following cases –

 

  • When a person’s condition is such that he/she cannot be moved to a hospital.
  • The condition when a patient takes treatment at home due to the non-availability of rooms in the hospital.

 

In domiciliary hospitalization, the cost reimbursed is up to the amount of sum assured.

 

Critical Illnesses:

Cancer, heart attack, chronic lung disease, coronary artery disease, paralysis, stroke, and major organ transplant are some of the critical diseases that are usually covered by health insurance companies. Thus, this is also an important feature that your health insurance plan must have.

 

Most people have a health insurance plan. However, only a few buy the right plan. The right one has these features, so go ahead and buy the one that is best for you. Besides, if you are looking for health insurance plan online, chose Royal Sundaram General Insurance Company Medical plans. It offers comprehensive health insurance plans at affordable rates.