5 Essential Health Insurance Facts You Must Know

Health Insurance

We’ve compiled a list of the top five things to consider before enrolling in a health insurance plan in India.
Are you planning to purchase a health-care policy? Before you do, consider the following facts:

1 You do not pay extra for renewal if you have made a claim the previous year.

Most people believe that if you have made a claim against your health insurance policy in the previous year, then you must pay more while renewing the plan the following year. This is known as ‘claims-based loading’ on the policy, and it was allowed till about the year 2016. Now, insurance regulators stipulate that such loading may not be levied on customers. Any increase in policy premium is to be based on a larger set of factors and intimated to each customer.

2 There are sub-limits/caps imposed on room rent, which has a bearing on the claim amount.

You will hear the terms’sub limit’ and ‘capping’ when purchasing a health insurance coverage. This is the maximum amount of money that the insurance company will pay for hospital room expenditures. When you file a claim for it, the provider will cap the room rent at a particular level and refuse to pay the excess charges. Assume that the total assured of Rs 5,00,000 is subject to a 1% room rent cap. The accommodation is rented for Rs 9,000 per day, however the sub-limit is Rs 5,000. As a result, the insurance will only pay Rs 5,000 instead of Rs 9,000.

3 The plan will generally not cover certain items – check these beforehand.
Despite the fact that most health insurance plans provide a daily cash allowance, certain things are not eligible for reimbursement. Food and other consumables, bandages, gloves, water bottles, and toiletry items are among them. Before you sign up, be sure you understand all that is included.
4 Policy porting is now allowed in India.
You can port your phone number to another operator and move your home loan from one bank to another, and you can do the same with your health insurance plan. However, you can only do so when your policy is up for renewal. Customers who transfer their health insurance coverage get to keep the credited benefits from their old policy. Because no two policies from various providers are exactly same, several conditions and inclusions may vary.
5 The hospital cannot make you pay for treatment if you have cashless health insurance.
Despite having cashless health insurance, some hospitals require customers to pay for treatment. This is done under the guise that the insurer is taking too long to pay the expenses. You can bring this to the attention of the insurance company and the claim’s Third Party Administrator. But make sure you only go to a network/member hospital.
The above-mentioned elements should be kept in mind when implementing the policy, since they are basic recommendations that should help in a variety of ways.

 

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