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Features of a modern health insurance policy

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Understand your medical insurance cover well before the purchase…

A suitable medical insurance policy protects you against health risks. When it comes to the wellbeing of you and your family members, medical policies form an essential part of the measures you can take for reassurance. It ensures that you receive the care you required and mainly a properly financial backup when you need it. When you invest in medical cover, it will not only mean that you receive the best medical treatment available but also give you peace of mind that you have done all you can to ensure smooth path during unforeseen events or illness and accidents.

In India, there are leading insurance companies that offer medical insurance policies with varied benefits, customized requirements and at affordable costs. Visiting the branches or online sites, calling up customer service or agents are some of the ways to purchase a medical insurance policy.

Of these, online purchase is most convenient and suitable way as you can buy the policy at the click of the button on your computers, laptops or smartphone from house or offices. Besides, it lets you compare the policies in terms of benefits and features, discounts offered, terms and conditions, claim settlement ratio, etc. Right from your admission to doctor fees, ambulance expenses to other treatment costs, everything can be covered under your medical insurance policy. In addition, depending on the plan you opt for, your online health insurance plan can also cover permanent disability, long-term or custodial care needs.

However, before going for a purchase it’s your needs that have to be accessed thoroughly so that you buy the right policy. Some information that you require at the time of purchase would be you & your family members age, health conditions, any hereditary disorders, place of living and working conditions, income source, and risk capacity to purchase a health cover. When a customer visits online, he or she can fill up the appropriate inquiry forms and based on this information the company will suggest you a suitable insurance policy.

It is advisable; always consult your health experts to ensure you don’t fall in the pitholes of high premium costs and low coverage.

A typical medical insurance policy will cover: Hospitalization reimbursement due to disease/surgical treatment, domiciliary Hospitalization expense, pre & post Hospitalization expenses and other treatment costs.

The minimum age to start a medical policy would be 5 years while the maximum would be around 80 years to buy the policy. Children between 3 to 5 can be covered provided on or both parents are covered concurrently.

It is important to understand the inclusion and exclusion, and various clauses of the company before the purchase. There are some companies who may exclude some health concerns if they fall under the category of pre-existing diseases. As per any medical insurance policy, 24 hours hospitalization will be compulsory for a claim to be settled. Therefore, read the fine prints carefully, so that you understand the benefits and getter a quicker and hassle free claim. Also, if you run in any form of doubt, contact customer service team or online chat team to clear them before the purchase of your medical policy.

Secure women with suitable health insurance policy

Women are the backbone of our society. They play their roles and perform their duties with due pride in day-to-day life. They spend a major portion of life in taking care of their family and keep them happy. It is as such they don’t even realize that they might anytime strike with critical illness or seriously affect their health. Therefore, it’s our responsibility to take care of them by buying a suitable health insurance policy.

In today’s time, health uncertainties can grapple you anytime and it may be difficult to cover up the expenses with the little savings you have. Besides, inflation only fuels up the issues all the more. Therefore, buying a suitable health insurance plan makes senses to keep every woman associated in your life sheltered with right medical care and the best of the hospitals and nursing care homes across India.

Single women, mother, sisters married women, working women all should have an adequate amount of insurance cover. It is the need of the hour, as it helps you safeguard their health, save money and create a shield of financial protection.

Today, women, especially in the urban areas, are trying to be self-independent, they have become equal breadwinners for their families. The adoption of a nuclear family system makes them more prone to disease or health issues as they have to manage their house and work life. Thus, the need and the importance of health insurance policy increase in women’s life.

Women oriented health plans cater their specific needs. Its cover women-specific diseases like breast cancer, uterus cancer, cervical cancer, vaginal and ovarian cancer, Maternity expenses, etc. Apart from this, they cover generic incidents like personal accident cover, pre and post hospitalization charges for critical illness. It offers additional support of living benefits in case of the accidental death or permanent disability.

Few checks before buying the health insurance plan:

When you buy health cover, you come across a variety of basic health plans offering cover for a minor disease. These plans might be cheapest but the cover provided would be insufficient. To avoid such financial crisis during medical emergencies it is better to compare the policies in terms of benefits & features, cover value, premium costs, claim settlement ration, etc.

The validity of your health insurance will be directly related to how long you have taken the policy. The moment you policy lapses they pre-existing disease which were covered in your policy will no more be effective. As long as you are paying the policy premium the health cover will be valid.

Its advisable women should buy medical insurance when they’re young as their health is at its peak and they’re free from any medical complexities. You get higher cover at lower premiums and your pre-existing disease will be incorporated early in your plans. The health policy will give you wider cover. As you grow old, the premium rates will increase and you won’t get comprehensive cover at such slashed rates.

Women-oriented health insurance policies also offer tax benefits under section 80D of the Income Tax Act, 1961. For women less than 60-65 years can get a tax rebate of around Rs 30,000 on their insurance policies.

Using The Web To Get The Most Suitable Medical Insurance Policy

Countless outstanding internet sites to select from, a range of websites to select when you are looking to buy your medical care insurance. How is it possible to start to filter it all down?

While the web seems to make it simpler than in the past to find the best price on all that you need you’ll find it tends to complicate the process of shopping around and when you are searching for a deal on medical insurance you want to know that you are not merely obtaining the best policy for the money but that you are getting a company that is going to stand behind their word. After all, when you purchase a medical insurance policy you are in fact buying a promise that the company is going to take care of you as they mentioned in the policy documents you signed and if they don’t this could certainly end up a significant problem for you.

Simply because making use of the web can help to expedite the entire process of buying medical care insurance doesn’t signify you should run through the process in an attempt to grab the first policy which comes with a fair price. As a matter of fact you should utilize the internet to shop around and collect information to help you make your choice.

There are several websites that are created to help you do just that. On the internet you will see that there are plenty of independent websites that are looking to direct you to the companies and policies that can meet your needs and budget and ones which are trustworthy. You can also utilize the net to look up terminology, information regarding the various types of health insurance options which are available to you, as well as check information about what is a reasonable price to pay for health insurance in the area where you live. Online, there is also contact information for every company, research their online reputation, and even contact your local Better Business Bureau to see if any complaints have been filed about them.

On the whole, the internet is a fantastic resource if you are looking to purchase a medical insurance policy. Much information can be obtained through online searches but it is important to make certain you do not look at this as an opportunity to cut corners but rather as a speedier and more efficient way to gather the information you need to make an informed decision about the policy which is ideal for your needs and budget.

Source: [http://healthinsuranceplaninindia.weebly.com/blog/using-the-web-to-get-the-most-suitable-medical-insurance-policy ]

Your Guide towards a Smooth Health Claim Settlement

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Insurance is an assurance given by an insurer to the insured, to help the latter at one’s most needed, financially trying times like a health scare or an accident. Yet when such an event occurs and one’s insurance claim is denied or delayed, it can be a very distressing situation, which compounds an already stressed time. The fact is that the onus of getting a claim honoured also lies in the insured’s hands. True that a claim may be denied for various reasons by the insurer, with clearly stated reasons for the denial. Yet there are those precautions which if taken care of can ensure a smooth and hassle free claim settlement.

Furnish Complete Information

Did you know that incomplete information and non-disclosure of facts in the proposal form followed by intentional or unintentional misrepresentation of facts are the most common reasons for claim repudiation or delay in claim settlement? Lata, a diabetic patient when going in for a health insurance policy failed to disclose her pre-existing health condition on the proposal form. Five years later when she developed a medical complication due to high sugar levels and had to be hospitalized, she filed for a claim, which got repudiated. She was in for a surprise when her claim was not honoured on the grounds of “non-disclosure” of pre-existing medical condition. So how could a health policy holder make sure that they do not ever face a situation like Lata?

Here are a few pointers

Read and fill in the complete proposal form. Make sure you disclose all relevant information about your family’s and your health status in the proposal form. Disclosing all information will also ensure that there is no conflict during the claim settlement procedure, especially with respect to any pre-existing ailment. The bottom line is “Honesty at the time for proposal pays”.

Also ensure that you provide correct information pertaining to your lifestyle and habits as well. For instance, state the truth about your smoking or drinking habits.

In case the proposal form is being filled by your insurance consultant or an agent, make sure you go through the details filled in thoroughly before signing the document. It is always advisable to fill these documents yourself. In case of Lata, she had signed the document without verifying the details filled in by the agent which led to inaccurate information being given as a consequence of which her claim was not honoured.

Understand your health insurance cover. This is an extremely important aspect which has been discussed in details below.

Do Not Misrepresent Facts

In India, misrepresentation of facts is another common reason for claims not being honoured. Misrepresentation is usually in terms of manipulated information while procuring the policy or submission of fake bills and documents while making a claim. Raju, who suffered from a bad bout of food poisoning, was consequently hospitalized for 3 days. When he submitted the claim for reimbursement it was observed that the cost of medication administered to him was much higher than what is usually given to patients suffering from a similar condition. He submitted a total bill of Rs. 50,000, when the average cost of treatment of the condition is not more than Rs. 20,000, keeping in mind the category of hospital he was hospitalized in. Upon scrutinizing the documents, it was discovered that the medicine bills were manipulated and exaggerated to make a taller claim. This lead to the claim being rejected and it also led to his policy being cancelled due to his intent to make a spurious claim leaving him and his family without any health insurance cover. Had he submitted the correct bills, his claims would have been approved.

A recent survey done by Accenture in India revealed that exaggeration of bills was considered a justified act by many in India. This may be due to the fact that most of the people are unaware that this is actually a fraudulent act. The other instances of misrepresentation which have been observed are, when a claimant

Claims for an Outpatient department treatment (OPD)as an Inpatient department treatment (IPD)

Backdates documents to showcase that the claim they have made is covered under the current policy period.

The next and the most vital aspect – is that of the insured not understanding his/her health cover.

Know your health insurance covers

Your health insurance cover, be it a cover given by your employer or a cover you have taken separately for your family and self, may have various limitations that are important for you to be aware of.

These are:

Sub-limits: Some health policies have a sub-limit on certain features like room rents or select treatments. Make sure that you are aware of these sub-limits while making a claim. It is also important that you know what aspects your claim will not cover. Most often, these would be service charges, administration charges, registration charges, all non-medical expenses, private nurse expenses, telephone calls, laundry charges, etc. You can go for an add on cover instead for instance Bajaj Allianz Hospital Cash that will help you recover these miscellaneous expenses.

Co-payment: Some health plans have a co-payment clause wherein the insured shares a certain amount of the claim. This would vary from insurer to insurer, and plan to plan. In order to be aware of what amount would be payable by you, it is a good idea to check about co-payment in advance.

Waiting period: When purchasing health insurance, make sure you are fully aware of the waiting period applicable for certain illnesses. Also, since the waiting period may differ from plan to plan and insurer to insurer, it is important to keep a note of these.

Claim against Day Care Procedures – Certain insurers provide policies that also cover Day Care Procedures such as surgery of cataract, chemotherapy/radiotherapy, or minor surgeries involving local anaesthesia; you can opt for a day care procedure. You must check beforehand on whether the medical procedure required by you is included in the cover. This may be a better option since you would not have to spend the minimum 24 hours in the hospital, as is mandatory for normal health insurance plan. This would also help you save on your hospitalization expenses, hence, conserving the sum insured.

Ensure the claim settlement is smooth

While the basic procedure for claim settlement remains standard, there are some nuances to consider between cashless claims and while getting your medical expenses reimbursed from the insurer. Another important aspect to consider is the mode of claim settlement i.e. through a TPA or in-house. Usually, insurers which deal with hospitals/policyholders directly have a faster turn-around-time for the claim settlement. It is therefore essential for you to consider the given aspects while selecting your health insurer.

[Source: https://www.demystifyinsurance.com/your-guide-towards-a-smooth-health-claim-settlement/%5D

Major Medical Insurance: Things to Know About the Affordable Small Business Health Insurance

Seeking medical attention might get costly when you suffer from unexpected illnesses or accidents. For this reason, it is advisable to get affordable small business health insurance to cover most of your medical expenses. One form of insurance you should consider is major medical insurance. This type of health plan provides many benefits that can provide financial security when unexpected medical expenses arise.

What is major medical insurance?

Major medical health insurance falls under managed health care because it has lower premiums. This health plan covers major hospital and medical expenses over a certain deductible. This, however, does not pay for routine appointments and prescription drugs. Although the out of pocket expense you have to pay before the policy begins is large, it is one of the least expensive forms of health insurance. Within this category are different types of coverage plans:

– Preferred Provider Organization (PPOs): This type of managed care allows you to see any health care provider you want. The insurance company provides a network of physicians and hospitals you can choose for medical treatments. This provides lower costs for co-payment and deductibles if you plan to choose a doctor or provider within the network. You can also choose a specialist outside the network, though you will need to pay for additional medical costs.

– Health Maintenance Organization (HMOs: This plan is less expensive compared to the PPO. It also offers major medical insurance coverage at lower costs.

Like PPOs, the insurance provider will supply a network of health care specialists, which limits your choices. You also need to choose a primary care physician from the network who can give you a referral if you need to consult other specialists. Coverage might get costly if you do not get referrals from your physician.

– Point of Service (POS): This is a combination of the first two plans. An insurance company provides the network of health care specialists who you can seek medical treatments from. This, however, does not restrict you to the network alone, as you can still choose physicians outside of it. Your primary care physician can refer you to other specialists within and outside the network. This also offers more flexibility when choosing medical treatments.

What does major medical insurance cover?

Major medical and affordable small business health insurance provide a wide range of benefits. This may vary between policies, but several major medical coverage options might include the following benefits: hospitalization, intensive and cardiac care, physicians’ diagnostic and surgical services, x-rays and laboratory tests, hospital medical and surgical supplies, nursing services (including private duty), therapies, and durable medical equipment (DME) rental.

What to consider before choosing health coverage

 

Choosing the right form of coverage can be confusing, as some plans might be better and more suitable for you and your family’s needs. Think of the following questions when choosing a health plan:

– How much is the monthly premium and deductibles?

– How much is the additional cost if you choose a specialist outside the network?

– What are the benefits included?

 

Source: [http://blogs.rediff.com/healthinsuranceindia/2016/07/11/major-medical-insurance/]

Issues to Consider In Finding Cheap Medical Insurance Plans For Individuals

Every person ought to come up with great decisions when selecting family medical insurance plans. If you are going to acquire one for your family, you must be aware of several factors. Family members need to have medical care insurance plans in order to meet the medical care expenditures for every member. This is certainly far more sensible rather than applying for individual plans for each member of the family. A single insurance policy may perhaps handle all of members and the particular premium which you pay would also be much less.

Most family medical insurance plans provide the standard insurance coverage necessary. Before you take an insurance policy, find out if it includes healthcare exams and screenings, hospitalization, prescription medications, crisis care, tooth services, plus eye health care. Maybe you might even find out if substitute treatments like acupuncture and homeopathy are included. Prior to a decision, these things have to be cleared out with insurance companies. You ought to consult with them the particular deal covers and advantage selections. This will help you find the greatest deal you’ll find for you and your loved ones.

Numerous policies are obtainable these days for people trying to find health care plans. Two potential options are private and group insurance. Such as other cheap health insurance for individuals, these plans deliver various services.

A private plan is normally a plan that you simply take out yourself. When deciding on a private insurance plan you need to know that an productive choice does not necessarily mean low cost. Since you ought to take into account your financial budget, it is prudent to decide on an insurance policy that addresses a number of probable issues.

On the other hand, your employer supplies a group insurance for you. A group medical insurance policy comes with a variety of benefits. It offers smaller premiums, better tax concessions and an extended insurance coverage length. The premiums depends on the employees’ medical history and background, age, and the nature of job. The firm deducts a certain amount from the regular monthly salary to cover this health care coverage. You won’t have to take out a separate policy for yourself in case your employer can provide an extensive healthcare coverage.

In case you are an older employee with a history of sickness a private policy can be cheaper and can give you reassurance. If you get seriously injured or ill, you know your desired medication will be open to you and also decide on the physician who will take care of you. In addition, your personal insurance provides you with your own en-suite room and all the comforts you will need to help in speedy recovery.

A group health care insurance has quite a few boundaries in their coverage while a private insurance policy will give you additional choices and control.

Make the most through your insurance plan by thinking about the advantages and disadvantages of every policy. The most significant thing to consider in picking among these kinds of private, group or family medical insurance plans is to make your mind up solely based on your requirements.

Source: [http://healthinsuranceplaninindia.weebly.com/blog/issues-to-consider-in-finding-cheap-medical-insurance-plans-for-individuals]