10 Unknown Facts about Your Mediclaim Policy
A health insurance plan offers the much-needed financial security during medical contingencies. The insurance provider covers hospital expenses such as nursing charges, cost of surgery and medicines, room rent, and alternative treatment, among others. You may, therefore, invest in such an insurance policy unfailingly, and have peace of mind knowing that you are covered at all times.
It is important to be well aware of all the facts before investing in a mediclaim policy. Following are ten lesser-known characteristics of your health cover.
1. Documentation process
Upon purchase of your insurance policy, it is imperative to keep your document up-to-date. In case of a planned hospitalization, you may inform your insurer well in advance and seek preauthorization of the treatment.
2. Rules for Non-Resident Indians
Non-Resident Indians (NRIs) may invest in a health policy in India by submitting a proof of residence along with other documents. The policyholder, however, has to seek treatment in India and pay premiums according to Indian actuaries.
3. The advantage of staying with your existing insurer
Numerous health insurance providers offer bonus or rewards to those who stay loyal to them. Some even provide the benefit of free health check-ups. You may, therefore, avail of such advantages in case you have stayed with your current insurer for quite a while.
4. Change of hospitals
This is not a very widely known fact, but some insurance providers allow you to change hospitals only if you wish to avail of a better quality of treatment, or if the request is approved by the Third Party Administrator (TPA) according to the terms and conditions of the policy.
5. Information about the cashless facility
It is important to note that your cashless claim may be disapproved in case the information submitted by you is insufficient. In order to avail of cashless benefit, it is mandatory to be admitted at any of the hospitals in the insurer’s network. Additionally, your claim may be rejected if you do not place the insurance claim on time. You may first have to make out-of-pocket expenses and then send in the claim for reimbursement.
6. Domiciliary hospitalization
There may be instances where you may have to undergo domiciliary treatment for more than three days, but you may be unable to visit the hospital. Insurers allow treatment from home under two circumstances – that you are unable to move to the hospital, or if the hospital does not have the means to accommodate you.
7. Difference between mediclaim and critical illness cover
While many believe the two types of coverage are the same, this is not true. A mediclaim policy covers hospitalization expenses, while a critical illness plan covers the dread disease. Hence, the insurer is liable to pay the entire sum assured irrespective of the hospital bills.
8. Change of TPA
Given that the TPA is appointed by the insurance provider, you cannot change your TPA without changing the insurance provider. You may choose a new TPA upon switching your health insurance provider.
9. Benefits of a premium calculator
In order to simplify the premium-calculation process, most insurers have made available a mediclaim premium calculator on their websites. This digitized tool helps you determine your premium amount with ease.
10. Health plans cover maternity expenses
The good news is that certain insurers offer policies specially designed to cover maternity expenses. This includes coverage for pre-natal expenses, delivery costs, and post-natal costs.
Armed with such information, you may invest in a health insurance policy at the earliest and enjoy the numerous benefits it has to offer.