Read the fine print of your Mediclaim:
Are medical conditions excluded?
Are special conditions covered?
Are regular medical expenses included?
Are there age limits?
Are there hospitalisation clauses?
Is your hospital in the TPA Network?
Are medical conditions excluded?
Are special conditions covered?
Are regular medical expenses included?
Are there age limits?
Are there hospitalisation clauses?
Is your hospital in the TPA Network?
You have made
the right decision of going in for medical insurance, protecting your interests
in the event of illnesses to you or to your family members. You would need
health cover to ensure that you are not taxed exorbitantly when you have health
issues bothering you anyway. Your health insurance policy is an important piece
of document that would give you financial freedom just when you needed it the
most. However, how familiar are you with your mediclaim document? How much have
you familiarised with the terms and fine print of your health insurance policy?
And how does it impact on your health cover?
Here are a few
aspects that you need to check for, before you go in for your medical insurance.
What are the exclusions?
Your health insurance policy policy could come with exclusions and it is important to
know where you stand with regard to the excluded conditions and clauses. Check
if you are covered for the diseases that you may develop in the first year of
your medical insurance, see if pre-existing conditions are covered and ensure
that your health cover has not left out any surgery or other treatment options
for specific health conditions and illnesses.
Are special conditions covered? If you or your dependants are likely to incur pregnancy related
expenses, check if your mediclaim document has included coverage for
pregnancy-related illnesses. It is a similar case with chronic illnesses as in
the case of arthritis or Tuberculosis, which may well be exempt from being
covered by your health insurance policy.
How about the regular expenses? Sometimes, you may not have cover for routine medical care, the
costs that you would incur on medicines or the amount that you would have to
shell out on OPD calls and expenses. See if your health cover is inclusive of
such expenses, if you are prone to certain conditions in the category.
Are there age limits? You
cannot take things for granted when it comes to the fine print of your
mediclaim document. Your health insurance policy comes with strings attached
and you need to be sure that your elderly parents are not excluded on account
of age limit clauses.
What are the clauses in hospitalisation? Now, that’s something that should catch your attention when it
comes to your medical insurance being of use to you. Your health insurance
policy may stipulate a minimum number of days of hospitalisation that you need
to take into account before you decide on health cover. You may also want to
see if there are restrictions and limits on room rents that you may be eligible
for, as these could also have implications on the total expenses that you can
incur on your illness.
Which hospitals are covered? If you have a favourite hospital, you need to check if your medical
insurance has recognised it for your health cover. You may not want to discover
after you have finalised on your health insurance policy that your hospital is
not on the Third Party Administrator (TPA) network or that you may not be able
to avail of cashless mediclaim with your existing medical insurance.
These are but
some of the clauses and conditions that you would have to look out for in the
fine print of your mediclaim policy before you could go ahead with your
health cover. Your health insurance policy is much more than what you see
underlined and highlighted in bold.
