HEALTH INSURANCE :
Evolution of man-kind has not only made them destroy nature but also themselves and with the increase in the number of health issues for man, even the cost of medicines and treatments are rising rapidly. However, a person who finds it difficult to pull together all his/her funds to meet their own medical expenses like, illness/surgical/hospital expenses and so on, the policy of a Health Insurance acts as a guardian. The policy holder will be credit with the required amount according to their Health Insurance plan, which will aid the holder from getting depressed/tensed about his/her financial crisis at an important hour.
THE BENEFIT OF CONVALESCENCE:
Convalescence refers to the total time spent on the recovery of a sick person. These Health Insurances, however, make sure that their policy holders are funded properly for their medical and medical-oriented expenses. In case the hospitalization gets prolonged for a week or so, then the insurer, to avoid further financial crisis, does pay a lump sum for their policy holder. In some policies, the cost incurred while the family members make a compassionate visit, is also covered. The supplementary costs are paid to their policy holders for hospitalization, when their income falls down. The expenses involved in alternative treatments are also included.
ORGAN DONOR EXPENSES:
Now-a-days, Organ donor / Organ transplantation costs in lakhs or even more. One of the main advantage of health insurances is that, they help with your medical expenses and therefore you can avoid any kind of stress before going for your organ transplantation as most of the insurance companies cover Organ Transplant Surgery as part of their health insurances. However, there are a few restrictions in this aspect. The cost incurred in hospitalizing the donor, the complications of post-surgery and the screening costs are not included under these policies. Either the entire cost is reimbursed or is offered as an add-on benefit by the insurer.
Not all sick people get treated in the hospitals. Some get their treatments at home under some medical supervision. The Health Insurance policies also cover the costs involved in such home-based treatments for their clients. The insurer have capped the overall amount that can be offered to their client and also the number of days for which the benefit will be valid/available
ALLOWANCE FOR ATTENDANTS:
In case the insured is a child and is hospitalized, then the insurer will offer an allowance for the adult attender. The terms of this aspect makes the payment of attendant allowance by the insurer fixed, in terms of days.
DAILY HOSPITAL CASH ALLOWANCE:
The Health Insurance policy not only takes care of its client and the attendants but also the expenses required for food and travelling, which are not included in the policy/plan. The insurer aims to focus on providing additional financial protection as allowance to their clients, through this process.
FREE HEALTH CHECKUP:
The insurer also offers free periodic health checkup to their policyholders after every 4 or 5 claim- free years, as per the guidelines of the health insurance policy. They also offer cashless health checkup, in case the tests are conducted at empaneled hospitals or centers.
OTHER SERVICES INCLUDED:
The Insurer not only focuses on the above mentioned expenses but also on the dental treatments and Bariatric (Weight loss) surgeries. These dental treatment expended are dealt with once in a few years with sub-limits and these bariatric surgeries are no longer regarded in the cosmetic category but is seen as a life-saving treatment for obese patients. However, these bariatric surgeries will be funded by these insurers only when they are done for a medical purpose.
- Proposer / Policyholder:
18-21 years of age is the minimum entry age and the maximum age for the policy could be between 60-100 years of age, or this could be extended to their entire life also.
Depending upon the type of policy, the spouse, parents or children can be allowed to be protected under the same policy. However, the child need to be at least 9 days old to be eligible and they can be insured under their parent’s policy up to the age of 18years, which can furthermore be extended to 25 years of age.
These Health insurance policies are renewable for a lifetime but it deals with medical screening that happens beyond a certain age and an increase in the premium amount.
Whenever you are subjected to apply for a health insurance policy, make sure you submit proper and accurate information as false information can be stated for rejecting your health insurance claim. In case, you are a smoker / a drinker, these information needs to be disclosed to the insurer for being on the safer side.
- Birth Certificate
- Voter’s ID Card
- Pan Card
- Aadhar card
- Driving License
- Passport, etc.
- Voter’s ID Card
- Aadhar Card
- Driving License and so on.
Once these documents are submitted, the insurance company will analyze these documents and verify if the provided information are correct and then the health insurance plan is issued.
2. Cashless claims
These claims work only after the insured person gets treated at any hospital, pays the full bill and later files for insurance reimbursement within the stipulated time. As the insured is expected to pay the full money, this may appear to be a burden financially for the insured. In case the insured is hospitalized, then the insurance company should be informed in advance.In case of Emergency , The insurance company can not be intimated in advance where the reimbursement claims are used.For making a reimbursement claim the following steps are to be followed:
- Inform the company about the claim.
- Ensure you collect all bills, invoices, discharge summary, reports, prescriptions and many more after receiving the treatment and settling the bill.
- Fill the insurance claim form and submit it along with the necessary documents.
- Along with the necessary documents, submit the filled insurance claim form.
- The insurance company will process your claim and verify the documents.
- The reimbursement will be paid, if everything stays in order.
- The company will send a query in case of need for more information.
- The claim can be rejected if the insurance company finds the stated reasons good enough.
If the insured person gets treated in a network hospital and if the insurance provider offers cashless facilities, then these cashless claims can be claimed by the customer, so that the customer receives a medical treatment without paying for the bill. In order to make sure that the insurance claim is settled fast and easy, the insurance companies tie up with many hospitals across the country. However, the insured has to pay for the non-medical expenses / for any treatment that is not included in the policy documents. To attain this facility the following steps are to be followed:
- Make sure that you locate a network hospital, else, ensure that the hospital you choose falls
- Under the insurance company’s network.
- As per the stipulated time, intimate the claim to the insurer.
- Planned hospitalization – usually 24-28 hours prior to admission.
- Emergency hospitalization – immediately or up to 48 hours of hospitalization.
- Ensure to present the insurance card and a valid ID at the designated desk in the hospital.
- Procure and fill out the claims form, and submit it to the concerned person at the hospital.
Once these are done, the hospital will find out if the insurer approves your request. Within 24hours of request the insurer will verify the claim and will send an approval if they are satisfied. Though this a cashless claim, it is still advisable to collect a copy of all bills, discharge summary, reports,prescriptions and the like.