Health Insurance is not just requirement to save money on medical expenses but a vital asset to have during contingent time.
Do You Understand the Importance of Health Insurance?
If you are one of the 45.7 million Americans in the U.S. without health insurance, you may not completely comprehend how important healthcare coverage really is. Most uninsured Americans cite the high cost of health insurance as the #1 reason for not having coverage. In reality, though, living without health insurance can actually put you at significantly more financial risk. One accident, illness, or injury could put your financial security in jeopardy.
What Health Insurance Provides
You can receive medical care without health insurance. However, the extraordinary costs of doing so strongly discourages the uninsured from seeking out medical care until it’s too late or the ailment has worsened. With almost all health insurance plans, hospital stays and sick visits to a doctor will be at least partially covered. Some health insurance plans also cover preventive care, mental health care, prescription drugs, and more. A good health insurance plan will pay for the basics of healthcare, but it can also serve as a preventive measure against future disease or illness. Be sure to compare health insurance companies before buying a policy.
Live Longer with Health Insurance
One of the most commonly cited reasons for declaring bankruptcy is medical costs. Uninsured people are caught off guard by a serious injury or illness, and it creates a financial disaster. Even a rather small injury, like a broken arm, can put a major strain on your finances if you don’t have insurance.
Further, I will be writing about the key points related to choosing the right health insurance policies. It is one of the important financial planning for you and your family. In the recent survey, it shows that India has the highest number of diabetes patients in the world. It is very shocking news and people have to be cautious for protecting their family from the unexpected incidents. This article explains the importance of taking the medical insurance and the key points needs to be considered while taking the health policy. If you have any doubts, please post it in the comments section. If like the article, please get the free email updates.
What is Sum Insured?
Sum Insured(SI) is the one important thing in the health insurance product. It is the maximum amount paid in case of claim. Taking the appropriate Sum Insured has to be decided up on the several factors like age, marital status, health condition, nature of work, etc. It is good idea to to talk to the financial adviser if you don’t have the enough knowledge on the financial planning.
Another big question is whether you have to go for the individual policy or the family policy which protects the whole family. It depends on the financial situation of your family. If you are not married, then you will go for the individual policy. Normally, the family policy is recommended to reduce the over all costs of the premium. If the money is not a problem, you can go for the individual policy as well. You should update yourself on health insurance faqs.
When to take policy?
There is no right time to take the policy. It is always recommended to take the policy at earliest to reduce the premium. In most of the insurance companies, taking the policy after the age of 35 will under go medical tests and other formalities. That will increase the premium amount payable for every year.
Points to ask before taking the policy
Here I am listing some of the important points which you need to ask before taking the policy.
- What is the maximum amount reimbursed for the room rent, boarding and nursing expenses?. Most of the companies restrict to 1% of the total sum assured.
- What is the maximum amount reimbursed on doctor fees?. Normally it is restricted to 25% to 30% of the sum assured.
What is the renewal period of the policy?
Hospital bills for very small to considerably large ailments are a pain. It’s difficult to meet such steep health costs on our own without burning a hole in our savings. Also, with medical costs escalating, some even compromise on quality healthcare, because of affordability. It is then that the importance of health insurance comes into the picture. Health Insurance provides us with the ability to afford better healthcare facilities for ourselves and our loved ones. What’s more, you can also enjoy tax benefits.
Health Insurance in India, popularly known as Mediclaim, is nothing but an Insurance which covers expenses related to necessary Hospitalization due to a Sickness or an Accidental Injury. A standard mediclaim covers comprehensive costs of Hospitalization, which include:
- Investigation costs before the hospitalization like Medical Tests, Doctor Fees,
- It includes cost for ambulance
- All costs while in the hospital which include room charges, surgery charges, diagnostic tests etc.
- Costs incurred post hospitalization for complete recovery, for example follow up doctor visits, diagnostic tests, medicines connected to the Hospitalization.
Due to skyrocketing inflation, quality healthcare, hospitalization is becoming very expensive. Large hospitalizations which cost lakhs of rupees can seriously burn a very big hole in one’s savings or worse, burden one with huge debt. Health Insurance plans help in spreading such a risk to larger no. of people, and hence bring the costs down per person.
How does a health insurance works?
Health Insurance is generally an annual Insurance policy, renewable every year. The policy covers Hospitalization due to Sickness and Accidental Injury, subject to certain exclusions and waiting periods, which are explicitly mentioned in the policy wordings. You can claim Health Insurance in 2 ways – Cashless or Reimbursement.
Cashless – Every Insurance Company has a network of Hospitals where they have a direct billing arrangement. In such cases Insurance Companies directly pay the admissible claim amount to the hospital. When the insured person is admitted in a Network Hospital, he/she or his/her relative would need to just submit his/her cashless card to the hospital billing desk, who will process cashless admission for the patient, subject to approval by the Insurance Company. In such cases, the Insured person will have to pay only expenses which are not covered under the Health Insurance Policy.
Reimbursement – In case you happen to be admitted in a Hospital which is not in the network of your Insurance Company, you will have to make all payments on your own to the Hospital, and then submit these original papers along with the Claim Form to the Insurance Company for reimbursement.
Tips while buying the right insurance plans
- One needs to understand that there is no perfect plan. Understand your needs well, plan for the long term, and go for the closest suitable plan. Don’t wait for that perfect plan with everything covered to arrive and risk delaying your coverage.
- Remember, you are buying an insurance for your old age. With healthcare inflation at 20%, do not go for a small sum insured of Rs. 1 lakh, if you can afford more. A premium of around 25% of your monthly salary is surely affordable.
- Demand the policy wordings (where all terms and conditions of the policy are mentioned) of the product you are going to buy. Before you sign the dotted line.
- Do not solely depend on health insurance from your employer. Employer sponsored coverage is changing every year according to claims experience and budgets of your employer. You may suddenly find yourself or your family with very low or no coverage. It is becoming more and more difficult to get insurance for people above 45 years or people who have an ailment or health condition like diabetes/thyroid/hypertension etc.
- Check the maximum renewal ceasing age of the policy. This is the age when your policy will discontinue. Today, there are policies available which can be renewed for lifetime. Go for lifetime renewable policies.
- Ensure you spend time in finalizing a good health insurance advisor, who would provide you unbiased advice across all leading insurance cos., as well as assist you for renewals and claims in the long term.
What is Family Floater?
Family Floater is a very cost effective product, that covers an entire family under one policy and one fixed cover. This fixed cover is shared with the family members, i.e. if Vermas, a family of three buys a Family Floater Mediclaim of 3 lakhs, the full family covered can make claims of upto Rs. 3 lakh in a year, subject to other terms and conditions in the policy. In most policies Self, Spouse, and Kids are covered in a family floater policy. On the other hand, Individual Mediclaim is a product where each member is covered under a separate coverage. Taking individual policies turns out to be more expensive than Family floater. If you are a young couple, Family floater would be a better choice.
What is PED (Pre-existing Diseases)?
Pre-existing Ailments or Diseases are Symptoms, Diagnosed Ailments, or any existing or past health condition which exist at the time of applying for Mediclaim Policy. When you apply for a Mediclaim, please ensure you provide a detailed medical background about your family. Ailments which already exist, are generally covered by Mediclaim after 4 years. In a recent trend, most Insurance companies now have started putting permanent exclusions for Pre-existing diseases in the policy.
Is Maternity Covered in health insurance?
No, Maternity and expenses related to Maternity are not covered under Standard Mediclaim. There are some policies which provide Maternity cover after an initial waiting period of 2 to 4 years.
What is TPA?
TPA is 24X7 outsourced agency of the Insurance Company, which keeps records of the policies issued by the Insurance Company, including people covered, benefits and exclusions. The TPA maintains the network of hospitals for the Insurance Company and provides the Cashless Card to the Insured Persons. TPAs process all claims including Cashless and Reimbursement claims on behalf of the Insurance Company.
Will Cashless Card provide Emergency Service?
No, Cashless Card is not like a Credit card which can be swiped at the Hospital and you don’t have to make any payments. The authorization of Cashless between the Insurance Company/TPA and the Hospital normally takes 5-8 hours, and hence cannot be depended on for Emergencies. In emergency cases, Hospitals may demand a deposit to admit the Insured patient. Always have a Credit Card with a good balance handy for such exigencies.
An Appeal of Health Insurance Advisor – Danes Rodrick (no sales pitch, no pun intended, no back link)
Because due to changes in life style and busy schedule and heavy Traffic people are either suffering from different diseases, Due to pressure at work place people are suffering from Heart Attack, Blood Pressure. Due to traffic people are facing so many accidents which injures them.
And when a common going to medical for his/her treatment then it will cost him very much. Some time they are not able to manage that amount so either they have to stop there treatment or they transfer them selves to Government Hospitals.,
Everybody needs a good health and everybody expect a good Hospital care so that they can cure soon. Thats why most of the people prefer Private Hospitals .
And it is not so easy to get admitted there due to so much of costing. That’s why everybody needs a Health Insurance.
The concept of Health Insurance from health insurance advisor’s point of view:
“Insured person pay a small amount for whole year,some policies are there which cover whole family under one policy. Then when ever they suffer from any disease and get hospitalized then that Insurance company will take there responsibility to pay the amount ( which was specified in policy) not whole amount.
Some Insurance companies are also paying cash less transaction that means Patient do not have to give any deposit in hospital when he/she get admitted in to hospitals and some companies are there who are reimbursement the amount after treatment.” He further advised.
So please friends Have a health Insurance Plan Soon.