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Do You Know All That’s Included in Your Health Insurance Policy?

Buying a health insurance cover is a responsibility we must take up for the well-being of our family. This will ensure our finances are safeguarded against any impact arising due to unexpected medical expenses.

The benefits included in the policy and the amount of premium you need to pay will depend on the type of policy you have opted for. It is important to have a clear understanding of what all is offered in the policy (i.e. inclusions) so that you do not lose out on the benefits.

Here’s a guide on all that is included in your health insurance policy:

In-Patient Care

Health policies cover the medical expenditures incurred by the policyholder in case of hospitalisation for duration of 24 hours or more. The coverage is available up to the sum insured, subject to policy terms and conditions, for expenses such as room rent charges, ICU charges, nursing expenses, cost of anaesthesia, blood, oxygen and medicines, operation theatre charges, surgeon’s fee and doctor’s fee.

Day Care Treatment

Thanks to the medical advancements, certain medical procedures no longer require extended hospital stay. Those procedures that require hospitalisation for less than 24 hours come in the category of day care treatment. Policyholders should go through the policy documents to check the list of day care procedures which are covered by the insurer. Usually, the cover is offered maximum up to the sum insured, subject to policy terms and conditions.

Pre-Hospitalisation

Treatment of an ailment might begin even when a person is not yet admitted in the hospital. There are a host of medical expenses that could be involved prior to hospitalisation. That includes costs of diagnostic tests, consultation charges, medication, etc. A health policy will save you from these expenses as you get coverage for a specified period (generally 30 days) as per the policy terms and conditions.

Post-Hospitalisation

While recuperating after discharge from hospital, a person may incur certain medical expenses related to follow-ups visits and diagnostic tests. In a health insurance policy, these expenses also get covered for a specified period (generally 60 days) as per the policy terms and conditions.

Pre-Existing Diseases

Pre-existing disease refers to the medical condition that the policyholder was diagnosed with, or showed symptoms or got treatment for, before buying a health policy. Usually, such diseases are covered subject to waiting period which is the minimum period that must be completed before a policyholder can get claim for treatment of the particular disease. Waiting period for pre-existing disease may be range from 2 to 4 years,

Alternative Treatment

 Nowadays, alternative medicine like Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) is highly preferred for curing several chronic ailments like asthma and diabetes. Certain health policies offer cover for AYUSH treatment. There could be a limit on the coverage available, ranging from 7.5% to 25% of sum insured, depending on the insurer and type of policy opted for.

To Summarise

In addition to the above-mentioned benefits, a good health policy also includes cover for ambulance charges, daily allowance and preventive medical care like annual medical check-ups.

The benefits of health policy can be availed in two ways. Firstly, the policyholder can choose to pay the medical bills from own pocket and later get the expenses reimbursed from the insurer. Secondly, he or she can opt for the cashless claim. Insurers nowadays offer the cashless hospitalisation facility wherein the policyholder can avail treatment using a health card at any of the network hospitals listed by the insurer. There are no hassles of cash payment involved; instead the insurer directly settles the bills with the hospital, subject to policy terms and conditions.

‘Care’ by Religare Health Insurance offers comprehensive health cover for your family. It fulfils your insurance needs in the best possible way through numerous benefits such annual health check-ups and no claim bonus.

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