Things to check for Health Insurance

Payment Options

Check whether the insurer offers cashless settlements or will the medical payments have to be made by you and reimbursed by the insurers later. If it is the cashless, you have to ensure that in your time of need, the insurance company is informed of your medical requirements so they can weigh in with a list of approved hospitals where you can seek treatment. If it is the reimbursement, you can be better prepared to keep a lump sum of money aside for critical times as the payments will have to be made by you to begin with. A wise move would be to check whether the hospitals near your residence, which might be used in case of emergencies, are a part of your insurance company’s hospital network.


Illness and Cost covered

Ask the insurers for a list of ailments and procedures not covered by the policy. For example, as of now dental and cosmetic surgeries are not covered by most health insurance providers. Also some insurer’s put a cooling off period for the Pre – existing diseases before they are entitled to be covered under the policy. Some policies do not cover diagnostic or medication costs. Outpatient treatments are not paid for by insurance companies either. Hospitalization for a minimum of one day is mandatory for the insurance to kick in. It is best to check all the details of the expenses that will be reimbursed. It will help you plan better to save for future expenses.

Policy sub-limits

Sometimes, there are sub-limits for various expenses within a policy for example – room rent cap, ICU capping, compulsory co-pay. You should be aware of how much the insurance company will pay for a particular expenditure. The policy might have the right amount for the treatment but the sub-limit ceiling might prevent the company from paying out for a particular medical cost.

Cooling Off period

The first 30 days after you buy your health insurance policy is called the Cooling Off period. Any hospitalization due to illness during these 30 days is not covered by most policies. The cover starts from the 31st day. However, hospitalization due to an accident is covered from the first day of the policy being issued. Please make sure you ask your insurance provider for further details on their Cooling Off period.

Pre and Post hospitalization Expenses:

Most people aren’t aware of these very useful features of the policy. When you are hospitalized and get the reimbursement for the claim, you are also entitled to get reimbursement of 30 days of medical expenses before hospitalization and 60 days after hospitalization. You have to keep all the record of all the medical receipts, and all the diagnostic reports safely with you. Only when the Insurance Company examines all these documents will you get expenses reimbursed.