Which health insurance buy?
The health insurance policy generally covers the rational and compulsory expenses incurred under the following items in the context of each insured person, subject to the total overrun of the sum insured (all claims during a policy term).
- Room, residence expenses
- Nursing expenses
- Surgeon, Anesthetist, Physician, Consultants, Expert Fees
- Anesthesia, blood, oxygen, operation theater fees, surgical instruments, medicines, medicines, diagnostic materials, X-rays, dialysis, chemotherapy, radiotherapy, cost of pacemakers, artificial limbs, cost of organ and other such expenses.
The sum insured can be proposed on a personal basis or on a convertible (floater) basis for the family as a whole.Accumulated Bonus (CB)
Health insurance policies can offer accumulated bonuses in which the sum insured for each year unclaimed is increased to a fixed percentage at the time of renewal which is subject to the maximum percentage (usually 50%). In the event of a claim, the accumulated bonus is reduced by 10% at the time of the next renewal.
Cost of health check
There may also be provision for reimbursement of health checks (check-ups) in health policies. Carefully read your policy to understand what things have been permissible.Minimum hospital admission period
Minimum recruitment in hospital is compulsory for certain hours to be eligible for claim under the policy. Usually this period is 24 hours. It does not apply to deadlines, accidental injuries and certain prescriptions. To understand the details, read the provisions of your policy.
Before and after hospitalization expenses
The expenses incurred for a fixed period after the date of admission to the hospital for a certain day before and after the date of discharge from the hospital, can be considered as part of the claim for expenses related to disease / illness. See the specific provisions in this regard.
Insurance companies have tied up with the hospitals of hospitals in the country. If the policyholder treats a hospital in a hospital, then the insured does not have to pay hospital bills. Through its Third Party Administrator (TPA), the insurance company arranges to make payments directly to the hospital. In the policy, the hospital has to pay by the insured for expenses not exceeding the specified sub-limits, or items not covered under the policy. The insurer can be treated in an unlisted hospital, in such a way that he will have to pay the bills first and later ask for reimbursement from the insurance company. Cashless facility is not applicable in this
Additional benefits and other single policies
In the form of ‘add-ons’ or riders, insurance companies offer various other benefits. There are other single policies that provide benefits such as ‘Hospital Cash’, ‘Critical Illness Benefit’, ‘Surgical Expense Benefit’ etc. These policies can be taken either in separate form or with a hospitalization policy.
Some companies have presented products such as top-up policies that are meant to cater to the actual expenditures exceeding the limitations available in basic health insurance.
Under health insurance policies the following are usually excluded:
- All pre-existing diseases (exclusion of pre-existing diseases, is determined by all non-life and health insurance companies alike)
- During the first year of the policy, any claim for any disease / disease during the first 30 days from the date of cover. This exclusion is not applicable to injury claims due to accident.
- Hysterectomy, Hernia, Hydroxyl, Internal Diseases of Genitalia, Fistula in the anus, Hemorrhoids, Syenitis and Related Disorders for Cataract, Benin Prostatic Hypotropy, Menorrhea or Fibromyoma during the first year of the cover.
- Circumcision is not recommended for the treatment of the disease.
- Eyeglasses, contact lenses, cost of hearing aids
- Dental treatment / surgery, if this does not require hospitalization
- Health benefits, general disability, genital external defects, V.D. Intentionally hurt injuries, use of drugs / alcohol, AIDS, diagnosis, X-ray or laboratory tests, which are not related to the disease requiring hospitalization.
- Pregnancy or childbirth treatment, including Caesarean operation
- Actual exclusion from one product to another and one company from another company can be different. In group insurance policies, it is possible to remove / delete exclusions on payment of additional premium.No short term policies
Health insurance policies are not issued for less than one year.