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Does Your Health Insurance Cover These Expenses?

Here are some simple but important things that you should keep in mind while choosing your insurance

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Most of the time, the terms and conditions in an insurance policy document are confusing. Health insurance policies come with different covers, add-ons, and, are tailored to the customer’s needs. This makes it a difficult task for some to understand and choose the right health insurance policy. For instance, you may buy a plan, but during the claim, you realise that the insurance company does not cover a part of it.

It is essential to understand the kind of covers available with your policy. For instance, there are basic plans that cover ambulance charges, room rent, etc. There are other covers, which come with a higher premium that covers critical illness, daily hospital charges, pre-post hospitalisation charges, ambulance charges, etc. When it comes to health, it’s always best to choose the most appropriate cover for your personal needs and lifestyle.

Here are some simple but important things that you should keep in mind while choosing your insurance:

  • Sum Insured: Health insurance is more than the monthly cost of a plan, it is a relaxation of the mind, so choose wisely. Do not see health insurance as an investment that will pay you a return in the short-term, rather see it as an investment that will one day save you from a big dent in your pocket, like people say, ‘Time aane pe kaam aayega (translation: it will be helpful at the time of need’. So, choose the sum insured that could cover the costs of major treatments like a serious accident or a critical illness. Also make sure that the cost of treatments in your city is kept in mind, as different cities have different medical costs, for example, Delhi will be probably more expensive that Dehradun, so you need a higher sum insured for Delhi
  • Add-ons: One of the most critical, yet sidelined areas, is add-ons. For instance, if you are a young married adult and are planning to have children, maternity add-ons will help you at the time of need. Just make sure you are aware of the waiting period that this benefit has i.e. the time you have to wait before claiming for the benefit or cover. Also, make sure you are aware of the sum insured available for the addons as that may not be the same as the total sum insured you have. For example, you may have a sum insured of 5 lakhs overall but for maternity it may be 20,000 or 50,000, depending on your plan. 
  • Medical declaration in full honesty: A lot of people try and hide their lifestyle habits, like smoking and drinking, or medical conditions, like if they have an existing disease, from their insurer. That’s a bad practice as at the time of claim, it will anyway come to the forefront and that may lead to a rejection of the claim. So we would suggest that be honest, pay a little extra premium if applicable, it will eventually be helpful for you only.
  • Reading the documents: It is boring and time-taking to read a policy document as one is not looking for an immediate claim but it is best to go through the policy documents right after buying the policy so that if there is any disconnect, the customer has the option to cancel the policy with refund under the Free Look Period provided, which is usually 15 days. Check for these covers and expenses: After you’ve done the above, here are some features that are important but are not covered by all plans provided by health insurance companies.  Make sure if these make sense to you, you look for a plan that covers the same:
  • Daycare procedures: Generally, a health insurance policy covers medical expenses for hospitalisation exceeding 24 hours. But if your policy has Daycare procedures covered, it will cover medical treatments that take less than 24 hours due to technological advancements.
  • Home hospitalisation: There can be unavoidable circumstances when the patient needs to be treated from home. For instance, if you have someone bedridden or very old who cannot travel or there are no beds available in the hospitals, in such cases, if your policy has this cover, it can be helpful.
  • Daily cash: This benefit takes care of smaller expenses during hospitalization by giving you a fixed amount after one day of hospitalization so that you can cover expenses like food, conveyance etc….

So, while buying health insurance should be your first priority, but don’t choose your policy in a haste, make sure you customize the plan according to what suits you and your lifestage. Also, look for some advantageous features, benefits or covers that cushion you in addition to the main covers.

Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.


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health insurance

Vivek Chaturvedi

The author is Head of Marketing, Digit Insurance

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