India has a vast terrain, extreme geo-climatic variations, and unevenness when it comes to population distribution. Lack of hygiene, biodiversity, and some other factors contribute to the spread of infectious diseases. Recently, we have witnessed the spread of the Covid-19 pandemic. However, this country had previously gone through major epidemic diseases like cholera, plague, and malaria. These diseases are now under control but the lack of health awareness is a major factor contributing to uncertainty in terms of health. Thankfully, health insurance plans are available today that reduce the financial implications of health issues.
Various types of mediclaim policies like individual health insurance, family health insurance, maternity insurance, and critical illness insurance are offered by several insurers nowadays. You may choose the ones that suit you and your family. The noteworthy features of medicare policies are highlighted below:
Benefits
A healthcare policy is a health protection plan that reimburses the cost of your hospitalization and other charges. You have to claim the reimbursement by submitting the medical bills and other documents along with the claim form.
However, these days, many insurers offer cashless settlement services to their customers. The expenses are directly settled by the insurance provider as you only have to inform them about your hospitalization and treatment.
If you have opted for a critical illness policy, a fixed amount is paid for the treatment expenses and other monetary losses. A critical illness policy covers life-threatening diseases like heart issues, respiratory issues associated with the cardiovascular system, cancer, etc. It does not cover the ailments not listed under the policy. Also, you cannot claim benefits for the ailments that you were suffering from before getting the healthcare policy.
Pre & Post Hospitalization
You may need financial assistance before and after taking medical treatment. Therefore, mediclaim policies offer pre and post-hospitalization coverage as well. However, in case of defined benefit claims like critical illness policy, you will have to utilize the sum insured for all the expenses incurred before and after hospitalization.
Consultation fees & room charges
A medicare policy covers the consultation fees required for taking advice or treatment from a specialist. Hospitals charge a fixed fee for the bed that you have acquired during your stay. Also, if you need a separate room, the expenses could be much higher. A medicare policy reimburses the consultation fees and room charges/bed charges as well.
However, there might be a room rent cap set for the charges associated with room rent. It is a fixed percentage of the sum insured provided by your insurer. For example, if you have a sum insured of Rs. 10,00,000 and a room rent cap is 1% of the sum insured, a reimbursement of Rs. 10,000 will be provided. Anything above Rs. 10,000 will be payable from your end.
Many insurers don’t offer the room rent limit. It means that the entire room rent can be reimbursed or settled by a cashless service.
Exclusions
Cosmetic surgeries, plastic surgeries, and injuries or health issues caused during a suicide attempt or criminal activity are not covered by medicare policies. If you suffered from an illness before taking the policy, it may be covered after serving a waiting period. However, this rule does not apply to a critical illness policy.
Accidents get covered under both regular health insurance and critical illness policies. However, only severe injuries like the loss of eyesight or limb are covered by a critical illness policy.
On the portal of Bajaj Finserv, some of the best health protection plans in India are available. Go through their details and apply if you find a suitable health protection policy from this portal.
