From hospital network to portability, there are a lot of features to consider while choosing a Health Insurance policy. Here’s how to go about it.
Health care is becoming more and more sophisticated and advanced with time, leading to early diagnosis and better treatments. But this advancement comes at a cost and this cost keeps on increasing year after year.
The skyrocketing medical expenses could prove to be a huge financial burden even for ordinary ailments. Health Insurance can help one get financial security to cover their medical treatment. Additionally, a Health Insurance policy also provides tax benefits under Section 80D up to a permissible limit.
So what should you look for while choosing a Health Insurance policy?
Check which policy offers the benefit of cashless treatment so that you do not have to do endless paperwork nor do you have to shell out a reimbursable cash advance. Also, check the number of hospitals the insurance company has cashless tie-ups with. Pay particular attention if nursing homes and hospitals near your place of residence have a cashless tie-up with the insurance company.
Claim Settlement Ratio
Knowing the Claim Settlement Ratio of an insurer gives you a fair idea of the likelihood of your claim being accepted or rejected. So, go for a company that has a higher claim settlement ratio, as the chances for claim rejection would be less compared to a company whose ratio is lower.
Do you know you can change your health insurer if you wish to, without losing the waiting period benefit of the current policy? So, always opt for a policy that allows you to port to other company. Do remember that porting is free, so never opt for policies that charge any fee.
Cover Size And Limits
Less premium should not be considered while choosing a policy. Choose a policy that allows you maximum coverage with minimum premium and all other conditions being the same. Also, take into account various caps in policies on different diseases and treatments.
The definition of a family may vary from company to company and so will the maximum members permissible to be covered in a single policy. As every individual has got a different family size and his needs to cover members may vary depending not only on his family size but also age, marital status and financial strength. So, compare all policies and choose the one that best suits your needs.
One of the important steps is to check whether the proposed insurer has a team working to specifically address Mediclaim issues and claims because many insurers entrust the work of doing the necessary documentation and processing the claims to third-party administrators (TPAs). This necessitates that information be exchanged between the company and the TPA, which could lead to slowing down the process.
Furthermore, there are certain rules and regulations that must be followed before a TPA processes a claim and then hands it over to the insurer. Naturally, this also takes time. And obviously, you want the whole process to be completed as soon as possible. So, look out for an insurer who has his own dedicated team to do all mediclaim-related work as your claim will be processed faster.
Waiting Period And Top Ups
Mediclaim policies have a waiting period clause that could differ from company to company, meaning the policy benefits start only after the specified time has elapsed after the issuance of the policy. No claim is permissible within this period. Also, check the top-up plans available with policies. A top-up plan is a facility whereby an insurance company offers you additional cover when you exceed your threshold limit.
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