Medical Insurance in India - Information & Tips
Your
Insurance may not cover your medical bill!
Tips for buying
medical - health insurance in India
Check the policy wordings before you buy medical insurance in India.
Not all your medical bills will be covered. Don't walk around with a
false sense of protection.
Medical Insurance in India is now heavily advertised and a large
number of people with families are buying policies to help them meed
emergency medical treatment. However medical insurance in India does
not cover all medical expenses and is nothing like medical insurance
offered in western countries where even a visit to your local doctor
is to some extend insured and paid for by health insurance.
A little bit of time spend reading and understanding the fine print
of the medical insuance policy you are buying can save you a lot of
headaces and financial hardship if you ever need medical care at
some point of time.
Let’s face it, the more claims they deny, their profits increase. So before you sign on the dotted line to buy that medical insurance that appears to be perfect for you and your family, take a moment to think and check the policy out.
Here are some points to remember when buying medical insurance in India.
Most people buy medical insurance in India by just selected the coverage amount. Normally coverage’s offered in India for medical insurance are from Rupees one lakh to Rupees ten lakhs.
Don’t assume that if you have medical insurance coverage of say rupees five lakhs that you can expect you medical insurance company to pay out all your medical cost up to five lakhs if you were to unfortunately require medical treatment. Most medical insurance companies that sell medical insurance in India set limits as to what maximum amount they will pay for each medical procedure and even for room rents when you are hospitalized.
For example, your policy may limit hospital room rent as a percentage of the sum insured on a per day basis. Here is an example of how this can affect just about every medical insurance policy holder in India.
Suppose you have a Indian medical insurance policy that insures you for Rupees one lakh, normally most companies limit the hospital room rent payable to just one percent of the sum insured.
Considering that in a hospital with good medical facilities in cities like Delhi or Mumbai a hospital room cost could end up being about rupees 6000 to 8000 per day!
In such a scenario, if you are hospitalized for two days, your insurance company would pay only rupees two thousand for the two days stay and you would have to pay the balance yourself.
If the hospital rate was rupees 6000 per day, then you would have to pay rupees 10,000 yourself of the total rupees 12,000 charged by the hospital.
Avoid surprises later when you need help. Check the master policy before buying any medical insurance.
Tips and Suggestions
- Never take the word of any insurance agent or broker and
assume insurance coverage for most scenarios. If it’s not stated
in writing in the policy document, then the chances are that you
do not have insurance coverage for it and won’t be reimbursed by
your medical insurance company.
Don’t buy an insurance policy with the attitude that you can change to another company if you are not satisfied with the present one. If you do this you lose in a big way because just about every medical insurance company in India does not pay for pre-existing disease treatment for four years.
Suppose you change to a new company after one year. You have to wait another four years to get coverage for your pre-existing disease.
The more often you change medical insurance companies; the worse off you will be as the four year waiting period will start every time you switch to a new health insurance company.
- Many medical procedures, such as for example surgeries for
cataracts may not payable for the first two years of your policy
and payments may also be restricted by a certain amount set by
the health insurance company. Check the insurance company’s
master policy to identify what procedures are not covered during
the first year or two of your policy and the amount set by the
company as payment for such medical treatments.
- Don’t get a false sense of security if you have family
medical insurance in India. Always keep some money aside for
medical expenses which may occur unexpectedly as not all types
of medical expenses are covered.
For Example:
Suppose due to an accident you are taken to hospital for treatment and discharged after five hours after getting your wounds attended to. Even though you have a health insurance policy that covers sums of up to five or ten lakhs, your medical insurance company will not pay for this type of treatment as they pay only if you are hospitalized for at least 24 hours.
- Choose the sum assured taking into careful
consideration what you can afford. Companies usually reserve the
right to increase premium rates. Remember check the policy
wording before buying medical/health insurance in India.
- Never take the word of any insurance agent/broker or
other insurance sales people. Unless it is clearly stated in
writing by the company.
- Remember your medical insurance policy is valid only within India. In case you travel abroad you need travel medical insurance.
Spend some time comparing medical insurance companies in India. Don’t just look at the premium rates but study the policy.
If you don’t understand something in the policy it is always better to ask for clarification and get answers in writing.
In the unfortunate circumstances that you or your family ever needs medical care, you don’t want the added pressure of being faced with denials of your medical claims.
The internet is full of complaints from frustrated people who had to suffer because their claims were either denied or delayed.
Read the master policy before buying insurance and pay special attention to what is not paid for by the insurance companies.
Don’t assume all insurance companies are the same, do your homework and find the best suitable plan for yourself and your family.