siliconindia | | December 20179Know Your Policy Exclusions: While deciding a health cover, looking at what is excluded is critical. Observe what medical procedures are excluded, as well as the initial waiting period of the policy. The initial waiting period is that time when the insurer will not admit a claim. This is the first and the most common exclusion. However, there might be other exclusions in case of medical emergencies. Most insur-ance companies do not cover pre-ex-isting diseases from day one. There is a pre-existing disease waiting period which can be anywhere between 30-90 days post the initial waiting period de-pending on the policy. Claims made for any ailment arising out of any pre-ex-isting condition within this period will get rejected. For example, if you have been suffering from some blood pressure variations, any complications arising out of it, like a low BP condi-tion to a condition of stroke will not be accounted for. Thus, seek a health plan that covers pre-existing diseases and entails a low waiting period.In terms of medical procedures, your health insurance policy will not pay for cosmetic surgeries or dental treatment unless it is required due to an accident and requires hospitalization. Cosmetic treatments may have become common and popular, but such treat-ments are not covered under health in-surance plans. This includes laser treat-ments, surgeries like liposuction, or weight loss programs, amongst several others. All types of dental treatments are also excluded from health insur-ance, as it is considered as a cosmetic procedure by the insurers.Hospital Networks: There are also hospitals that have a direct association or tie-up with the health insurance company. Most insurance companies have a tie up with a host of hospitals to provide their consumers with a smoother claims settlement process. The benefit of having network hospitals within the fold of a health insurance cover for you is that you can avail of the cashless facility, which considerably lessens the strain for finances on the patient and their family. So, look for a health insurance plan with a maximum network of good hospitals in or near your area. More-over, if you are going for a pre-planned hospital visit, you might just choose one among the network hospitals. Premiums: This is one of the de-cisive factors while choosing a policy because you must pay this amount out of your pocket every month. Look for a policy which provides you a good sum insured after paying premiums on time. Please do keep in mind with a larger sum insured; your premiums will also rise. It is also important to understand what kind of ailments that you may need treatment for and choose a policy which provides you coverage for those diseases.Share Complete & Accurate In-formation: Avoid providing incom-plete or inaccurate information about any major previous hospitalisation or any existing condition. Any discrepan-cy at a later stage may lead to rejection of the claim. Hence, one must share all the relevant information at the time of filling the proposal form. Hospital Expenses: Health insur-ance policies have a limit on the ex-penses incurred in hospitals, fee for ambulance, consultation charges of doctors and other miscellaneous hos-pital expenses. Room rent is one of the main expenses you bear during hospi-talization. Many insurers have a cap on daily room rent. This decides what kind of a room you'll be able to afford through your health plan. For exam-ple, you may want a private room in-stead of a shared room; therefore, you must ensure that your insurance plan provides you what you need. It is crit-ical to know your eligibility for differ-ent expenses incurred in the hospital. Else you might have to pay an extra amount out of your pocket. Co-payment: In co-pay insurance policies, you must pay part of the medical expenses, regardless of the sum assured. So, if you have a health insurance with a 20 percent co-payment clause, it means you must bear 20 percent of the hospitalization expenses each time you make a claim in a policy year. However, this doesn't reduce the total sum insured and premiums for a co-pay policy are usually lower than otherwise. So, if you have a co-pay insurance policy, do understand the clause, and make claims accordingly. Renew Your Policy Regularly: As every health insurance policy comes with some waiting period to be able to claim for certain pre-disclosed ailments, it is imperative that all customers renew their policy regularly to avail of its full benefits.A proactive approach will make sure you are able to get your policy to pay for your hospitalisation quicker and easily to a large extent. Also, since a lot of times hospitalisations are unplanned and urgent, a good policy and prior knowledge of how things work will help make the process that much smoother. Munish Daga
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