Health Insurance Plans

pays for your hospital bills for diagnostics, surgery etc.

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Coverage I Get in A Health Insurance Policy

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The rising cost of medical treatment makes it inevitable for a common man to buy a Health Insurance Policy for his family. Any form of sickness is most undesired for anybody but we all know illness can strike anytime and take a great toll on the peace of mind. In some unfortunate cases, the cost of the proposed treatment is so high that the patient is not able to afford, which aggravates the pain of the situation.

A health insurance policy if purchased timely, would give you the mental peace of being able to take the right medical treatment when required. While you buy a medical health insurance policy, it is important that you are aware that the policy has several clauses that define which risks are covered and to what extent. You should be aware of the extent of health insurance Coverage and understand the clauses well, so that you choose only that policy that best fits your coverage needs.

On a broader level health insurance plan are classified as Hospitalization Plans and Critical Illnesses Plans, details of which are mentioned below.

Hospitalization Plans

Health insurance plans cover your medical expenses in case you need to be hospitalized and cover almost all illness with Riders attached. There are variations among hospitalization plans in terms of coverage benefits that they would offer. The risks covered by hospitalization plans are not unlimited and are defined by the following clauses:

1) Critical Illness cover/Rider -

A few plans might have this as an exclusion. Those who intend to seek extra critical illness coverage may opt for: a) a critical illnesses rider or b) a separate critical illness policy. These policies provide you health insurance coverage against critical illnesses such as heart attack, organ transplants, stroke, and kidney failure among others. These plans aim to cover infrequent and higher ticket size medical expenses.

2) Renew upto age -

Hospitalization plans might allow renewal of policy only upto a certain age, while a few allows life time renewal.

3) Pre and Post Hospitalization coverage -

The insurance plan would only cover treatment costs only for a pre-specified duration prior to and post-hospitalization. A 30 days pre-hospitalization and 60 days post-hospitalization expense is the general trend.

4) Pre-existing Illness Coverage -

Pre-existing diseases as the name suggests refer to those medical conditions or illnesses that may already exist at the point in time you buy health insurance. Costs related to hospitalization on account of pre-existing disease are not covered for duration of upto 2-4 years, from the date you buy the policy.

5) Room Rent Limit -

A few health insurance policy have a cap on the hospital room rent that they would reimburse. You should be aware of the prevailing rents of hospital rooms and take a decision accordingly by selecting a policy that has the appropriate caps.

6) Day Care Procedures -

Medical treatment has undergone a sea change and these days, for many illnesses you may be hospitalized, but would not require hospital stay. Such medical treatment comes under the ambit of day care procedures like chemotherapy, incision of the cornea, incision of the prostrate, nasal sinus aspiration, radiotherapy etc. Health insurance policies may not cover treatment costs in many of these cases. These are exclusively listed in the policy terms.

7) Maternity Expenses -

Maternity expenses may or may not be covered under the policy and you should check before buying. Policies which cover maternity expenses would pre-define the duration post which the cover will expire.

Therefore, before signing a policy, it is important to know the extent of health insurance coverage and clauses of the policy.