Check List for Medical Insurance Policy
21 Jul, 2012 9:53p.m.
Here is a list of things that you must keep an eye out for when you are looking to buy Health Insurance or Mediclaim policy.
Coverage: Not all of the diseases are covered by insurance companies. Go through the list covered by the company. Your decision should be based on the kind of lifestyle you lead. You canalso consider health complications that run in the family. Diabetes, kidney stones, heart diseases are known to be passed on through the generations.
Pre-existing disease: You have to reveal about your existing illness and your medical history, even if you are leading a normal life. Concealing information is one among the ground for most claim rejections.
List of Policy Exclusions: The insurance companies have a list of diseases that are not covered by the policy. This list contains the medical conditions that won’t be covered by the Health Insurance Company in their policy. The typical exclusions are Dental Cosmetic Surgery and alternative therapies such as acupressure, acupuncture, yoga, massage, aromatherapy, reflexology and naturopathy.
Network Hospitals: Network Hospitals is a group of hospitals that have tied up with a Health Insurance Company or a TPA  (Third Party Administrator). The main benefit offered by the Network hospitals is that they offer top quality service 24/7 which comes in handy in case of emergencies. Another benefit provided by the Network Hospitals is that they offer the cashless facility that lets you get admitted for free and thus reduces the financial burden on you during the hospitalization. Initial Waiting Period : No health insurance policy will cover you from the date of purchase of insurance. The cover usually begins after 45-60 days. Therefore, in case you undergo treatment anytime during this period, you will not be entitled to any claim.
Waiting Period for illness to mature: Many Health Insurance Companies have a ‘Waiting Period’ when it comes to Pre existing Illnesses – Illnesses that the Insured had prior to buying the Mediclaim policy. The Waiting Period is mainly between 1-4 years, varying from company to company. Individual or floater plan: A family floater plan covers the whole family and is usually cheaper than individual plans. Covering ageing parents would mean most of the cover is likely to go into their treatment, and this would reduce the cover for the rest of the family, evenif the premium paid is slightly higher.
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