Understand these 5 terms and conditions before buying health insurance

When it comes to health insurance, it pays to know the nitty-gritties of the policy you have chosen

November 26, 2018 / 10:56 AM IST

Adhil Shetty

With the steep costs of availing hospitalisation, treatments, and medication, it only makes sense to protect yourself in every possible way by buying health insurance that offers comprehensive coverage. But to ensure that you get value for the money you spend and choose the perfect policy, it is important to understand some critical insurance terms and conditions.

Waiting period

This is the first element to consider. Each health insurance policy has a waiting period, which is a defined period of time, immediately after purchasing a policy, when you can’t make a claim.

For instance, if your health insurance policy has a waiting period of 60 days and you buy the policy on November 30, 2018, you will be able to make a claim only after January 29, 2018.

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Room rent provisions

In case you have to be hospitalised, your insurance company will cover costs of your hospital room. But, this is covered only up to a certain extent.

It is very important to check what the extent of per day coverage is because you will have to bear any extra costs. What’s more, the other charges are also levied as per your room type and will be deducted accordingly by the insurance company.

So, if your room rent coverage is very low, your out of pocket expenses will be much higher towards the room as well as other medical charges.

Check if the network is wide enough

It is important to look at the list of hospitals and clinics where your health insurance policy covers cashless treatment. The wider the network of cashless hospitals, the more useful you’ll find your health policy to be.

Besides, the cashless facility means that you won’t have to negotiate claims processes. The insurer will settle the bill directly with the health service provider.

Don’t forget pre- and post-treatment expenses

If you’re scheduled to have a surgery you will have to have consultations with a doctor beforehand, undergo tests and maybe even be hospitalised a day prior. Similarly, after the surgery, you’ll have to stay hospitalised for a few days for post-operative care, which will also include follow-ups with doctors, tests, and medicines.

So, it’s imperative that your health policy covers these expenses in addition to those of the medical procedure.

Watch out for the deductible

A deductible or sub-limit is the amount that you have to first pay towards any health costs. Only when the total crosses this amount will your health policy kick in.

The higher the deductible, the more you will have to take on before the policy comes into play. So, evaluate the pros and cons of a higher deductible, its feasibility given your income and expenses and then decide if the policy works for you.

At the end of the day, a health insurance policy is a legal document binding you and your insurer. So it’s only prudent to scrape beyond the surface to see whether your premiums are justified and if your policy is going to deliver on the promises it’s making.

The writer is CEO of BankBazaar.
Moneycontrol Contributor
first published: Nov 26, 2018 10:56 am

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