Why do you need a Health Cover?

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Why do you need a health Insurance?
With the rise in the level of lifestyle related ailments, the risk of getting hospitalised is also on the rise. To make matters worse, the cost of hospitalisation is rising much faster than general inflation levels. Unless there is a health insurance plan to back it up, it can be financially damaging to one's wealth.  
  
 

Do not, therefore, ignore the importance and role of a health insurance plan. By paying a small premium each year, the risk of incurring a huge medial cost is contained. With healthcare costs rising at more than 15 per cent a year, having an adequate coverage for self and family members helps. Remember, it should no longer be a choice, but a necessity in view of the escalating cost of medical treatment.

What are our Health Cover choices ?

Merely buying just-about any health insurance plan may not suffice. The hospitalisation may not be always for a general treatment or a minor ailment requiring a few days stay. There could be a medical emergency that may require only a few days of hospitalisation but coping with it after being discharged from hospital, may require large amount of funds. This typically happens if one is diagnosed with a life-threatening or a serious ailment.
Therefore, to fulfill the need of medical insurance, one should buy health insurance in such a way that it covers all the medical needs. This may be met by buying both kinds of health plans: one, which would reimburse costs (indemnity plans), and the other, which would pay a lump sum to meet medical expenses (defined benefit plans).  
  

One buys health insurance plans to meet the cost of hospital bills at the time of a hospitalisation. But life is full of surprises. When the hospital bill is handed over, you may get a surprise if the entire cost of hospitalisation is not reimbursed. In such an event, someone not holding a Daily Hospital Cash (DHC) will have to pay from out of pocket.

If your employer provides an option for group health coverage, grab it even if you have to pay a portion of the premium. The coverage amount may be restrictive so check if it is sufficient. Also, remember, especially if you are in the private sector that this group cover will continue only as long as you are in the job. The period between switching jobs may leave you unprotected. Moreover, a few insurers are calling off their contracts with employers, thus leaving several employees stranded without any coverage at all. Therefore, having your own health insurance policy helps.

How do I settle a Health Insurance claim?
The litmus test of any insurance policy is at the time when a claim arises. According to recently published industry data, it has been established that the number of customer complaints against health insurers has gone up, primarily on account of claim settlement.  

As a policyholder, one should be aware that even a cashless facility can be denied in a network hospital. Such an incident may arise if the information sent by the hospital is insufficient or if the ailment is not covered under the policy or if the request for pre-authorisation is not sent in time.

But, even if the cashless facility is denied, one can subsequently, on discharge from the hospital, submit the claim for reimbursement.

 
  At times, there could be a medical emergency and one may have to get oneself or a family member admitted to the nearest hospital which may turn out to be a non-network hospital. In such a case also, the claim will only be processed on reimbursement basis. 

What's the best way for Health Cover? 
Young families may opt for family floater health covers where children up to the age of 25 are covered. Around 40, one may consider buying a critical illness cover. Keep reviewing the amount of coverage every 3-5 years and, more importantly, maintain a healthy lifestyle.

While choosing a health cover, one should ideally start by comparing plans from 2-3 preferred insurers. Have a close look at the inclusions and exclusions in the most basic plan being offered by them.

Opt for plans that come with low or no sub-limits in them. Do not base your decision solely on the premium instead prefer simple plans with less of conditions and restrictions in them. And remember, every member of the family needs health insurance cover to tide over any unforeseen medical exigencies anytime in future.  

 

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