For those who love to keep themselves safe against the cost of treatment, it is vital for them to have health insurance. It can prove to be as the biggest savior in case one has to face any critical illness. Though the market has a plethora of companies that offer medical insurance with different premiums and plans, one has to choose a comprehensive policy as per his need and know each aspect of the same before moving to finalize it. Almost every insurance company offers different plans with different features, and hence, for an individual, it is necessary to check if he will get the desired benefits or not.
However, a common man who has no background of this industry, it can be a serious concern as which plan will be most suitable for him. To avoid any confusion and select the right policy, one can check the answers to the below questions from the company or his advisor. If he finds them perfect, he can go for the recommended policy.
What will be the sum assured?
Sum assured is the amount that one can get in the event of a claim. It can be different in case of different profiles. One must note that it varies as per age, premium, and medical condition of the policyholder. Usually, people go for high sum assured, but one must check the diseases which are covered under the policy and then decide the amount of sum assured.
What diseases will be covered?
In this era, many companies have multiple plans. Some of them have specific plans for those who are prone to diseases such as cancer. If one thinks his profile at risk of any type of cancer, he can either go for a policy that is exclusively for different types of cancer only or can check with general policies that also cover cancer. However, at this step, one needs to know the difference between both of these policies first. In the exclusive policy, it will include only cancer, and the premium will be moderate, while in general policy, it will cover other diseases also, and the premium will be high.
What are the limitations?
In policies, the insurance companies keep certain restrictions such as room tariff, cost of pre and post hospitalization, the cost for the diseases where admission in the hospital was not required, cost of specific tools such as pacemaker and stent, and consulting charges of visiting doctors. Usually, no policy covers treatment for dental problems and cosmetic surgeries. However, in which case what all will be covered is decided by the company. Still, before going for the policy, one needs to have a general idea if he will have coverage against certain diseases or not.
Should I go for cashless policy or reimbursement?
The support provided by the insurance company is in two forms. It can ask the policyholder to pay first at the hospital and reimburse the amount or can ask him to go to certain hospitals where he can have cashless treatment. With such hospitals, The Insurance Company has a tie-up, and they are known as network hospitals. However, cashless never means that the client will not have to pay a single penny from his pocket. There are also a few charges such as process fee etc. that one needs to pay first.
One needs to go for the policies that can offer cashless facilities, as in case of reimbursement, one has to pay first to the hospital, and one may not have that much fund available also. To have the benefit of cashless treatment, one need to have the treatment done in a network hospital only, and hence; one needs to know the names and address of hospitals which are in network.
Who will pay for the medical tests?
Before going ahead with the insurance company or agent, one needs to know if he will have to go for the medical test or not. If the medical test is to be done, who will pay the charges for the same? In many cases, companies ask the client to have medical tests, and after getting the same, they increase the premium mentioning the medical condition of the client. If the client refrains from paying an additional payment, companies deduct the handsome amount as medical test cost, and one gets hardly half the amount paid as premium. To avoid such an incident, one needs to be vigilant and inquire about this at the beginning of the discussion only.
What will be the premium?
Many times premium for the same amount and diseases varies from company to company. In such a situation, one needs to compare the same and decide.
These are some of the essential questions answers of which must be checked before going for payment to any of the insurance companies in the market. It can help one save from any surprise at the time of the claim.