The lesser heard facts about health insurance policies 24^th September 2022

The Covid-19 pandemic has led to a demand for health insurance policies. People are now aware of the importance of health insurance cover in case of sudden hospitalisations and expensive treatments. Moreover, many people also opt for it to avail of tax benefits.

Let us take you through a few lesser heard facts about health insurance plans in India. This will facilitate you to make a better and informed choice if you are also planning to buy a health insurance policy for yourself and your family.

1. NRI health insurance policy:
It is now possible for a non-resident Indian (NRI) to avail of health insurance cover in India. An NRI person will have to submit residence proof along with other necessary documents. Companies use Indian parameters to ascertain the cost of the treatment and premium amount. The treatment will have to be done in India to enjoy the policy benefits.

2. Pre-existing diseases:
Yes, you can get health insurance coverage even with pre-existing diseases. The insurance company will start coverage after 36 or 48 months of buying the policy, as per the terms and conditions. You will have to disclose the ailment at the time of buying the policy; otherwise, the insurance company can reject your claim at a later date.

3. Limits:
There are sub-limits set under your policy cover for certain types of expenditure. Generally, insurance companies put a cap on room rents based on the total sum insured. For example, suppose your total policy cover is 10 lakh rupees, and the room rent has a cap of 1% of the total cover. You are eligible to spend only Rs.10000/- a day on the room rent. You will have to pay it from your pocket if it exceeds that amount.

4. Recharge of the insured amount:
Exhausted your health insurance coverage amount? No need to worry. Some insurance companies allow us to recharge or upgrade our policy cover amount! For example, suppose we have insurance coverage of 5 lakhs INR, and it gets exhausted. We can opt for the refill and reinstate the cover if we need it over the remaining tenure.

5. Daycare coverage / Maternity coverage:
Many health insurance companies have started providing cover, even for daycare procedures. The patient need not be hospitalised for over 24 hours to benefit from the cover. This has made it convenient for people undergoing procedures such as chemotherapy, dialysis, radiotherapy, etc. Similarly, some policies now provide us coverage for maternity-related expenditures as well.

6. No age restriction:
Some insurance companies have started providing health insurance coverage without restricting the insured's age. People over 65 years of age can also get health insurance coverage now. Moreover, they can also buy a family floater plan and get coverage for their spouse and other family members as well.
The policy will remain functional and valid until the insured continues to pay the premium for the policy timely. They cannot deny the coverage with the growing age of the insured.

7. Reimbursement policy:
When purchasing, we generally check the network hospitals first in our health insurance policy in India. It is believed that the policy benefits will apply only in those hospitals. This is not the case.
Coverage is valid and works even when admitted to a non-network hospital. It does not matter if it is not on the list of eligible hospitals for cashless treatment under a policy. Patients will have to settle the bill themselves at the time of discharge. The insured will get reimbursed from the insurance company at a later date after the submission of all the required documents.

One should carefully go through the terms and conditions of a policy before opting for it. You should not just get lured by a low premium amount. It may exclude coverage for certain treatments and facilities, and you may suffer later at the time of need. The benefits and coverage provided under health insurance plans in India vary from one company to another. Hence, be prudent and choose your health insurance policy wisely.

Click HERE to know more about the best health insurance plans in India.

Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.