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mediclaim



Health Insurance Plans -

Health Insurance or Mediclaim as commonly know refers to protection that is provided to a policyholder as a cover against unexpected medical emergencies. Today there are different Health Insurance Plans available to a consumer. With each of these Health Insurance Plans having their own unique USP, but they all can be differentiated on the bass of 8 broad categories.
a. Waiting Period & Duration before Pre-Existing diseases are covered in the Policy
b. Lifelong Coverage
c. Type of Health Insurance
d. Extra Coverage’s of Critical Illnesses
e. Presence of Maternity coverage’s for females
f. Day Care treatments covered
g. Product Premium
h. Co – Payment options


Cashless Mediclaim

Cashless Mediclaim plans are those which allow a policyholder to get admitted into a network hospital without the need of a paying any upfront admission fee and discharge fee as the same is paid by the health insurer. The cashless mediclaim reimbursement is capped to the level of sum assured the person has and the coverage’s under the plan.

Family Floater Health Insurance

This plan covers your entire family under single health insurance policy.
Family Floater including Parents or in-laws
It covers the medical expenses of extended family but only up to certain number of dependents including parents or in-laws. Sum insured under this policy is shared across family members and as compared to an individual insurance, it is less expensive.
Family Floater Plans refer to those which cover the entire family under one plan. Under a family floater plan the people covered share the total health insurance available to them. The benefit under such a plan is that since a large group of people share the same insurance cover the premium to be paid is far lesser in case they all would have bought an individual plans for themselves.

Taking an example, if a family of 4 (2 Adults and 2 Children) takes a family floater plan then there premium for a health cover of say around Rs. 5 Lacs would be close to Rs. 10,000, whereas, if all of them had a separate plan of Rs. 5 Lacs their premium would have exceeded Rs. 12,000 easily.

Individual Health Insurance

Buy this plan to ensure the medical costs of an individual as it includes the medical expenses of pre- and post-hospitalization incurred towards the ailment or disease for which medical tests are essential before hospitalization and at the time of discharge.

Health Plan with OPD Coverage

OPD benefit claims can be made on a re-imbursement basis only.
Individual Health Insurance plan offer more protection to a policyholder, as in such a policy the policyholder can consume the entire amount alone without have to worry about sharing it with other members of his family incase of a floater policy.

Group Health Insurance

Whenever a large group of people say over 20 who work, stay or are bonded by some nature of job are willing to get a Health insurance plan, they should opt for a Group Health Policy. Under a group health policy people who may have adverse health condition can also easily get health cover due to the greater negotiating power that a group contains versus a individual policy.

Senior Citizen Health Insurance

As a person enters the golden age as many state of 60yrs, they start to lead a new life a life of a retired person. The needs and wants of a person at this age are completely different from those that they would have had at age 40 yrs or 50 yrs. Thus they need health insurance plans which are suited best for them at this age, but sadly enough there aren‘t many. When a person above 60yrs of age goes to buy a health insurance plan he needs to check:
i. The network hospital closest to his residence
ii. Co-Payment options which will ensure his hospital bills are never stopped
iii. Lowest time frame for coverage of pre-existing disease
iv. Lowest amount of waiting period


Maternity Insurance

Standalone maternity insurance are a rarity, thus many insurers include this as a part of their regular policies and also critical illness policies that they specifically design for women. Under maternity insurance, the female is covered for any complication that arises during her pregnancy and related to child birth.

Health Insurance Contract TermsWe have always been taught to check before we sign the dotted line and this also stands true for a health insurance plan contract. We often hear news of claim rejection this is due to a simple reason that we never read that the proposal form or the health insurance contract stated. This is always due to a hurry we are in and the insurance agents who are ready to make a quick buck. Health insurance contract terms define the coverage’s that your policy offers and the other tiny details that would ensure that your claims are never rejected.

Benefits & Features All major health insurers offer common benefits and features.
These all include:

» Cashless reimbursement of hospital expenses
» Coverage against all pre and post expenses related to hospitalization
» Coverage for pre-existing diseases
» Tax savings under section 80D
» In Patient hospitalization expenses


Health Insurance Claim Process The process of claim filing is different from a network to a non network hospital. While filing for a claim in a non-network hospital a policyholder needs to fill up a claim form, attach all original bills to be claimed and share the same with the branch of the health insurance provider who then reimburses this amount. In case of network hospital all formalities are done by the hospital.

Health is very precious and maintaining a good health is really difficult. Get ready to afford the best medical facilities for you and your family. Health Insurance covers expensive medical costs during accidents, sudden illness and surgeries. The best health insurance cover in India also includes doctor’s fees, charges on your room, diagnostic and medical facilities, ambulance service cap, oxygen, blood, medicines and things like artificial limbs or pacemaker etc which may arise in future.

Health insurance is the best way to handle crisis situations like injury or illness at any age in life with ease. It takes away the burden of medical expenditures, whether planned or sudden. Policyholder may get cashless facility based on insurance company only if insured visit one of their networked hospitals.

Health insurance companies will pay the medical bills of the insured when policyholder gets injured in an accident or becomes sick. Healthcare plans are available for an individual and groups as well. It ensures that all hospitalization aspects are well covered, so that you can concentrate your attention on good health of your family.

CRITICAL ILLNESS COVER & RIDER


Critical Health Insurance


A critical health insurance policy hells cover certain set of diseases as prescribed under a policy only. As the name suggests critical health insurance, they cover all those major diseases which are either terminal or can reduce the human body to a vegetative state. Some of these would include, Alzheimer's disease, blindness, deafness, kidney failure, major organ transplant, multiple sclerosis, HIV/AIDS contracted by blood transfusion or during an operation, Parkinson's disease.

Critical illness cover offers protection against loss of income on diagnosis of Cancer, Heart Attack, Kidney Failure, Paralysis, Bypass Surgery, Major Organ Transplant, Stroke, Multiple Sclerosis or Heart Valve Replacement Surgery.

If you have a rider and diagnosed with critical illnesses, then policyholder get a greater cover at less expensive costs. In case of a separate critical cover, you need to pay the due treatment amount in lump sum only if diagnosed with a critical illness.

Top Up Health Insurance Rider

In case the hospitalization cost is beyond the mentioned limit, then the extra amount will be paid by the insurer. If an employee wants a medical cover but more than what is offered by his employer’s group cover, then top-up cover is much better. If policyholder owns two health policies from two different insurance companies, then each insurance company will pay its part of the claim.

Cover for Pre-existing Diseases

Pre-existing diseases are medical illnesses or conditions which exist already at the time customer purchase health insurance. It may possible that the policyholder or a customer purchasing the health plan is not aware of such conditions. All the clarification about pre-existing diseases is necessary while buying a health insurance plan.

Renew Up to Age

Most insurance firms have set age limits up to which you can renew your health insurance policy. Once you crossed that age limit, then health insurance cannot be renewed.
 
 
Mob.: +91 96 1919 4464 / +91 98 20 49 4464
Email: dsubhash1980@gmail.com
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