HEALTH POLICY FEATURES YOU SHOULD BE CAREFUL ABOUT
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While choosing a policy, don't be guided just by the
premium being charged.
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The policy's features are more important.
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Almost all policy documents are available on the Internet
today.
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Download brochures and read the terms and conditions of
policies carefully before making a choice.
1. Sub-limits
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Many policies come with sub-limits on the sum assured.
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Besides room rent, there are sub-limits on surgeries, ICU
charges and other procedures.
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The policies without sub-limits are better although they may charge
higher premiums.
2. Co-payment
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Depending on how you look at it, this can be a boon as
well as a bane.
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Co-payment means the policyholder will bear a specified
percentage of the claim amount, while the insurance company will foot the rest
of the bill.
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This brings down the overall cost of insurance but also
means you don't get full coverage.
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There are various co-payment plans, including those that
apply above a certain age or kick in when treatment is undertaken in a
non-network hospital.
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The co-payment clause applies to plans that have
differential premiums for metros and non-metros.
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If you paid the lower premium applicable to a non-metro
but get treated in a metro, the insurer may ask you to pay a part of the cost.
3. Network of hospitals
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Check if the hospitals you would prefer to go to are on
the insurer's network.
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Unless these hospitals are in the network, the cashless
facility will not be available.
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Opt for the insurer which has tie-ups with reputed
hospitals that you would prefer to go to.
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It's even better if these hospitals are close to your
house.
4. Exclusions
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Different health plans have different rules regarding
exclusions.
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These are diseases and procedures that a policy will not
cover, either for a specified time period or for the entire term.
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For instance, cataract or knee replacement may not be
compensated for in the first two years.
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Insurers apply this rule to avoid having to pay in cases
where people buy insurance covers after they have been diagnosed with a
disease.
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Stay away from policies that have too many exclusions or
where the cooling-off period is very long.
5. Day-care procedures
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Many policies do not compensate you unless you are
hospitalised for at least 24 hours.
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Day-care procedures are normally not covered.
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However, nowadays, owing to improvements in technology,
you don't need to get hospitalised for several procedures, including
non-invasive or laparoscopic surgeries.
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Some of the newer policies recognise this fact.
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Opt for plans that cover the maximum number of day-care
procedures.
6. Alternative treatments
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Some policies also cover alternative treatments such as
homoeopathic, Unani and ayurvedic medicine.
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It is better to opt for policies that also cover such
alternative treatments, though these will cost more than the normal plan that
covers only allopathic treatment.