Mediclaim Policies: Important Features to Look Out For
Mediclaim Policy is a type of contract between the insurer and the policy holder wherein the policy holder pays a fixed sum to the insurer and he, in return, promises to bear the money spent by the policy holder during hospitalization.
When you opt for a medical insurance plan you receive a reimbursement for the hospitalization charges that have been incurred and the medication or surgery that you or your family member has been through for the disease that was covered. Some policies also have cashless option wherein you do not pay any cash to the hospital for your hospitalization bills covered under the policy.
This policy extends to any one who falls under the age slab from 5 years to 75 years that is if you fall under the mentioned slab you can hold a mediclaim policy in your name. However, infants and children below the age of 5 years are also untitled to hold a mediclaim policy but that come in joint names with the guardian.
Mediclaim policies are also offered for groups wherein companies or organizations by these policies for their employees provided they have a strength of minimum 50 employees.
How to Choose Mediclaim Policies?
- Make sure that the plan you are going to buy provides you coverage of hospitalization as well as expenses incurred on medical tests, surgeries, doctor fees, anesthesia etc.
- Majority of mediclaim policies come handy with exemption under Sec 80D of the income tax.
- Mediclaim policies also include expenses like room, nursing expenses, oxygen, surgical appliances, chemotherapy, X-rays, dialysis, medicines and drugs, cost of pacemaker, cost of organs, artificial limbs etc.
- Try to get a policy that also covers dental treatment expenses and maternity expenses.
- Look out for all the critical illness that is covered under the policy.
- There are policies that can provide you with some additional benefits when you pay some extra premium. Just like Top-ups in your mobile recharge!
- There are policies where you can shorten or extend your coverage period as per your convenience and requirement so keep this in mind while choosing.
- Make sure to closely review the insurance payment options while you buy your mediclaim. Cashless facility that is being offered by the insurance companies where the insurance provider directly settles the bill with your care taker serves to be the fittest option.
- Prior to buying your mediclaim policy, make sure that you have a clear list of the network of hospitals that are being covered under it. It is always advisable to opt for a policy under the flagship of a company that includes higher number of reputed hospitals. If the hospital close to your residence is also included in the list of network then that will surely work in your favor as in case of an emergency you tend to rush firstly to the nearest hospital.
- Make sure that you thoroughly go through the list of exclusions - that is the list of medical conditions that will not be covered in your policy. Yoga, massage, naturopathy, acupressure, dental cosmetic surgery etc are few services that, as of now, are a part of fixed exclusions.
- In case of pre-existing illness (an illness that the insurer already has before buying the policy), the insurance companies provide for a waiting period. The waiting period generally extends from 1-4 years varying from company to company. It is always advisable to opt for a company that offers minimum waiting period.
- Also make sure that you look out for other policy limits and read out the fine prints of the policy documents carefully. Taking advice from an expert may come handy.
- It is also important for you to keep a note of discounts that are available to you. For example, there are companies which avoid giving cashless policies and offer discounts in that place as they feel that hospitals cheat them by over billing so they avoid going the cashless way. However, it is always advisable to cut out the frills that are being offered to you as these are means to lure you. You should always opt for a policy that suffices your healthcare needs.
- Always aim at buying a policy that gives cover to all the family members without burning a hole in your pocket.
- Aim for maximum renewal age as a policy that does not cover you when you need it the most is not worth laying a hand on.
You cannot ignore the fact that mediclaim polices provide you with peace of mind and sense of security not only for yourself but also to your family. However, it is important for you to choose a plan that fulfills all your healthcare needs. Make sure you have done all the research prior to taking your final call.
Contributed By: Megha Sharma
Megha Sharma works as a guest lecturer in Delhi. She holds an MBA & Doctorate from the UPTU. With extensive knowledge and experience in various financial products, she also works as a consultant in banking & finance domains wherein she offers advice to her clients in managing personal finance.