The highly contagious Covid-19 which spreads like a wildfire has helped spread awareness around health insurance. People have realised the importance of health insurance so that at the time of any health-related problem, it can be easily treated. Health insurance usually covers pre and post-hospitalization expenses, room rent, ambulance facility, doctors’ fees and medical expenses.
But in every circumstance, it is not necessary that the insurance company will bear all the cost of your treatment. Not everyone understands the ‘Terms and Conditions’ attached to the policy. In such a situation, before buying a health policy, it is important to understand which policy is capable of meeting your needs.
You must understand the rules related to the waiting period while buying a health insurance policy. Buying a policy does not mean that the insurance company will cover you from the very first day of buying the policy. Rather, you will have to wait a few days to make a claim. The period from the time you buy the policy until you can claim any benefit from the insurance company is called the waiting period of a health insurance policy. This period can be from 15 to 90 days, during which you cannot file your health policy claim.
If you already have a disease, then these are certain rules
According to IRDAI, 48 months before the time of taking insurance, if a person has suffered any kind of illness or accident in which he has got treatment from a doctor or is undergoing treatment or needs the advice of a doctor, then pre-existing diseases will be considered.
Usually, such a disease can be covered only if it is vetted for four years. Some companies keep a waiting period of 36 months for this. In such a situation, if your health declines in the middle, then you will have to bear the cost of the hospital yourself. Each policy has different terms and conditions.
If you want to claim under health insurance, then it is necessary that you have been admitted in the hospital for at least 24 hours. That is, if your health deteriorates, you will have to stay admitted for 1 day in the hospital.
You can claim the amount from the insurance company only after submitting its documents. But there are some diseases which can be treated in a very short time. After this, the patient can go home the same day. Cataract surgery, lithography, dialysis and chemo etc. take less time.
Many types of policies come with a co-payment clause. This means that if you file a claim, you will have to pay a part of it yourself. Suppose the insurance company will pay 90 percent of the total expenses in the hospital, while 10 percent has to be given to the policy buyer. Almost all the schemes available in the market for senior citizens come with a co-payment condition. Therefore, you should choose the same policy which offers you to pay less on other claims. If you wish, you can also choose to waive the co-payment by paying an extra premium. However, some insurers keep the co-payment amount fixed, while some set a range.
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