Questions Buyers Should Ask His Health Insurance Company

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Buyer is a diabetic patient and recently, have developed renal complications which need in-patient care. He owns health insurance coverage, so he has no worries of finances. But, at the time of hospitalization, he is in a big shock because his healthcare plan does not cover complications arising because of diabetes. Coverage offered by mediclaim policies differ insurer to insurer and among various health plans. Therefore, it is important to be aware of all the clauses before you select the right insurance product.

Below are some of the questions which buyers should ask his insurance company to ensure that he is getting the best deal:
What does your policy covers?
Most insurance companies in India cover accidents and surgeries. But, some policies exclude ambulance expenses, maternity cover and outpatient treatment. So, it is better makes sure that if your insurer include these clauses or not. Do not forget to know how much coverage is offered.

Does your health coverage exclude something?
During the first year of plan, treatment of specific diseases is not included in a plan. Many insurance companies in India begin including these treatments after a certain months of waiting period. The list of diseases may differ from policy to policy. Some plans exclude pre-existing diseases. It is better to know what diseases are included and which ones are exclude. Some insurance products do not cover expenses of spectacles, contact lenses, venereal disease, use of intoxicating drugs, AIDS and alcohol and general debility.

What extra advantages and other riders does your health insurer provide?
Search what riders or add-ons your insurer provides. Some insurance companies in India give benefits like critical illness benefits, hospital cash, surgical expense benefits etc. As a buyer, you have to know that these benefits are available along with your plan or may have to purchase the plan separately. Some insurance products pay for certain expenses towards general health checkup at least once in a few years.

What benefits are provided by health insurance companies in India?
Review existing healthcare plans and then select between individual and family schemes, long-term healthcare plans, senior citizens insurance schemes and cover for specific diseases. Some insurers do not have separate healthcare plans for children, they are included in the family insurance.

How is health insurance premium calculated?
Age and medical history are some of the major factors that calculate the premium. If the buyer is older, then the health insurance premium will be higher because old age people are more prone to illnesses. In case buyer is having any prior medical history, then premium amount will be higher. If policyholders have not claimed for some years, then the insurer may offer bonuses to them.

Are medical tests necessary to buy health coverage?
Some schemes need a medical checkup while others may not make it mandatory. But, it is necessary to make a declaration regarding policyholders health condition in the proposal application. So, buyers have to do medical tests. The premium amounts are calculated based on buyers declarations. In case he hides anything at the time of buying a plan, then his claim may get refused.
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