Cashless Medical facility

                                                                

                                               [image source : topnews.in]  

Cashless medical facility got popular mainly because of the government schemes say in Tamil nadu when you have government card, you can show it in hospitals for any surgery, your details will be sent to Government and on approval, and surgeries will be carried out for free. Hospitals will be claiming their amount from government separately. This facility is for who had opted for government hospital care.

Even in many of the corporate offices, employees can inform the insurance company in advance if they are going to do surgery in future date, all the medical bills will be settled by insurance company to the hospital. You can have hassle free care in the hospital.

How about others?

This facility is for everyone who had enrolled for health insurance policies with any of the insurers. All the insurance companies will be having a network of hospitals and we can get admitted in any of the hospital for any medical care. After the penetration of insurance has increased to a certain level insurance companies had started managing it thru Third Party Administrator namely TPA for any claim approval or rejection. Customer can also get admitted without informing and get it reimbursed from the insurance companies directly.

Benefits of Cashless facility

Any medical emergency can meted out with cashless health insurance policy. Any financial emergency creates a lot of stress and during medical emergency it will be difficult for the associated family members, it will be difficult to have so much liquid money all of a sudden and this cashless policy brings in peace of mind during those situations. Further it is always better to enroll for the higher sum assured as all the medical bills can be brought in during emergency. Great network of hospitals brings in sigh of relief as any nearby best hospital can be chosen.

Things to check

Is all the best hospitals are covered in the network chain of the insurance company? TPA’s of the chosen company should have the track record of immediate response of any request being sent by customer. Poor understanding between TPA’s and your chosen hospital can bring in delayed response which may delay the operation.

Choose the high Sum Assured and check the copayment, as the amount mentioned in copayment should be paid by you. Check the waiting period of your health insurance policy before going for any cashless claim in hospitals as it may get rejected. Sub limits on all your treatments including rent needs to be checked in advance to have a peaceful treatment without any worry on money to be paid.

What is health insurance Policy?

[Image source : moneycrashers.com]

Insurance is nothing but risk protection, in the same way health insurance is the pure protection of one’s health. It is grouped under Life insurance. It is being provided by most of the insurance companies in India. Similar to Term policy this one also pure risk protection, if you get any disease it can be used or else this policy will be of no use, let us see how this is very essential in today’s world.

Need for Health Insurance

If we keep ourselves in good health condition, one may presume no need of this policy, but you may not know the daily risk which may result in serious injuries all of a sudden. The increase in medical inflation may not be known to you unless someone close to has been cured for any ailment. Therefore it is best to keep this policy as a friend. Even a close friend may not be able to help you with the money during his difficult times, but this friend i.e having this policy will be of great help which will help you in getting out of hospital easily.

Benefits

Most of the insurance companies offer 24 hour day care treatment also which will be of great help. Ambulance cover, second opinion can be sought if we have doubt with the first medical checkup as it may help in unwanted spending. Pre natal and post natal hospitalization cover is provided. Room rent, doctor fees, surgery fees, medical bills etc will be covered with this single policy. In some of the companies free medical checkup is allowed once in a year as add on benefit. A two year policy will have a reduced premium and protect you from increase in price of premium due to inflation.

Offered in India by

                                                [Image source : healthinsuranceindia.org]

In most of the corporate companies, this is being offered as group policy, where there will be a cap limit to any of the ailments or else there will be co-payment rule. In co-payment person has to share part of his medical payments by himself and the rest will be borne by the insurance company. In India health insurance is being offered by Religare, Apollo munich, ICICI prudential, Max Bupa etc.

Exclusions to check:

The most important thing to check is the waiting period, during which policy will not be covered for specific disease. Any serious pre existing disease has to be told to the insurance companies in advance to get it checked for policy coverage, because once found later the paid premium will be of no use. Diagnostic charges, alternative therapies, abortion, additional supplements, specific ailments, resulting from war are not covered in this policy.

More importantly any savings or investments will be lost in curing disease itself, as life is more important than money we have, any sufficient health insurance policy will be able to protect you from sudden erosion of wealth.

Pregnancy insurance policy in India

Why Pregnancy Insurance?

Maternity insurance may gain popularity going by the number of Cesarean options being carried out in hospitals and recently a leading daily has reported that many of the hospitals are going for operations rather than curing the ailment with available alternatives. Further the raising medical bills when you opt for best medical care will make many to opt for this insurance. The ration between Cesarean and normal delivery is 65:35 and this makes the risk for the life of women who becomes pregnant

Benefits of maternity insurance

After waiting period hospitalization and day care treatment will be covered. All the maternity related expenses will be covered. Some of them cover pre and post hospitalization related medical expenses. Post hospitalization includes visit to doctor for periodic check up till it gets completely cured. Nowadays corporate provide maternity cover as add on to their health insurance policy, but the limit may not exceed 50000. It is advisable to take a private maternity cover policy to get a exclusive coverage.

What to look for

The main reason to check in maternity or pregnancy insurance is from when the coverage will start. Mostly all have waiting periods which needs to be carefully looked upon and the most important thing is already pregnant women cannot enroll for this policy. New born baby cover also needs to be checked as complications arising for new born will not be covered in regular health policy unless enrolled and approved by the medical insurance companies. Basically only 2 pregnancies will be covered under this policy and the gap between 2 children should be 24 months in most of the policies.

What is not included?

Regular medical bills are not included as part of this insurance cover. Any event that may result in abortion of fetus is not covered and above all medical expenses that we may incur during pregnancy period is also not covered. Any pre existing illness that may affect pregnancy is not covered. Treatment for fertilization and pregnancy is also not covered under this policy. All other exclusions mentioned in the policy have to be looked upon.

All the leading insurance companies in India offer maternity cover as add on benefit and also a standalone policy. Protect yourself against any risk arising out of pregnancy. It is a new life not only for the new born during pregnancy but also for the women. Life without a woman is incomplete in life and special protection is really needed and has to be provided.