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Things to find out about Mediclaim Policies
Renew-ability ?? Take policies that are renewable till your life time. After all if the policy does not get renewed beyond a certain age you will find it impossible to get a fresh policy on reaching that age. So go for policies that are renewable till lifetime.
Sub-limits - Ignore policies that have a room rent sub-limit as it can seriously impact the amount that you get paid for every hospitalization.
Disease specific amount Sub-limits - Be aware that most policies have specific sub-limits for treatments such as cataract, knee or hip replacement etc.
Specific Expenses Sub-limits - Apart from room rent sub-limit covered above (avoid policies that have room rent sub limit) and please be aware that some policies also have expense sub-limits on items such as medicines and doctors?? fees.
Waiting periods - Be aware that most mediclaim policies will not pay hospitalization expenses for any pre-existing disease for a period of between 1-4 years. The exclusion will also apply for any hospitalization due to a disease that was a consequence of the pre-existing disease.
Co-payments - Be aware that the policy can require you to pay a portion of the ??eligible?? expenditure from your side. This is called co-payment in insurance parlance. The co-payment is normally conditional such as after reaching a certain age or for hospitalization expenses incurred for a pre-existing disease or for hospitalisation expenses incurred outside the preferred network of the insurance company.
Type of rooms - Also there are some policies will restrict the type of room (normally twin sharing room) that you can get yourself admitted to for the purpose of getting treatment. If you choose a higher category room there could probably be a co-payment imposed or the expenses would be reimbursed based on what you would have incurred if you had stayed in a twin sharing room. The second type of conditions can seriously curtail the amount of claim that you can make and you should avoid policies that have such conditions.
Which Zone can I be treated in?
Some policies will restrict the geographical parts of India that you can be treated in. If you choose to get treated in another part of India that has a higher premium there is normally a co-payment that is imposed.
Things you should not worry about
Medical examination before the policy is issued
This is in fact good for you. Coupled with complete disclosure from your side this will ensure that you have the least problems at the time of making a claim. All insurance companies will reimburse 50% of the medical examination cost if they agree to issue the policy to you.
Coverage of Pregnancy
Only a few policies cover this and that too after a waiting period of 4-6 years after taking the policy. The amount of expenditure covered is also limited to 15-50 thousand depending on the type of delivery.
Things that you should definitely do
Make complete disclosures including any history of past diseases or treatment. It is better to have a more expensive policy or even not to have a policy rather than get a policy by hiding facts which will make the policy useless when a claim arises.
Read Brochure of the policy carefully before signing on the dotted line.
Check out all the things that are listed above.
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