Health Insurance: Important Points to Remember

Health Insurance is a type of insurance which primarily covers the medical expenses. Under an ideal Health Insurance, you can protect yourself and your family from medical expenses by giving a very small amount each year and this amount is commonly known as the Premium.

There are many other aspects of the health insurance but following points should be considered carefully in relation to the Health Insurance and its formalities involved:

• Fill the form of Health Insurance by yourself as your agent might fill your wrong information. Each and every part is of immense importance so the best option is to take the lead in this.
• Health insurance has many different types of policies available. Keep your age and family in mind and choose the appropriate and befitting policy. Do a good research online and contemplate on different policy’s features and compare their premiums and purchase the suitable policy for yourself.
• When you buy a Health Insurance policy, there is no claim of medical treatment for the first month / 30 days in the first year, but the claim of accident or injury is covered in these days.
• For your family, it is important to have a family floater policy of at least Rs 3 lakhs.
• Do not hide any history of illness.
• Details of whom you are taking, their health history, Name, Age and Birth date should be correctly filled inside the form.
• Get information about which disease which is not included in Health Insurance or how many years insurance can be involved. Ex: In the first two years of health insurance, many diseases like a hernia, hydrocele, piles, and cataracts are not included.
• If you have to be admitted for medical treatment in the hospital, then your health insurance card and photo identity card should be shown to the hospital staff so that you can get the benefit if the cashless facility is available.
• If there is no cashless facility in the hospital, within 12 hours after admitting in hospital, you should call the Health Insurance Company Toll Free number given on the back of the card. This does not make the process difficult to Hospitalization Claim Reimbursement.
• The claim of health insurance / the Xerox copy of all documents sent while claiming should keep with it.
• If you have any have any issues with the complaints or payment from your health insurance company, then you can complain/inform it at complaints@irda.gov.in or call 155255.

These are important points that will help you to take health insurance so that you can avoid the hassle of medical expenses, and you will not face any problem in getting good treatment at a difficult time.

At Medimanage Health Insurance, we educate our clients on all the factors and also the benefits that they can derive from their policies. We strive hard to achieve the client’s satisfaction.

Claiming Health Insurance Benefits

Whenever you or any of your family members or dependents are admitted to the hospital due to an illness or an unfortunate accident, then health insurance provides adequate financial cover. Policyholders can claim health insurance either through cashless mode or in some situations, the policyholder may have to pay all the outstanding amount in the hospital and then the claim is submitted to the insurance company.

You can do this in two ways under the claim of a health insurance policy –

1. The Medical Service Provider can directly deposit the claim from the insurance company. When a person takes a cashless health plan, he should show his ID card so that the third party administrator can help you with the claim. TPA helps you in doing the claim and paying the correct bill in the event of critical illness.

 

2. If your hospital is not in your health insurance company’s network and cannot file a claim on your behalf, you will have to file a health insurance claim form to request for the payment. All the necessary documents should be presented to the insurance company for compensation within 30 days of leaving the hospital.

To claim the insurance, you have to take care of certain things:

• The form of claiming should be filled properly. It is important to keep in mind that your signature is properly done.
• Before leaving the hospital, taking discharge summary, a copy of the inquiry report, and receipt of a bill, prescription and pharmacy reports are important.
• It is important for the doctor to show the certificate for what type of operation has been done and how it is being taken. At the same time, the person should be shown his bill, receipt and the identity card of the disease.
• In addition to the accident, chronic disease is also shown in any situation.
• When submitting the claim, you should submit fresh bank mandate with the details of the policyholder’s bank account and IFSC.
• If your insurance plan does not cover the disease that has happened to you then it may also be that in some cases your claim is considered “no”. But if your claim is not considered, then keep in mind that you file a complaint with your insurance company within 15 days. You should contact your TPA for partial payment.

Medimanage Health Insurance Brokers guide clients through every step to avoid any sort of confusion of choosing policy which is best for them by providing unbiased solutions.

Health Insurance and the Economy

Health insurance is one of the most important and highly recommended investments one can make as it acts as an ozone and protects you and your family from the unforeseen health disasters and financial crisis. Health insurance has evolved a lot in the recent years and is now transformed into an essential priority for every person in every section of the society.

The basic structure of the health system is now taking a new shape and definition and the strong relationship between the health investments and the economy is getting converted into the policies that define the interaction between these two entities.

Health investments and the economic structure are strongly interlinked. The national income has the direct impact on the development of the health infrastructure of the economy. For wealthier nations, it is an easy task to amend and ameliorate the health structure of the country but this may not be the case for every nation and hence, the need of developing an institutionalized system becomes mandatory.

The need behind institutionalizing the entire structure is unavoidable and is something that cannot be overlooked. The policies of the two entities are also interlinked, for example, if the taxes on the cigarettes and other tobacco products are increased, it helps in putting the restrictions on the use of such products in many public places. These strategies are undertaken by many nations of the world and it is also the same when it comes to India, the government has increased the taxes on these products and the banning of their use on the public places is also evident. Many countries have taken this step way ahead and eventually banned the entire use of tobacco in the pubs and other places of the social gathering.

The truth is that the countries with unstable and delicate health sector tend to have fragile economic structure and they find it difficult to attain and experience sustainable growth.

Lesser the investment in the health sector, lesser will be the chances of creating a great health infrastructure and lesser will be the life expectancy which directly affects the overall productivity of the nation.

The policymakers are excessively emphasizing on figuring out the ways in which they can expand the awareness of the health care benefits and enhance its outreach.

Medimanage insurance is one such insurance provider that believes in the delivery of standard healthcare facilities to the common people. At Medimanage, we constantly strive to develop and incorporate methods that can be used to make the people aware of the benefits of having a health insurance and also to create dynamic policies that can protect their financial savings.

Tech Trend and Health Insurance Industry

With reference to the recent statistics based on the surveys conducted, Indian economy continues to have lesser density of the insurance sector and primarily this ratio is defined and driven by the rural areas of the nation where the access to these financial and health institutions are not well constructed and there is a limitation to the outreach of these facilities.

The paradigm shift of the population towards the technology has given a hope of success to the organization as the industry has now figured out a way of increasing their reach and enhance the customer experience.

Companies are now emphasizing on the use of latest technologies to create the infrastructure of the digital insurance sector. Major technologies that are playing a vital role in this transformation are:

1. Cloud Computing
2. Advanced Digital Analytics
3. Mobile Internet
4. Internet of Things
5. Artificial Intelligence
6. Social Media Platforms

The increasing use of technology has redefined the company-customer relationship. The health insurance sector has also witnessed a great rise in this department. The account details, payment details, policy expiration update and several other data can now be sent using the technical alternatives and these steps also make the conversation more personalized and bring the parties together.

Regulation of the data and customization of the products using the technical tools has enabled the consumer to pick up a policy of his own preference and this has significantly attracted the consumers towards the insurance market.

Insurance is a very important sector for any economy and over the years, the use of this investment has proliferated. There are many reasons behind this sudden rise including the increase in the price of medical facilities but the prime reason was the technical advancement and technical tools which also served as a weapon to increase the awareness among the people so that they opt for the insurance and secure their family from any unforeseen trouble and financial impediments.

The market condition suggests that people look for inspiration and personal connection before choosing their medical insurance and the technical platforms have enabled the companies to reach out to the crowd and target the untouched areas which primarily are the rural areas of India. Generating the awareness among the people is a great target and challenge for the companies and based on the data that shows the recent development in the industry, one may state that the health insurance companies are somewhat successful in penetrating into the market and with time this development will increase to benefit the sector.

Medimanage insurance is one such insurance provider that incorporates all the latest technologies to ensure that the insurance sector reaches out to maximum people. We understand the requirement of people and design our plans accordingly.

 

A Paradigm transformation in the Health Insurance Industry

Involvement of technology is evident in almost every industry including the Healthcare, the emergence of the Internet of Things (IoT) is the prime reason for this major role of Internet and Technology. This integration is extremely rewarding and the benefits are not only limited to the Health insurance sector.

There are certain aspects in the Health insurance in India which is having the potential of improvement and requires consideration of several aspects. Even when the industry is experiencing a rapid growth, the practice of old methodologies of the health insurance practices at times lead to the prolonged intervention with the patients. This is a common practice which is experienced by many.

Technology has enabled access for everyone and now even minute details related to a subject can easily be investigated and examined. As a result of data explosion, digitalization, and the increase in demand for instant information, integration of technology has become an unavoidable requisite for every business and service provider.

 

Integration of technology in the health insurance sector has also changed and ameliorated many traditional practices and there has been a continuous innovation in the process of offering the best experience of having a health insurance. The innovation has already reached a level where, in certain parts of the world, even the facial expressions during the live video calls are used to assess and evaluate the credit risks. Health care solutions and Health Insurance industry have experienced a rapid and exponential growth because of this digitalization of the process and massive availability of potential data.

There is a huge absence of the availability of medical facilities and other medical solutions in the rural areas of India where majority of the population resides and as per the surveys, there are only 2% of the Doctors available to them. In all these areas, every form of the medical solution is completely dependent on the schemes funded by the government and at times there is a compromise of quality and the delivery of the services through these schemes. Another major problem is the absence of the social determinants of the basic healthcare such as nutrition, food, water, etc.

With the encroachment of the health insurance facilities, the system has improved and with the integration of the technology, there has been a significant change in the practices and it is now easier and more convenient for people to make justified use of all the government schemes related to the health care.

Health Insurance industry has experienced a huge transformation in the recent times and is expected to have a greater rise in the quality and outreach in coming future.

 

Factors for choosing a Health Insurance

Right from its foundation, concept of Health Insurance has always been an important aspect of not only securing the future from the sudden health crisis which may eventually lead to a huge financial burden or even bankruptcy but it is also considered as a very favorable area of investment and has a significant role in maintaining the economic stability.

Opting for a right and suitable insurance plan can be onerous and may include a lot of research work to determine the absolute suitability as per your income and future plans. There are a plethora of companies who have multitudinous plans for you with different premium plans, following factors may be considered before making a decision on the same:

1. Premiums: One of the most important factors that are taken into huge priority is the premium amount. If you have a business setup, this is the first thing that the employees notice and this should be shared with them as they make a contribution in the same.
2. Available Options: One should consider all the plans available and contemplate the options before choosing any plan. Plans differ in the premium options, secured areas, and other miscellaneous deductibles, therefore, proper research work is very important.
3. Fundamentals of Coverage: This is a major factor for any plan that you choose, the prime question is that what sort of coverage does the plan has to offer? To ensure that your plan has everything to offer that you need, you must read the documents carefully and inspect every detail of the mentioned points.
4. Other Deductibles: After the premiums, this is the second most important factor that needs our undivided attention. Deductibles affects the budget of everyone and hence, people pay a very close attention to what sort of other deductibles are present while opting for an ideal health insurance plan.
5. Prime Objective: The main reason why you pick up a health insurance plan is to safeguard you and your family from the expensive medical fee and treatment costs. Usually, plans do cover many areas that you may not need so it is better to exclude those sections, for example, if you do not need any dental or eye coverage, make sure you get to customize your plan accordingly.

A complete medical insurance does protect from a lot of unforeseen troubles but a scrutinized look should be given to the plans before finalizing it and one must be open to seek the advice from others and be willing to consider their suggestions too.

Evolution of Health Insurance in India

Health Insurance in India is one of the most prominent industries where according to the surveys conducted in the year 2011, nearly 3.8% of India’s GDP was used up in the Health Sector. The evolution of the Health Insurance is also quite a learning experience where the identification can be divided into three distinct milestones to enable the ease of understanding.

The first period was before the Independence where the Life Insurance was started and began to evolve, the second phase was the early few decades of the Independence where Life insurance gained popularity and the concept of Health Insurance was understood as the Government-sponsored programs and the last phase was when the Health Insurance experienced maximum growth primarily because of the liberalization of the economy and awareness in general masses.

The growth in the last phase was significant and as per the surveys, more than 25 percent of the total population in India had marked their presence and had access to the Health Insurance.

When we analyze the evolution of Health Insurance in India, we can easily identify that Life Insurance was the precursor of Health Insurance and the prime reason for the growth of Health Insurance was the growth of the economy and a clear understanding of the health insurance benefits by the public.

Insurance in India was started in the year 1818 by the Oriental Insurance company in India although this was only meant for and limited to the European community yet the concept was incipient in India and a year later after the foundation of Indian Medical System, Bombay Mutual Life Assurance Society began the offering of Life Insurance for Indians too but at a higher premium rates as compared to the British people but the twentieth century witnessed an emergence of many insurance companies in India. The National Insurance Company came into existence in the year 1906 which is the oldest insurance company in India that exists till date.

Life Insurance Corporation which came into existence in the year 1956 was the main reason for the nationalization of the Life insurance.

The initiation of the opening and exposing of the Health Sector was done during the economic reforms in the year 1991.

The government of India also took a major step in the year 2003, when they launched a Universal health Insurance to ensure that the insurance can also reach out to the untouched mass of below poverty line.

The health insurance industry has evolved through many phases of development and there is still much room for development as many published case studies do suggest that there is a possibility of improving the regulation and transparency of the private Health Insurance but with the growth of the sector, the industry is going to witness extreme growth in near future.

Importance of Health Insurance

A good health can be the most productive asset for any individual. Be it the physical or mental health, it is important for us to stay healthy in order to accomplish our daily tasks and goals. Having a good health is nothing but practicing right kind of a lifestyle which primarily includes having the right diet, the right amount of exercise and the right amount of sleep.

A good health is something that we all enjoy but in the today’s era of modern lifestyle and hectic routine, it becomes very difficult for most of us to pay a proper attention to our health including our eating habits and as a result of which, we end up having several health issues. Our habits not only affect our body’s health but it also hampers our mental health and the signs of which we can experience in the form of insomnia, stress and severe headache.

It is important for us to maintain a proper balance between our lifestyle and our work but it is also very important for us to have a health insurance as there has been a huge rise in the prices of treatment and other medical services.

Having a proper and consistent health insurance is of extreme importance for multiple reasons including the advantage of enjoying healthcare benefits. Uninsured people get less medical care and also the absence of a standard insurance may lead to a great financial burden on the entire family. Health insurance may take multiple forms but they have all got some common features which can help you easily understand what are you covered for.

A health insurance relieves you from the uncertainty of financial burden which could have otherwise been an impediment for you and your family. Apart from all the benefits that an insurer has to offer, it also ensures a stability in your family, in your business and also in the economy.

When things go right in your personal and business life, the time correct for you to have a health insurance because that is when you can efficiently take financial decisions about investments and savings. Insurance does provide an investment channel where the payment of premium amounts not only enable you to have a systematic saving but also the maturity amount gets you a hefty amount.

Medical insurance acts as an ozone to protect you from any fiscal issues because of unforeseen illness and unanticipated disease. Because of all the benefits that a proper medical insurance can offer to you and your family, it is considered to be of immense importance.

Health Insurance Policy and its Care Coverage

Life is all about experiencing the best of it in doing anything. Health insurance understands the importance of these experiences and that such experiences can rejoice in true sense only when every individual is healthy and does not worry about the unforeseen medical problems.

The primary objective of a health insurer is to ensure good health to all its clients and eradicating their worries of probable health uncertainties which may arise in future. A health insurance plan helps you to safeguard you as well as your family against medical and financial risks. The insurer takes care of the hassles related to the client’s treatment so that he/she may stay away from all worries and could focus on their recovery only.

Care Coverage:

• Pre-Hospitalization coverage: All the procedures through which you undergo before your finally reach the hospital like investigative tests, routine checkups etc. are highly expensive. Such medical expenses are the coverage plans of a good health insurance policy.
• Ambulance coverage: To get a medical attention as soon as required is of utmost importance. That is why the expenses incurred while using the services of road ambulance during or before your hospitalization is also reimbursed by good health insurance policy. 
• Hospitalization for more than 24 hours: All the nursing plans. Surgeon’s screen, anaesthesia, doctor’s fee, OT charges etc are usually paid by the insurer.
• Hospitalization for less than 24 hours: The expenses incurred in providing you one daycare are also covered under health care procedures.
• ICU charges: In case of emergencies, your primary focus should lie on your recovery. Your agents are there to look after your treatment expenditures.
• Lifelong renewability: A good health insurer will never leave you in the middle of your journey and honour his commitment by providing lifelong renewability schemes to renew your policies.
• No age limit for enrollment: To enrol into a health care plan, there should not be any age limit.

It is now recommended to buy online mediclaim policy that offers you healthcare products to individuals, family and even to corporates. Health insurance is a new concept and has made a significant progress in a very short period all because of the security schemes it offers. To buy online mediclaim policy is a good option as you can compare which policy is best to hold, also, it reduces paperwork and unnecessary formalities.

 

How does a mediclaim plan work?

Before you buy an online mediclaim policy, you must know the procedure of its working. The claims are of two types- cashless procedure and other is reimbursement. While you buy an online mediclaim policy, go through each policy and make a comparison to go for the one which suits your need the best way.

Cashless Procedure:

It is that type of mechanism, where the patient is admitted or treated in our network of hospitals and thereafter the insurer will settle down the claim, either a part of it or full with the concerned hospital. This means that the patient needs not to give even a single penny to that hospital. For a smoother claim process, follow these steps:

At first, in all the empanelled hospitals, you will find an insurance desk within the hospital premises. The policyholder should obtain from there the pre-authorisation form, fill it duly with all your correct details as any wrong information or any omission will delay your entire claiming process. The form is stamped by your hospital and the company approves your assured sum and thereafter a fax is sent back to the same hospital stating that an amount ‘X’ is sanctioned for treatment.

Reimbursement:

If you want to get reimbursement, you should inform your insurer about your hospitalisation or if the hospitalization is likely to happen in near future. Either you send an email or inform by making a phone call. For acquiring reimbursement, submit all your payment receipts, medical bills of all medicines even if bought from an outside chemist. Make sure to get your original discharge slip, slips of final payment of bills, so that reimbursement can be given to the person.

Checklists before you buy a mediclaim plan:

• Individual plans and combo plans for the family: In an individual plan, every individual should be insured for a specific sum, whereas in a family floater, all family members are insured against a fixed amount. In some plans, if the primary person of the family dies, under the family floater scheme, the policy will be closed and even the young members of the family cannot renew it. Whereas, In some cases of individual plan, the individual can be insured on different parameters. But the attainment of specified age will not have any impact on the coverage plans of family members.
• Renewability Age: Although the policy offers you the coverage for just a year, in actuality some insurance providing companies like Medimanage believe in strong and long-lasting relationships with their customers. So the insurance policy will cover you for your lifetime.

Medimanage is a top health insurance policy in India which focuses on providing unbiased healthcare solution. They have professionals who provides expert advise and then owns the responsibility to service the product. It is the best health insurance agent whom you can rely on.