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.