Health Insurance - Best Plan and Guide

Meilleur plan et guide pour toutes les polices et tous les régimes d'assurance maladie.

💠Health Insurance - Best Plan and Guide

A Health Insurance Policies would be normally covers all the expenses necessarily & reasonably incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured.

Room, Boarding expenses

Nursing expenses

Fees of surgeon, anesthetist, physician, consultants, specialists

Expenses includes like medicines, anesthesia, surgical appliances, blood, oxygen, operation theatre charges, drugs, diagnostic materials, Radio therapy, cost of pace maker, Artificial limbs, X-ray, Dialysis, chemotherapy, cost or organs and similar expenses.

💠Sum Insured

The Sum Insured offered in insurance may be on an individual basis or on floater basis for the family as a whole.

💠Cumulative Bonus (CB)

A health Insurance cpmpanies policies may offer Cumulative Bonus for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal subject to a maximum percentage (generally 50%).

💠Cost of Health Check-up

Health policies may be also contains provision for reimbursement of cost of health check up. You should read your full policy carefully to understand what is allowed.

💠Minimum period of stay in Hospital

In order to become eligible for doing a claim under the policy, minimum stay in the Hospital is necessary for a certain number of hours. Usually this is 24 hours. This time limit may be not applied for treatment of accidental injuries and for certain specified treatments.

💠Pre and post hospitalization expenses

All the Pre and post hospitalization expenses included in during certain number of days before to hospitalization & after hospitalization expenses for specified period from the date of discharge may be considered as a part of the claim provided in the expenses relate to the disease / sickness. Go through the specific provision in this regard.

💠Cashless Facility

Insurance companies may have tied-up arrangements with a network of hospitals in our country. If policyholder takes treatment in any of it's network hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company itself through its Third Party Administrator will arrange it's direct payment to the Hospital. Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured also can take treatment in a non-listed hospital but in this case he/she has to pay the bills first and then seek reimbursement from Insurance Company There will be no cashless facility applicable here.

💠Additional Benefits and other stand alone policies

Insurance companies may offer various other benefits as 'Add-ons' or riders. There are also stand alone policies that are designed to give benefits like 'Hospital Cash', 'Critical Illness Benefits', 'Surgical Expense Benefits' etc. These all policies can either be taken separately or in addition to the hospitalization policy.

💠Exclusions

The following are generally excluded under health policies:

All pre-existing diseases.

Under 1st year policy, any claim during the first 30 days from date of cover, for sickness / disease. This is not applicable for accidental injury claims.

It excludes 1st year of cover in cases like Hysterectomy for Menorrhagia or Fibromyoma, Cataract, Benign prostatic hypertrophy, Hernia, Hydrocele, Congenital Internal diseases, Fistula in anus, piles, sinusitis and related disorders.

Circumcision unless for treatment of a disease

Cost of specs, contact lenses, hearing aids

Dental treatment / surgery unless requiring hospitalization

Convalescence, general debility, congenital external defects, V.D., intentional self-injury, use of intoxicating drugs / alcohol, AIDS, Expenses for Diagnosis, X-ray or lab tests not consistent with the disease requiring hospitalization.

Treatment relating to pregnancy or child birth including cesarean section.