Everyone knows the benefit of having a mediclaim health policy in his or her life. However, a majority of the people in India do not go through the entire mediclaim policy booklet. You should understand every word written in the policy booklet for you to make the perfect claim. Even the best medical policy for family would include certain words that require explanations. Some of the insurance terms can appear like jargons. However, they are not. You should read and understand the same. We shall now look at some of the common terms in an insurance policy that could cause confusions in the minds of the people.
You should understand one point very clearly in India. The insurance cover is available only if your medical condition entails hospitalization for a minimum period of twenty-four hours in a network hospital. You may have doubts as to what constitutes a network hospital and what does not. In the past, this used to be an issue. Now, the insurance booklet contains the list of all network hospitals in India. The insurance companies update this list every year and provide you the latest one when you renew your mediclaim policy.
Pre-hospitalization and Post-hospitalization expenses:
This is a very positive aspect of mediclaim policies in India. In case you suffer from a disease that entails hospitalization, you can claim the pre-hospitalization expenses for a period of thirty days prior to your hospitalization. This entails that you should keep all your medical diagnostic test reports, medical prescriptions, as well as the bills ready on hand. At the same time, the insurance policy also covers the post-hospitalization expenses for a period of sixty days as well.
This term can be quite confusing for the policyholder. You can see the rejection of many claims due to this factor. Hence, it becomes imperative for you to understand as to what is a pre-existing disease. This could include any disease or symptoms of the disease you might have had or shown prior to purchasing the insurance policy. You have to make a declaration to this effect at the time of purchasing the mediclaim policy.
You should have a clear idea about what your insurance policy does not cover. This could include certain disease such as cataract, hernia, etc for a minimum period of two years. Subsequently, you may get the cover if you renew your policy on time. The insurance policy document would have listed out these exclusions clearly. Going through the same is to your advantage.
Many people believe that the insurance policy covers the diseases from the moment you take the policy. It is not so. There is a minimum waiting period of thirty days for any disease. The pre-existing disease could have a four-year waiting period whereas disease such as cataract etc can have a waiting period of at least one year.
Today the medical science has made tremendous advancements. Certain procedures such as eye surgery, chemotherapy, etc require less than twenty-four hours for treatment. The present day mediclaim health insurance policy has provisions to honor such claims as well.