Most Asked Questions About Health Insurance?

There is a growing awareness about buying health insurance plans, yet, a lot of doubts remain. Let us have a quick look at the list of top 10 FAQs in health insurance to attain a better understanding of the health insurance concept,

List of FAQs in Health Insurance

Q. 1) Can I claim health insurance from my and my spouse’s company if we both have media claim plans?

Yes, you can do so! If you’re covered by your employer for an amount of Rs. 2 lakhs and also have coverage under your spouse’s plan from his/her employer for another Rs. 1 lakh, then you can file for reimbursement to a maximum of Rs. 3 lakhs. The only thing to be kept in mind is that you should first file a claim with your company and then with the spouse’s company.

Q. 2) Will health insurance cover only surgery or all kinds of hospitalization expenses?

A health plan provides cover for accidents, surgeries, and even normal hospitalization for any treatment. The only requisite is that the insured needs to be hospitalized for a specified number of hours.

Q. 3) Is there a guarantee that claims will be approved?

The claims will be approved provided you have given complete and accurate information to the insurer at the time of buying the policy. Also, at the time of hospitalization whether it is planned or in an emergency, do update the insurer and provide all necessary documentation. If everything is according to the policy documents and meets the required terms and conditions, the claims will be approved.

Q. 4) How to study policy documents?

You must be aware of policy details. The things to look out for are: check what is not covered in your health plan, what are the limits set by the insurer on various kinds of treatments like cataract surgery, maternity benefits, room rents, etc. This will ensure you don’t get any nasty surprises at the time of filing a claim.

Q. 5) Can premiums change over the years?

Yes, the premium is subject to change depending on the claims you have filed. Even if no claims are filed, based on age the insurers charge different premium amounts. The good part is they have age brackets like 25-30 years, 30-35 years, and so on and so forth. So if everything else remains the same and you belong to a particular age bracket, the premium will only increase if you move on to the next age bracket.

Q. 6) Do I require one health policy or more?

One is enough if you have an adequate sum assured with it. Having 2 separate policies is a wise idea if you want to separate the risks. For example, you can have one with you, your spouse and children and another with your parents. But only if the health plans are offering substantial benefits and are affordable.

Q. 7) Can I get treatment from different hospitals?

Ideally, you should select the best network hospital to get treatment from, but for some reason, you have to change hospitals, you can still health insurance benefits. However, it would be subject to approval from the third-party administrators (TPA), who would evaluate your situation and will check if you meet the terms and conditions of the plan.

Q. 8) What should I do if there is any dispute with the insurance company?

For all disputes, you can first approach the customer complaints cell of the Insurance Regulatory and Development Authority of India (IRDAI), and if you don’t get a solution there, you can then approach the Grievance Redressal Cell of IRDAI.

Q. 9) What is Critical Illness and Why is it Important?

Critical illness covers life-threatening diseases like cancer, bypass surgeries, kidney aliments, stroke, etc. and their treatment is very expensive. Having a critical illness rider or a standalone critical illness policy helps you to cover the financial risks associated with these diseases. The insurer pays the lump sum amount at the time of diagnosis of any of such diseases instead of waiting for hospitalization.

Q. 10) Can I be denied cashless hospitalization?

If you are admitted to a non-network hospital of the insurance provider or if your ailment is not covered as per the terms of the policy, the insurance provider can deny you the cashless benefits. Therefore, it is important to read the terms and conditions carefully to be aware of such details.

Q. 11) What is a sum insured in health insurance?

If the agent is telling you about the policy, then he tells you about a fixed amount which you get on claiming in a financial year is known as sum insured.

Q. 12) Can I purchase two medical insurance policies?

Yes, you can buy two different policies for covering yourself properly. As per IRDA’s new norms, anyone can buy two different policies and he’ll also get the claim of both policies, but you’ll need to know that how will you get a claim from both.

Q. 13) What do you mean by a pre-existing disease?

Pre-existing disease means that the disease which is already in your body before taking the policy or the disease which you are suffering from right before taking the policy is called pre-existing disease most of the policies never include PED with their plan to cover.

Q. 14) What is a free-look period in health insurance?

While buying a health policy, if you think that this won’t be going to work or you are not satisfied with the policy, then you have 15 days as a free-look period. In between 15 days, you can cancel the policy and it won’t charge any penalty.

Q. 15) What to do if I am admitted to a non-network hospital?

First, you need to know that, is your policy provides you with cashless hospitalization because in this case, you have to inform your insurance company before getting admitted to a non-network hospital. Second thing, if your policy is not offered you cashless hospitalization then you have made claim and, medical bills, hospital bills are mandate documents.

Q. 16) What is the benefit of buying health insurance at a young age?

As younger as you can buy the policy, it’ll more beneficial for you because with time you can transfer your individual policy to a family floater policy.

Q. 17) What are those ways by which you can find the best health policy?

There are certain ways through which you can find the best policy for yourself.

Hope these Health insurance FAQs helped you clear a lot of doubts.

For any more FAQs in Health Insurance or queries, feel free to write to us or visit https://www.comparepolicy.com for all the necessary information.