Lesser Known Facts about a Mediclaim Policy

by Vinaya HS on December 17, 2015

in Finance

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Mediclaim policy is the safest and best to protect you and your family with financial security against any medical emergencies. But it is very important that you buy your medical insurance only after thorough research and carefully reading about the terms and condition of the policy.

Mediclaim policy is especially very important for you and your family if you are the only breadwinner of the family. A sudden medical expense can often cause financial instability.

Most of the working population in India has realized that it is crucial to have medical insurance. But there are many facts that insurer’s are unaware of. Here are some of the most important clauses, terms and conditions that you must know about:

  • Permission for Changing Hospitals in Between Treatment: There are only a few insurance companies that pay the expenses even if you decide to shift to another hospital for better treatment or any other reason. So make sure that you read the terms and conditions regarding change of hospitals as many mediclaim policy companies do not reimburse the expenses incurred at the second hospital and so do not let you change hospitals as well.

  • Hospital Room Rent Sub-limit Dictated by Mediclaim Insurance Policy, India: Be aware of the room sublimit terms and conditions of your policy. Most mediclaim policies fix a percentage of the total sum assured as the sublimit of the room you stay in the hospital. It may go up to even Rs. 5000. If your house rent is more than that, the promised amount for other treatments is reduced proportionately. So make sure you read and understand the rent limit clause well for all the policies you are considering so that you can buy the best mediclaim policy in India.

  • Terms and Conditions For Co-Payment: Co- payment refers to a small percentage of medical expenses that has to be borne by insurer. Mostly, the percentage for co-payment is between 10% to 20%. The situations in which the policy holder may have to co-pay are:

  1. If you or any of your family members are seeking treatment in a non-network hospital.
  2. It is compulsory if the patient is 65 years or older.

A mediclaim policy is definitely a boon for the insurer as long as he/she reads through all the documents carefully and understands the terms and conditions well. It is a great way of ensuring good treatment for you and your family without worrying about the finances.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

Further reading:

  1. Commonly Used Terms and Phrases in the Health Insurance Sector

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