A Complete Guide to choosing the right Health Insurance Plan
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With coronavirus taking up a toll on millions of human lives for the last two years, getting health insurance is what we all need. With the increasing cost of healthcare, health insurance has become a necessary factor in the personal finance of every individual.
During a medical emergency, people often regret not having a health insurance claim which proves financial aid in such a crisis. Let us help you with choosing the right health insurance plan for you.
What is Health Insurance?
Health insurance is a type of insurance that covers all your medical expenses resulting from illness or an unforeseen accident leading to your poor health conditions. Health insurance includes your hospitalization and expenses of the doctors and the nurses.
Just for your knowledge, there are two types of health insurances:
- Mediclaim Health Insurance Plans– This is the most basic type of health insurance plan. It includes the total expense of your treatment while you are admitted to the hospital. The insurer pays off your entire cost once you submit your actual hospital bills.
This type of insurance covers all your family members depending on the bond that you have agreed to with some of their conditions applied.
- Critical Illness Health Insurance Plans– This health insurance plan includes specific life-threatening diseases requiring prolonged treatment. The insurer pays off only the critical illness that the customer chooses. It does not fit your hospitalization expenses.
Choosing the right health insurance plan
Choosing the right health insurance plan is a task in itself. It would help if you thought smartly when selecting one. When you have decided to buy a health insurance plan, choose an insurer who will satisfy all your needs. Here is what you should look for in your health insurance plan.
- Your health insurance plan should cover a maximum of critical or life-threatening diseases.
- The insurer should have tie-ups with an extensive network of hospitals, making it easy to get treatment at your nearest hospital.
- It should be flexible enough that you can choose a plan that suits you best.
- The plan should have a long life that is beneficial for you even in your old age.
- Select a health insurance plan that does not have any increase in its premium during its term.
How to claim medical insurance?
Before telling you about how to claim medical insurance, let me tell you about the types of medical insurance so that you can claim it accordingly.
There are two types of medical insurance:
- Cashless- This medical insurance offers you to be admitted to a medical hospital. The hospital welcomes you as it has a tie-up with your medical insurers. All you need to do is provide your medical insurance documents at the time of admission to avail yourself of the medical facilities. Cashless medical insurance is either planned insurance or emergency insurance.
- Planned– For a designed cashless medical insurance, you have to inform your insurers about your planned treatment before your hospitalization to avail the facility of your cashless treatment.
- Emergency– In case of an emergency, you can contact your provider to know about the nearest hospital that it has its tie-up with. Your medical bills will be paid by your insurance provider to the hospital following all the necessary and required documentation work.
How to claim Cashless Medical Insurance
- You should be admitted to the hospital that your insurer has a tie-up with (network hospital).
- Provide your health card to the insurance department of the hospital.
- Third-party administrator (TPA) pre-authorization to be sent to your insurance provider.
- Once you receive the authorization you will require documents.
- The insurance company provider will pay your bills directly to the hospital.
- Reimbursement– This medical insurance can be claimed If you get yourself admitted to a hospital that the insurance provider has no tie-up with. You cannot use the cashless claim facility here. You have to pay your entire hospital bills and then claim for reimbursement.
How to claim Reimbursement Medical Insurance
- Fill the insurance claim form
- Attach all your medical records like the medical bills, receipts, investigation reports, discharge summary, address and Id proof, NEFT details.
- Send all these attachments along with the form to the insurance company claim department.
- All these processes should be completed within 15 days of your discharge.
Conclusion
It is not just about buying the best health insurance plan for you and your family, but you must review your health insurance plan annually to ensure that the project you have purchased is suitable and relevant to your needs.