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While we all are aware of how a Mediclaim policy helps one to deal with exorbitant medical bills, therefore, one should be aware about the steps they need to follow to buy the best Mediclaim policy.
In this article, we are going to discuss how a Mediclaim policy works, reasons why you need a Mediclaim policy and some tips which will help to choose the best Mediclaim policy.
How Does Mediclaim Policy Work?
A Mediclaim policy is a plan offered by an insurance provider where the insurer pays for the medical bills incurred by you or your family members in case of severe illness.
To understand how does a Mediclaim policy work, one needs to be aware about what is included and what is excluded from the policy.
Inclusions in a Mediclaim policy
There are some common expenses which are covered in a Mediclaim policy. Here’s a list
1. Hospital charges
It includes expenses of oxygen cylinder, blood, organ donor expenses, room charges, organ donation, tests.
2. Day Care Treatment –
Here, any treatment which does not require the individual to be hospitalised for more than 24 hours is covered.
1. Pre and Post Hospitalisation –
Several Mediclaim policies tend to include the expenses that are incurred before and after the policyholder is admitted in a hospital.
2. Hospital Stay –
When a policyholder is admitted in a hospital, the hospital authorities charge for the room rent, ICU charges. These can be availed under the Mediclaim policy.
3. Consultation charges
Most of the Mediclaim policies cover doctor fees. Since these days, the doctors charge exorbitant fees.
Source:https://www.irdai.gov.in/admincms/cms/Uploadedfiles/BAJAJ15/Mediclaim%20Insurance.pdf
Exclusions in a Mediclaim Policy
There are certain parameters which are not covered in a Mediclaim policy. Here’s a list: -
1. In a Mediclaim policy, pre-existing illnesses are covered only after the waiting period is completed.
2. In cases of plastic and Cosmetic Surgery
3. In cases of external devices such as planting hearing aid or contact lenses.
Exclusions in a Mediclaim Policy
There are certain parameters which are not covered in a Mediclaim policy. Here’s a list: -
1. In a Mediclaim policy, pre-existing illnesses are covered only after the waiting period is completed.
2. In cases of plastic and Cosmetic Surgery
3. In cases of external devices such as planting hearing aid or contact lenses.
Why Do You Need a Mediclaim Policy?
In case you or your family members need medical attention, getting access to a hospital can be financially draining. So, it is better to plan your finances well in advance and buy a Mediclaim policy.
Here’s a list of reasons why you should get a Mediclaim policy for yourself or your family members
1. To deal with lifestyle related illnesses
Due to our sedentary lifestyle, lifestyle diseases are rapidly rising. Especially among people below the age of 45 years. Diseases such as diabetes, stroke, obesity, which were earlier common among older people, have now started affecting the younger generation.
So, one should be smart and opt for a good Mediclaim policy which covers regular health check-ups. Early detection of severe illness can help one to manage their illness as well as take care of medical expenses.
2. To protect your family
When you search for the right Mediclaim policy, you can opt for a family Mediclaim policy. This is because it covers all your family members such as spouse, children. Getting a family health insurance policy is a smart decision as it helps you to alleviate undue stress about exorbitant medical costs.
3. To access additional cover
If you are someone who has already invested in a Mediclaim policy, it is a good option to get an additional Mediclaim policy.At times, a policy doesn’t offer a wide coverage. In such a case, it is wise to opt for a policy which offers coverage for unforeseen situations in the near future such as critical illness. With a rise in medical treatment, investing in a higher sum assured allows you to take care of your finances.
4. To deal with medical inflation
Due to rising inflation, there has been a rapid increase in the costs of doctor's consultation, diagnosis tests, ambulance charges, operation theatre costs, medicines, room rent. All these factors can cause immense financial burden. If you pay an affordable premium every year, you can avail medical facilities at an optimum rate.
5.To safeguard your savings
In case you or your loved one undergoes a serious illness; it can put a strain on your finances and can also cause you mental anguish and stress. Therefore, it is a good idea if you have opted for a Mediclaim policy. When an insurance provider offers a Mediclaim policy, they require you to avail cashless treatment. It is a good facility as you don’t have to stress about reimbursements.
4. To deal with medical inflation
Due to rising inflation, there has been a rapid increase in the costs of doctor's consultation, diagnosis tests, ambulance charges, operation theatre costs, medicines, room rent. All these factors can cause immense financial burden. If you pay an affordable premium every year, you can avail medical facilities at an optimum rate.
5.To safeguard your savings
In case you or your loved one undergoes a serious illness; it can put a strain on your finances and can also cause you mental anguish and stress. Therefore, it is a good idea if you have opted for a Mediclaim policy. When an insurance provider offers a Mediclaim policy, they require you to avail cashless treatment. It is a good facility as you don’t have to stress about reimbursements.
Also, you can use your savings to fulfil other plans such as sponsoring your child’s higher education abroad, building a home, spending your savings on your children’s marriage.
Moreover, a Mediclaim policy allows to avail tax benefits as per prevailing tax laws, subject to change. Overall, with the help of a Mediclaim policy, you can plan better for your post retirement life.
Tips to Choose the Best Mediclaim Policy
We understand the importance of the best Mediclaim policy. Therefore, we have curated a list of tips which will help you to choose from among the best Mediclaim policies in India for yourself and your loved ones.
Here’s the list-
1. Always look for plans which offer a wide network of cashless hospitals
Once you have selected the type of coverage you want, you can compare the different types of plans. The first factor one should keep in mind is the policy should provide a wide network of cashless hospitals. This is because you can easily avail cashless treatments in a network hospital during a medical emergency. It helps you to focus on getting the treatment for the illness instead of worrying about the mounting bills. Max Life Insurance offers a wide network of cashless hospitals where a policyholder can avail treatment and we will settle the bills directly with the hospital.
2. High Claim settlement ratio
Another tip you must follow is to look out for an insurer whose claim settlement ratio is excellent. In simple words, a claim settlement ratio is the percentage of claims which an insurance provider is able to successfully clear in a financial year.
So always opt for an insurer and a Mediclaim plan which has the highest claim settlement ratio.
3. Limits and capping
In case a policyholder is hospitalised, the hospital charge bills under various sub heads like ambulance charges, room-rent charges. Thus, you should invest in a Mediclaim policy which has low or zero limits and caps. It will help you to avail more compensation when you file a claim.
4. Short waiting periods
Many Mediclaim policies have a waiting period for pre-existing conditions. The waiting period can be 1 to 4 years. Therefore, you should buy a Mediclaim policy which has a short waiting period. There are some insurance companies which offer premium loading- it means if you want to reduce the waiting period, you pay a higher premium.
5. A budget-friendly premium
One of the most useful tips to ensure that you select the best Mediclaim policy is to opt for an affordable premium. Always look out for a plan which offers a good coverage and is well within your budget.6. Buy a plan at a young age
Choosing to invest in a Mediclaim policy offers many advantages. Since you are young and healthy, you can get plans at lower rates. Also, you can avail wider coverage options. A lot of Mediclaim policies have a pre-existing waiting period. This means they exclude coverage of pre-existing illnesses. Because you are young and fit, this waiting period will end while you are still young. Therefore, you will the advantage of exhaustive coverage for situations where you may fall sick in your old age.
5. A budget-friendly premium
One of the most useful tips to ensure that you select the best Mediclaim policy is to opt for an affordable premium. Always look out for a plan which offers a good coverage and is well within your budget.6.To safeguard your savings
In case you or your loved one undergoes a serious illness; it can put a strain on your finances and can also cause you mental anguish and stress. Therefore, it is a good idea if you have opted for a Mediclaim policy. When an insurance provider offers a Mediclaim policy, they require you to avail cashless treatment. It is a good facility as you don’t have to stress about reimbursements.
Frequently Asked Questions (FAQs)
Q1. What are the features of the best Mediclaim policy in India?
The best Mediclaim policy offers
1. Cashless facility at network hospitals
2. Available for both the policyholder and their family
3. It offers tax benefits
Q2. What are the benefits of the best Mediclaim policy?
Here’s a list of benefits of the best mediclaim policy
1. To deal with lifestyle related illnesses
2. To protect your family
3. To access additional cover
4. To deal with medical inflation
5. To safeguard your savings
6. Buy a plan at a young age
Q3. What is a mediclaim policy?
A Mediclaim policy is a plan offered by an insurance provider where the insurer pays for the medical bills incurred by you or your family members in case of severe illness.
Q4. What are the inclusions in the best mediclaim policy?
Here’s a list of inclusions in the best mediclaim policy
1. Hospital charges
2. Day Care Treatment
3. Pre and Post Hospitalisation
4. Hospital Stay
5. Consultation charges
Q5. What are the tips to buy the best mediclaim policy in India?
Here’s a list of tips to buy the best mediclaim policy in India
1. Always look for plans which offer a wide network of cashless hospitals
2. Good Claim settlement ratio
3. Limits and capping
4. Short waiting periods
5. A budget-friendly premium
Q6. How do I choose my Mediclaim policy?
- Right coverage amount
- Compare various quotes online
- Make sure the insurer has a high claim settlement ratio
- Suitable policy is one which is affordable
- Taking into account the hospitals being covered
Source:
https://www.un.org/en/chronicle/article/lifestyle-diseases-economic-burden-health-services
https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-health-problems-youre-actually-not-too-young-for
https://www.irdai.gov.in/ADMINCMS/cms/whatsNew_Layout.aspx?page=PageNo3916&flag=1
https://www.policyholder.gov.in/uploads/CEDocuments/Guidelines%20on%20Standardization%20in%20Health%20Insurance%202016.pdf
ARN No : Jan22/Bg/25B
