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Things Covered in a Health Insurance Policy

Health Insurance Claim

Health Insurance is one Product that every individual household must have in order to secure their family members from the exorbitant expenses that may arise due to an emergency of sudden illness. Getting Adequate Health insurance coverage provides peace of mind with the promise of assistance whenever the need arises. It affords you the best medical treatment.

Cashless health insurance is one of the types of health insurance policies. Cashless health insurance plans are effective and valid only within the network of hospitals that are associated with the insurance company. All you have to do, while getting treatment in any of these network hospitals, is to simply file claim and the hospital bill will be settled by the insurance company and medical care provider.

Therefore, you need to carefully go through the list of network hospitals and get your treatment from amongst them. Cashless health insurance plans generally cover prescription medicines, stay in the hospital and other treatment related expenses. Cashless health policy saves your precious time from first settling the bill and then following the procedure of filing the claims and so on.

POLICY BENEFITS- What is covered in a normal health Insurance Policy ?

In-Patient Hospitalisation Benefits :

  1. Room, Boarding, Nursing Expenses as given below :- Single Standard A/C Room or Room rent as per limit in your policy.
  2. Surgeon, Anesthetist, Medical Practitioner, Consultants & Specialist Fees.
  3. Anesthesia, Blood, Oxygen, Operation Theatre charges, cost of Pacemaker etc.
  4. Cost of Medicine and drugs
  5. Ambulance Charges : Emergency ambulance charges up to a sum of Rs.1000/- per hospitalisation.

Pre & Post Hospitalization

Pre-hospitalization medical expenses incurred up to 30 days are payable.

Post-hospitalization medical expenses incurred up to 60 days are payable.

If you intend to undergo a medical procedure in Health Insurance Claim , it has to be duly informed to the insurance provider with details like the hospital, concerned doctor and the medical procedure etc. It also provides cover for day care expenses as well as medical emergencies. You need to preserve all the relevant medical reports, documents and the bills in order to utilize the health care plan to its optimum level.

In the event that the expenses of hospitalization or the overall treatment exceeds the pre-approved sum in the policy, the remaining or the balance amount is to be paid by you. Health care provider usually informs the policy holder if such situation arises. However the costs like the admission fee, the visitor’s fee, toiletries etc are not covered under the cashless health insurance policy.

Only 27% of Indians have health Insurance and others are at a constant risk of bankruptcy.

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