November 15, 2024

Health Insurance Prerequisites That You Should Know About

Health Insurance Prerequisites That You Should Know About

Did you know you might be subjected to a medical examination before you receive a health insurance coverage? This is one example of the many thing you must know before buying a health insurance cover. When buying one, not many are aware about such prerequisites. This often leads to confusion when buying and an unhappy policy coverage till the next renewal. To avoid all this hassle, this article elucidates some of the basics that you should know whether it is offline or online health insurance plan.

#1 Medical check-up

A medical check-up is one of the major preconditions to remember when buying a health insurance cover. Whether you purchase online health insurance, or opt for the traditional approach, insurance companies require you to submit a medical report. This medical report helps your insurance company assess the risk that they are about to assume if an insurance cover is extended to you. Moreover, it also helps determine the premium for your policy. An individual with no ailments will have a lower premium when compared to one with pre-existing conditions.

#2 Hospitalisation requirement

Some insurance plans require you to get hospitalised for at least 24 hours to avail health insurance benefits, but not all plans. Some insurance companies offer the benefit of day-care facilities included in the base coverage. Here you need not get hospitalised since many modern-day treatments like cataract procedures, radiotherapy, chemotherapy, dialysis, tonsillectomy, etc do not require you to get hospitalised. Apart from hospitalisation requirement, you also need to confirm whether your insurance cover includes pre and post treatment expenses. Different insurance companies have coverage for different period. So, confirm whether these coverage form part of policy’s scope.

#3 Cashless facility

You would be surprised to know that cashless treatment requires a shorter settlement time as compared to a reimbursement mode. The primary reason being the insurance company settles the admissible medical expenses directly with the insurer and requires only the balance from the policyholder. On the contrary, in reimbursement mode, the insurance company evaluates the eligibility of the expenditure as per your policy terms and then settles the claim with the policyholder. While you can avail a reimbursement mode from any medical facility, cashless treatment can only be availed at a network hospital. These network hospitals are those that are affiliated with the insurance company. Health insurance plans for family largely benefit from this cashless facility since you need not liquidate your investments to repay the medical bills. Thus, make sure to check for the availability of cashless facility with your insurance provider at the time of purchase.

#4 Waiting period

Another essential prerequisite when buying a health insurance cover is the waiting period of your policy. If you have any pre-existing disease or ailment, the insurance company levies a waiting period wherein no insurance coverage is offered for this specified duration for that particular pre-existing ailment. On the other hand, some insurers may even charge a loading amount for offering coverage from day one.

#5 Cooling-off period

At the beginning for a specific period, the insurance company doesn’t cover the treatment for any ailments. This is called as the cooling-off period and is specified in your policy terms. Make sure you know about the cooling-off period but also ensure it covers hospitalisation due to accidents.

Keep in mind these health insurance necessities before you finalise your purchase. These requisites are not only limited to any specific type like health insurance for senior citizens, but instead are applicable to almost all health insurance policies. So, make the right choice before buying a suitable coverage for your family.