Health Insurance Plan Settings

Health Insurance Plan Settings

1) Maximum renewal age: The maximum renewal age is the age to which a person can receive insurance cover. This parameter is the most important factor as the need for health insurance with age is felt. Therefore, you must search for the plan that offers the longest contract extension.

2) Lower limits: Lower limits are limit values ??that apply to the different service areas. There is a maximum limit that the insurer must pay for certain expenses during treatment. For example, some insurance companies have set a ceiling on the rent that they would repay. If, in such a case, the costs incurred exceed the limit set by the insurer, the remaining amount must be paid by you. There would be other lower limits on how to consult the doctor,

3) Maximum insurance cover: This is the maximum amount for which a person may qualify for insurance cover. Each insurance company has its own insurance for the sum insured. The choice of coverage depends on our needs and solvency. The sum insured varies between 2 and 50 lakhs, depending on the insurer.

4) Costs before and after hospitalization: This includes the cost of medical tests, medications, tests, etc. incurred during the pre-and post-hospitalization period. According to the insurer, the insurance period can be 30 days before the hospital stay and a maximum of 180 days after the hospital stay.

5) Preconditions: Some insurances cover pre-existing illnesses after a defined waiting period for continuous renewal. For example, a policyholder with diabetes would be insured according to his or her age and their plan selected after a waiting period of 3 or 4 years. We have to choose the insurance plan that has the least waiting time.

6) Day Treatments: Some illnesses or treatments are covered even if a 24-hour treatment in the hospital is not required. This is usually a mandatory clause.

7) Ambulance costs: If the policyholder has to be hospitalized, the insurance companies reimburse the costs of transporting the ambulances. Every company has a fixed amount as an ambulance fee.

8) Medical Testing: Companies have a list of pre-defined medical tests that a person must complete if they are over 45 years of age or the amount requested exceeds a certain amount. The obligation to examine is different. In addition, these tests are fully supported by the insurer.

9) Non-recoverable premium: If the policyholder did not claim the "cover bonus" in the past year, either by reducing the premiums or by increasing the sum insured.

10) Tax benefit: The amount paid as a bonus entitles you to an income tax deduction in accordance with § 80 (C).

11) Non-allopathic treatments: Some insurance companies cover Ayurveda, Unnani and homeopathic treatments.

12) Cosmetic and other operations: In most cases, insurers do not cover cosmetic surgeries, dental implants, weight loss or surgery.

13) Network Hospitals: These are hospitals that are affiliated with insurance companies to offer cashless treatment. On the basis of the health card provided by the TPA (third party administrator) you have the right to receive a treatment without payment.

14) Treatment at home: In many cases, the patient must be treated at home and not admitted to hospital. In such cases, many insurance companies pay back the processing fees.

15) Additional payment: this means that the costs are shared between the policyholder and the insurance company. If a particular company defines the co-payment option as 10% of all claims submitted, you will have to pay 10% of the cost and the insurer will pay 90%.

16) Debt relief: additional fees will be charged for any additional premium that follows a year in which a claim has been made. These fees depend on the requested coverage. The premium fee can be very high in some cases. Always check the additional premium fees of the companies.