Where heart attacks and accidents can happen anytime, healthcare costs are only increasing, Mediclaim becomes crucial as it covers all your medical expenses. Let us first understand what Mediclaim policy actually refers to. More importantly, how does it work and why should one should set up such mechanism?
A Mediclaim policy is thus a health insurance product that covers expenses incurred for hospitalization and medical treatment of an individual up to a limit. It is a policy that where the policyholder is reimbursed the cash spent on the treatment or wherever the insurer pays the bill with the facility where the policyholder is being treated—if the facility is affiliated with the insurance firm. Simple, right? Well, not quite. This idea may sound quite basic, but it quickly descends into a web of complicated terms, exceptions, and small print to be aware of.
Why are Mediclaim Policies so Important?
Here’s the thing: Medical expenses are unpredictable with regard to their time of occurrence and their magnitude. A simple flu could lead to a several-days’ hospitalization. A minor break might turn into other problems down the road. Today you have no sign of the disease, but the next day you could look a completely different picture. In such circumstances, bearing the costs incurred in hospital and other treatments is often overwhelming. This is a role that Mediclaim policies play, as **effective shields** which minimize the impact of such incidental costs.
Imagine this: an emergency operation, Road traffic accident or chronic disease that necessitates frequent visits to the hospital. In fact for the majority of people, even one such episode food could seriously stretch their income. Mediclaim policies are the safety net, intended to help you rebound when falling down. They make sure that whether you or any of your families become ill, affected or injured, it is not necessary that you spend all your savings or struggle over payment at the end.
But wait, there’s more! Mediclaim is not only a saviour from those skyrocketing medical expenses. And it releases you from worry, to feel that you have provided for the future of your health.
What is Mediclaim Policy and How does it operate?
Let’s break this down. When you buy a Mediclaim policy, there is an understanding between the buyer, who is the policy holder and the company, that the buyer will provide a premium – this can be a lump sum at the beginning of the year or several instalments in different months of the year. In exchange, the insurance company offers to cover specific types of medical costs that you may incur in the future, but here’s the kicker: there’s a catch. That is known as the sum insured. This is the figure up to which each sickness or injury will be covered during the effective time of the insurance policy. In case with the provided services and products any costs which are over the indicated amount will be charged on you.
Now, some of you may be thinking, “Well, that sounds like taking a risk.” In a sense, it is. It is believed that you will use the money in insured amount only and the insurance firms on the same note expect you will not require high cost medical care than your policy allows for. Though, that’s just the relief of the matter. A Mediclaim policy presents a number of layers of conditions, exclusions, waiting periods, and sub-limits that on one note serve as benefits but often prove to be quite a hassle.
For example, there is some time, which people have to wait to get a particular disease treated. A lot of insurance plans will not include pre-existing conditions or specific procedures such as surgeries for a certain period of time, thus a lot of costly preventable diseases could develop or progress within the first couple of years of their insurance policy. Well, it is very important to have this especially when NAV goes up with lovely ‘surprises’ that are hidden in the policy you never really read.
Types of Mediclaim Policies: Diverse and Confusing
However, not all Mediclaim policies can be described as the same. Indeed what is offered can be almost bewildering. In broader categories you have got an individual policies in which one person is covered by the policy and family floater policies in which entire family can be covered under a single sum insured. There is then the senior citizen Mediclaim policies targeting the elderly who of course know that they spend a lot of money on their health issues maybe because of their age bracket.
There’s more. One can also obtain group Mediclaim policies from the employer whereby the policy only has a fixed package of benefits for everyone. However, they might not afford the high-here health care needs or families which have many dependents. Some also provide in domestic treatments where admission in the hospital is not required but home treatment such as IV therapy or other forms of nursing care are provided for.
Are you overwhelmed yet? Good! Although knowing thesmall letters is half the job when talking about Mediclaim policies.
Cashless Mediclaim: A Blessing in Crisis
Now, let’s talk about a key feature of many Mediclaim policies: cashless claims. To have to run around trying to get funds in the middle of a medical crisis only makes the situation worst than it is. And that is where the concept of cashless Mediclaim gains its importance. Here’s how it works: If the patient is admitted to a network hospital, then there is no charge that the patient has to make from his/her pocket. But in your case, your insurer pays the bill on your behalf of the hospital directly.
However, the move of making cashless facility is highly beneficial because it takes out heavy burden of having to spend cash on the spot. However, and this is always the catch – there is a catch – this facility only services hospitals that come under the umbrella of the insurer. If you go to a non-network hospital, you might still be able to claim back your money but it is a much more complicated process, where you need to surrender and submit several papers, proofs of expense, and then wait for weeks, or even months, to get your money back.
Some of the points would-be Mediclaim policyholders need to bear in mind before they zero in on a particular plan.
There are quite a number of aspects that you need to consider when you are interested in getting a Mediclaim policy. It’s not just a matter of identifying which company has the lowest premium in their insurance policies. For this reason, the cheapest policy may turn out to be very expensive, for it may provide very little cover or come with very many conditions. So, how do you choose?
First and foremost, glance at the sum insured – let me be clear, you are not going to be happy being tied to a policy that offers inadequate cover as per the major treatments accessible in the current health system. The next thing should be to confirm the **waiting periods especially where you have some pre-existing conditions. It takes years before some policies will agree that they will attend to such conditions while others exist with a specific waiting period.
You should also evaluate the network hospitals under the policy. When you get a cashless society, it is such a relief and if your area of residence enjoys such a facility then it’s lucky indeed. And don’t forget the co-payment clause: for some policies you are supposed to pay some of the medical bills and this turns to be rather costly in the long run if you do not plan your finances well.
Conclusion
A Mediclaim policy is not simply to provide for hospital bills; it is about protecting your future against the unforeseen. It is a combination of budgeting and worry free, but only in the one you select. Thus getting a Mediclaim policy may seem like walking through a magical labyrinth fraught with several surprises. However, for those who take the time to understand them, read up on them and be smart about them – they could quite possibly be one of the best investments you will ever make.
However, go further, check the available plans, read the small print and find out whether the policy you select meets your healthcare requirements and financial capabilities.