mediclaim

What is Mediclaim Insurance/ Mediclaim Policy?

Media claims are the part of health insurance that acts as “a shield” against your medical expenses and also provides protection against unseen happenings in the future. You can avail the benefits of the policy by paying the cost called “Premium.” This plan comes with a defined tenure, after which you have to renew it.
Do not let hospital expenses to drain your pocket. Compare with different policies that are available in the market and make informed decisions.
Mediclaim policy is a general hospitalization benefit offered by both private and public sector insurance companies in India. This policy will cover all the below-given situations:

  1. Covers accident cases
  2. Covers sudden illness cases
  3. Covers surgery cases during the policy tenure

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process health insurance

Steps to get your insurance settled

When we buy a health policy, claim settlement is one area we panic the most. With our assumptions, we think the process is complicated because of the lack of proper awareness; it can indeed be hassle-free.
Today, we shall help you with the process to claim settlement on your health policy.
Claim settlements are done in two ways:

  1. Cashless claims
  2. Reimbursements

Steps for Cashless Claims

If it is a planned hospitalization (a situation where you are aware that after a few days, you need to avail medical treatment), you can go for a cashless settlement. Below are the steps you need to follow:

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terminology of health insurance

Terminologies of Health Insurance

Do you feel lost when an insurance provider starts talking about health insurance? When he uses the fancy jargons involved with health insurance? It’s OK—we know that the terminologies regarding health insurance can be hard to understand. Hence we have come up with these few terms that are often used with health insurance:

1. Allowable charge: it is also known as “allowed amount,” “maximum allowable,” and “Usual, Customary, and Reasonable (UCR)” charges, this is a fee that is charged by a health insurance company to be a reasonable charge for medical services or supplies based on the area where the service is being provided.

2. Benefit – the amount payable by the insurance company to a policyholder for medical costs.

3. Benefit level – the maximum amount that a health insurance company agrees to pay to the policyholder.

4. Benefit year – the 12 months for which health insurance benefits are calculated, not necessarily coinciding with the calendar year. Health insurance companies may update plan benefits and rates at the beginning of the benefit year.

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Health-Insurance

Reasons to buy a Health Insurance

“The task we set for ourselves is not to feel secure but to be able to tolerate insecurity.”
-Erich Fromm.

Health insurance is essential for every individual. A medical emergency can devastate anyone, anytime and impact an individual emotionally and financially. It is advisable if you to buy a health plan early in life. Here are the top reasons to convince you to purchase health insurance:

1. Start early

The health insurance premium is highly dependent on age, and there is a pitch in the premium slab post 30. For instance, if you purchase a health plan of Rs. 5 Lakh at the age of 25 years, then you need to pay a premium of Rs. 5000 but the same policy would cost you more at the age of 35, even with a change in your health indicators. Hence, buy a policy as early as possible to pay a lower premium.

2. Incidence of illnesses have increased

You don’t have to be 60 to buy health insurance. Inactive lifestyle has increased the occurrence of lifestyle disorders involving heart, cancer, lung conditions and stroke, stress-related hypertension is affecting young corporates who have no idea how unhealthy they are until something severe happens, and they wake up to reality. Moreover, health insurance policies offer annual health checks ups to encourage health awareness. Also, preventive services include counseling, screenings, and vaccines that help you to manage your health better.

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defined_benefit_plan

Understanding Defined Benefit Plan

Health insurance covers your unfortunate medical expenses. Your hard-earned money can be utilized for better. The cover you buy also includes pre and post hospitalization expenses and other benefits. On the other hand, defined benefit plans policy work the same.
Defined benefit plans are the type of health insurance plan where a predefined payment will be made to the policyholder on the occurrence of predefined events irrespective of how much expenses have been incurred as hospitalization expenses. Thus, the sum assured is not dependent on your hospitalization expenses — no need to furnish hospital bills or any other bills to claim the benefit.
Under the defined benefit plan, we have

  1. Critical illness plan
  2. Hospital Daily cash plan
  3. Any other health insurance plan which makes pre-defined payments to the policyholder on the occurrence of a pre-defined event irrespective of whether and how much expense has been incurred on treatment.

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indemnity-plan

What are Indemnity Plans?

Like other plans, an Indemnity plan will reimburse the cost of medical expenses to the policyholder. This plan will refund the actual amount incurred as an expense during the medication, and the reimbursed amount should be within an assured medical cover.
Indemnity health plans are also known as:

  1. Traditional indemnity plan
  2. Fee- for service plan

For example, the cost of cover is Rs 5 lakhs, and a hospital billing amount is Rs 2 lakhs. The company has to pay Rs 2 lakhs to the policyholder. The balance amount is left with the company until the maturity of the policy.
And this agreement with the company will be predetermined. The best example is the “Mediclaim Insurance Plan”- a popular health product.
Generally, this plan has a predetermined deductible. The part of medical expenses will be paid to the policyholder, and the insurance company will pay the remaining amount, and this is “co-pay.” Some health insurance plans will not have any deductibles, where the insurance company will incur the entire cost.

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health insurance

Importance of Health Insurance

“Good Health and Good Sense are two of life’s greatest blessings.”

There are plenty of reasons why health insurance is not just a good idea, but it is a necessity. The benefits will depend on the plans you buy and exclusions of the policy.
Many will face a financial crisis when it comes to medical emergencies and to meet the medical cost, people will switch into their savings, and they drain it entirely. So, in situations like this, a health insurance plan could be a real “life-saver” because it covers your hospitalization expenses.

Health insurance increases your accessibility to quality health treatments, including private healthcare, where the cost is still a barrier for many. Health insurance ensures you to get appropriate treatment promptly irrespective of their financial capability.
Especially in a country like India, people have a reduced capability to afford proper medical treatment. Medical insurance provides the much-needed financial stability to an individual.

Why is Health Insurance important?

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health-insurance

All about Health Insurance

Health is Wealth

At some point in life, everyone faces various types of health risks and uncertainties. And it’s important to understand these risks. Knowing the risks, you and your family may face can help you find ways to avoid health issues.

What are Health Risks?

A health risk is not something that will harm you or affect your health. Risk doesn’t mean that something terrible will happen; it’s just the possibilities. Health risks include your age, family health, and lifestyle.
There are some risks which can’t be changed. Such risks are “genes” (inherited diseases from your parents) while some risks are in your control like diet, physical exercises, etc.,
Your absence can devastate your family or your dependents. Thus, understanding the health risks can help you make smart and informed decisions.

How can you reduce the risk?

You can reduce the risk by transferring it to the insurance companies. Insurance acts as a “Financial tool” against your health risk. Let’s learn about “Health Insurance.”

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health insurance

Check out these points before you buy a Health Insurance

“In the end, it’s not the years in your life that count. It’s the life in your years.” 
—Abraham Lincoln

Buying health insurance is like a back-up plan for your life. Health insurance covers the whole or a part of the medical expenses incurred by you. Various insurance companies are offering numerous policies. The need for health cover is increasingly becoming more critical, and hence choosing the right health plan is essential.

Here are a few points that you need to check before you pick up a Health Insurance:

  • Lifetime renewability:

The regulating authority of health insurance companies is IRDA (Insurance Regulatory Development Authority of India). As per IRDA regulations, health insurance companies are mandatorily required to offer health insurance for up to 65 years. Most of the private companies do not have any such age limits in their plans. Once the policy is issued, individuals will be solely responsible for renewing the policy timely. If the individual fails to renew the policy, at the time of claiming, they will lose the real benefits of such a lapsed policy.

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hesitant about health insurance

Why people hesitate to buy a Health Insurance?

“Some things are so unexpected that no one is prepared for them. “
-Leo Rosten

We buy health insurance because we treat insurance as a means for saving money to meet hidden health expenses in the future. It will be challenging for a family to arrange the funds required for the treatment in case of emergencies. Thus, we can say that health insurance serves as a “financial tool” for an individual.
However, it is also necessary to have a clear understanding of health insurance so that you can be shrewd in your buying decision.

Here are some of the reasons as to why people are hesitant to buy health insurance:

  • Cost:

One of the main disadvantages of health insurance is cost. Paying the premiums can be very difficult for the middle-income group. And health coverage for all the members in the family seems like a burden to people, especially if he is the sole earner in the family. One must not consider paying premiums as a financial burden because, with health insurance, you are ensuring that you and your family can bear the cost of medical expenses without mortgaging any property or gold.

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