Retain the Facts and Dilute the Myths about Health Insurance

Health Insurance is one such proposition where people are surrounded by various myths, which reduce the utility and benefits of a health insurance policy for them.

November 15, 2016 5:08 IST | www.comparepolicy.com
Insurance is a vast subject and a layman may not understand the technicalities associated with an insurance policy. And due to the lack of insights, people tend to believe and trust certain myths. Health Insurance is one such proposition where people are surrounded by various myths, which reduce the utility and benefits of a health insurance policy for them.
So, if you already have a health plan or planning to buy one. It is important to reveal the common myths along with the facts associated with them, this will give clear picture regarding ones Health Insurance Policy.
MYTH 1: All pre-existing diseases are covered
FACT: The most common prevailing myth is that the health insurance policy covers all pre-existing diseases from the time you buy a health plan. The fact says that, the pre-existing diseases are covered, but within the purview of a clause which allows the inclusion of specified pre-existing diseases based on a waiting period. The waiting period clause ranges between 1-4 year basis. The coverage and conditions of various pre-existing diseases vary from insurer to insurer.
MYTH 2: Employer based Health Insurance Policy is sufficient
FACT: Your employer might have insured you with a group health insurance plan, but do you think with the limited sum insured offered by your employer based health plan is enough? With skyrocketing medical costs, having an adequate sum insured under your health plan is important. Employer based health sum insurance might be sufficient for hospitalization for small illnesses but for treating major/critical illnesses, the medical cost involved is huge, which can shake your financial equilibrium. Also, employer based health insurance plans do not offer you flexibilities and other value added services like a no claim bonus. The health plan offered by your employer will last till your employment contract. Once you switch your job, the health plan may not be able to provide you the protection against your health care expenses and treatments. Buying an individual plan based on your need with an ideal sum insured or health cover is a prudent decision.
MYTH 3: Cashless treatment is available always under a Health Plan
FACT: Cashless treatment is one of the USP of buying a health insurance plan, but it is available in all circumstances may not be a reality. Primarily, to avail the cashless treatment facility, the hospital you are undertaking treatment must be on the list of empaneled network hospitals, which has a collaboration with your insurance company. Treatment undertaken, in a non-network hospital is not cashless and the entire expenses have to be borne by the policyholder. Later, the policyholder can get the reimbursement  for the claim by submitting hospital bills and other documents. Some insurers also apply a co-payment clause of 10-20% (percentage of the claim amount has to be borne by the policyholder) if the treatment is taken under non-network list of hospitals. Also, to highlight that the claim helpdesk of the hospitals may not work round the clock. So, if you reach hospital late night due to an urgent medical condition, you need to submit the money to begin the treatment at the hospital and later connect with your insurance company and hospital claims helpdesk team to settle the claim as cashless.
MYTH 4: 24 hours of hospitalization is compulsory to get all types of claim
FACT: This is one of the greatest myths regarding getting a Health Insurance claim. 24 hours of hospitalization may not be required for all treatments or surgeries. With the advancement in the technology, there are certain surgeries which just take 3 to 4 hours stay in the hospital and the patient may go home post that. There are specified Day Care Procedures mentioned in your Health Insurance Plan like dialysis, cataract, tonsillectomy, radiation, etc., which may not require 24 hours of hospitalization and still the policyholder will get the claim. So, do check that the maximum number of day care procedures are covered under your Health Plan.
MYTH 5: Health Insurance Policy is purely a tax saving instrument
FACT: Getting a tax rebate on the premium paid under Section 80 D of Income Tax Act, 1961 for buying a Health Insurance plan is certainly one of the benefits. But buying a health plan only to avail this benefit may not be wise. To buy a sum insured which suits your tax saving requirement is not the right strategy of buying insurance. It is important to buy a sum insured, which matches your requirement based on current and prevailing medical costs, medical condition, age, budget, inflation, etc. Merely buying a health plan for getting a tax benefit may not serve any purpose, and you might compromise on other important health insurance benefits to attain only tax benefit out of your Health Insurance policy.
MYTH 6: Buying Online Health Plan is not reliable and is an expensive deal
In this era of digitization, buying insurance online is just like buying any other commodity online. There are multiple benefits associated in conjunction to buy a Health Insurance Plan online. The most important benefit is that the insurance plans bought online are cheaper and less expensive than the ones bought via your agent/broker. The reason being, the premium for online insurance plans do not include the intermediary costs (like commissions paid to agents or brokers) whereas, you are directly buying the plan from the insurance company. Also, buying an insurance plan online is a hassle free and convenient process. You can purchase the plan at your own convenience and comfort. The policy issuance is also quicker with less documentation formalities by the insurance company.
It is important to eliminate the myths and realize the facts for your utmost benefits. Health Insurance policy is not an expense rather it is a financial back up which will rescue you from those cumbersome medical bills in the era where medical inflation is much larger than the general  inflation. Understand your Health Plan benefits, key features, exclusions, terms & conditions carefully before making a final choice.

The author Harjot Singh Narula is Founder & CEO, www.comparepolicy.com  

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