1. What is Health Insurance?
Health Insurance provides risk coverage against unforeseen health expenditure that may result in financial hardship. Health insurance covers hospitalization due to illness and accidents. No one can say when a young & healthy need hospitalization due to illness, accident or swine flu or due to dehydration caused by food poisoning. It is good to have health insurance policy, which takes care of you & your family members. Your parents and parents should also have suitable health insurance policy.
2. Can I buy health insurance policy if I am not an Indian National but am living in India?
Yes, If you are a student studying in India or working on a valid work visa then you can get the policy.
3. Why should I buy Overseas travel insurance?
Indian health insurance policy is valid within India. If one is traveling overseas then one may need medical cover for consultation, accident & other illnesses cover without any pre-existing illnesses this policy covers baggage loss / passport loss / delayed flights allowance also.
4. Can I buy more than one Health Insurance policy?
Yes , One can buy more than one insurance policy , the claim would be from one Insurance company & along with the documents we need to furnish the other policy document also if the amount of claim is more than one particular Insurance policies sum assured . Let us say Mr. X has two policies from Co. A with risk cover Rs.2 Lac & Co. B with risk cover Rs.3 Lac , Now at the time of claim the hospital bill is Rs.4 Lac . The amount of claim is going to be shared by both the companies .
5. My wife and children are residing at mysore while I am here in Bangalore. Can I cover all of us in one?
Yes, Policy is valid on all India basis and is also applicable if you are based in Bangalore hospitalization while traveling or want specialized treatment in another city may be Mumbai or Delhi.
6. Are maternity/pregnancy related expenses covered under health Insurance plans?
Yes Only Apollo Munich and Max Bupa cover with certain condition (Payable after certain number of years and also have limit on claim payable with limit delivery and caesarean delivery.
7. Does health insurance cover diagnostic charges like X-ray, MRI or Ultrasound?
If one is hospitalized, then charges for X-Ray,MRI or Ultrasound are payable provided these are required under treatment for which you are admitted. If these tests are conducted within 30 days prior to hospitalization and 60 days post hospitalization diagnosis for which you are admitted for curative treatment then this is also payable. If any of these tests are not relevant to the treatment then these are not payable.
8. Is private healthcare a luxury or a necessity?
You could argue that since we have trains and buses and other forms of public transport you have no actual need for a car. Yet many people have one because it makes life so much easier: it’s more dependable and reliable and it’s part of the higher standard of living that you work hard to maintain. You don’t strictly need a health plan, but then you don’t need the stress of worrying and waiting either. You need the reassurance that you will receive prompt treatment, in quality facilities, at a time and place of your choosing. You need the confidence that your health is in good hands.
9. Who will receive the claim amount under health insurance if the policyholder dies during the time of treatment?
Nominee will receive the amount if the policyholder dies during the time of treatment.
10. Can I seek treatment at home and be reimbursed for it under health insurance?
It Can be possible in exceptional cases only when there is epidemic and no beds are available in hospitals. You have to take approval from insurance company while undergoing treatment-Otherwise your claim will be rejected.
11. Why should I buy overseas travel insurance?
Indian health insurance policy is valid within India. If one is traveling overseas then one may need medical cover for consultation, accident & other illnesses cover without any pre-existing illnesses this policy covers baggage loss / passport loss / delayed flights allowance also.
12. If I change from one individual health policy to another, can the company impose preexisting condition exclusion on the new policy?
Yes, If you had lodged claim with earlier company then new company will treat the disease as pre-existing the claim will not be payable for next 3 years.
13. My employer provides me with health insurance coverage. Is it advisable to take another policy on me?
Yes it is advisable to take another mediclaim policy.
14. I have health coverage through my employer but I’m changing my job soon. Is it possible to continue the mediclaim policy give by employer.
One should always have their own health insurance policy. It is not possible to continue the mediclaim policy from one employer to another employer.
15. Please suggest a policy that covers regular check-ups and OPD treatments, Including dental?
Health insurance policies do not cover OPD and dental expenses..
16. What is day care procedure?
Day surgery is the surgery where patient need not in hospital for 24 hours and is discharged after few hours the day surgeries covered under mediclaim policy. They have elaborate list .Other insurance Companies have shorter list and it appears in the policy document.
17. Who is a third party administrator?
TPA is an abbreviation for third party administrator. These companies are BPO of insurance companies and are there for coordinating all aspects of claim arising due to health insurance policies.
18. Are naturopathy and homeopathy treatments covered under a health policy?
In all policies nathuropathy is not covered.However homeopathy is now being covered by some insurance provided treatments is taken in a homeopathic hospital,which is empanelled with the insurance company.Some permits use of homeopathic medicines during post hospitalization period.
19. Does my Individual insurance policy cover mental health benefits(treatment for mental diseases)?
No. It does not cover treatment for mental diseases. We do hope that in near future insurance companies will with innovative products which will cover this.
20. If the claim has been made for a particular ailment, does it become a pre-existing diseases for the next term?
No, if you continue with the same insurance company. But if you go to new company then it will be treats as pre-existing one and it becomes non payable.
21. My son is studying in the U.S.A. I want to take health insurance for him. Will any one guide me which one in India offers the best policy for an Indian student in the U.S.A?
Yes, you can contact an insurance advisor Mr. Umesh Khosla at +91 11 46667999 .
22. Is it possible to transfer insurance from one company to another and yet get the no claim/history of?
Yes , Now IRDA has come with Health Insurance portability with effect from 01.06.2011 .
23. What are the benefit of floater plan?
Family floater policy is giving you better rates. If you have a normal policy then every member is eligible mentioned against his name. In family floater sum is for the family so any one/some/all family members to claim.
24. What should I keep in mind before obtaining services from TPA? Just call helpdesk at +91 11 46667999 or +91 9810385111
