Hyderabad: When medical inflation is rising faster, it is imperative to keep yourself and your family protected against unforeseen medical emergencies. Hence, health insurance has become more of a necessity than a choice since emergency medical treatments and hospitalisation can take a toll on our financial health. Thus, investing in health insurance plans can be the best investment to safeguard your future.
Similarly, you need to know all the terms and conditions before availing of a policy. Particularly, sub-limits imposed by the insurer. Only then, it will possible to wriggle out of a medical emergency without spending from your wallet. Prefer a policy that covers all your hospitalisation expenses. Sometimes worried over higher premiums and affordability, people tend to avail a policy with sub-limits. It means you are pre-fixing the amount for an illness or expense to be incurred. Then expect an insurance company to compensate accordingly.
For instance, let us assume you have a policy for Rs 5 lakhs. The sub-limit for the treatment of any disease can be fixed at Rs 30,000. Beyond this, the policyholder has to bear the expenses. The ambulance fare is fixed at one per cent of the policy amount. Similarly, even for illness or treatment, specific amounts are fixed. There will also be limits on pre-hospitalisation expenses and also on post-discharge expenses. It will be determined on the days of treatment or a fixed sum has been assured. It is said that such limits cut down the responsibilities of insurance companies.
Insurance companies generally impose such restrictions for the treatment of cataracts, sinuses, kidney stones, piles and obstetrics. The list of illnesses and sub-limits vary from one insurance company to another. Policyholders have to study terms carefully. After proper understanding, it is better to be well-prepared, otherwise, hospitalisation could lead to problems, including spending from your wallet.
Insurance companies impose sub-limits on room rent, ICU, ambulance charges, home treatment and OPD. If the room rental limit is stated to be one per cent of the policy value, those with a policy of Rs 5 lakh will be paid only Rs 5,000. If the rent for the hospital room is higher than this, then it will impose financial stress on you. Some insurance companies even regulate sharing and special rooms. Despite this limit, ensure that they pay 2-3 per cent.
Insurance companies pay for expenses up to 30 days before hospitalisation and up to 90 days at home. Sometimes insurance companies can reduce the number of days. This should be carefully observed while taking the policy. It is always best to have a policy with as few sub-limits as possible. Even if the premium is slightly higher, it will be less compared to future expenses, TA Ramalingam, Chief Technical Officer, Bajaj Allianz General Insurance.
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