You know approximately 71% Indians are struggling with the skyrocketing medical care costs. It forces them to skip top-quality treatments due to financial concerns. This emphasises the severity and intensity of the problems related to healthcare access.
In this situation, buying a mediclaim policy for the family is a lifesaver decision. Understand key details of health insurance plans for family to ensure comprehensive policy benefits.
What Details Should Every Family Know Before Buying a Mediclaim Policy?
- Sum Insured
Must know the sum insured of your policy, which is the maximum amount the health insurance company will pay for treatment expenses during the policy year. Hence, choose a sum insured based on your lifestyle needs and potential healthcare costs. If you live in Tier 1 cities, consider a higher sum insured medical insurance policy for family.
- Pre and Post Hospitalisation Coverage
You know, a short hospital stays for a treatment can result in a huge billing amount. In this scenario, choose the best cashless health insurance with pre- and post-hospitalisation coverage.
For example, pre-hospitalisation involves lab examination and doctor visit fees up to 30 or 60 days before hospital admission. Similarly, post-hospitalisation covers medicines, ambulance, and monitoring costs after 60 or 90 days from discharge.
- Waiting Period
While purchasing a medical insurance policy for your family, you must check the waiting period for any specific or pre-existing diseases. Mostly, a mediclaim policy has a 24 or 36-month waiting period. During this period, no claim will be accepted.
- Restoration Benefit
Do not forget to check this feature that benefits restoration of the entire or partial sum insured on exhaustion during a claim in the policy period. For example, if you used up your Rs. 5 lakh coverage for one treatment, the amount will be refilled. It also allows you to claim for another clinical need during the same policy period.
- Sub-Limits
It is important to be aware of the sub-limits in your chosen policy. Sub-limits are caps on expenses, such as room rent, specific treatments or ICU charges. Choose plans with minimal or no sub-limits to avoid your out-of-pocket expense and ensure flexibility in hospitalisation coverage.
- Claim Settlement
You can check customer reviews on the claim settlement of your chosen insurance company and choose a quick claim settlement policy. Mostly, the best family health insurance plans come with cashless claims and reimbursement options. Choose a plan that commits to settling claims within 2 or 7 days of application.
- Add-ons or Rider and Alternative Treatment
Riders or add-ons are crucial when the policy excludes certain expenses such as maternity, accidental disability or death, and pharmacy bills. You need to cross-check if the policy covers modern and AYUSH treatments, Ayurveda, Yoga, Unani, Siddha, and homoeopathy.
- Co-Payment Clauses
Checking co-payment clauses in your mediclaim policy is important. According to the clause, the policyholder needs to pay a fixed amount or a percentage of the hospital bill. Therefore, choose a policy without any co-payment option.
Why is a Medical Insurance Policy for Family Important in India?
- Increasing Medical Care Cost:
The harsh reality of the present day is that everything becomes costly, including medical care. An average hospitalisation or treatment cost is soaring steadily, which contributes to unexpectedly higher bills and a financial burden for the common man.
For example, an unexpected 13% rise in healthcare costs in India is making healthcare facilities less accessible.
- Rising Prevalence of Chronic Diseases
In India, cancer cases are predicted to increase to 2.08 million, with a 57.5% rise in 2040. Besides that, 28,413 deaths were reported due to heart attacks in 2023. In India, around 4.9% children are struggling with chronic kidney disease, across 3.4% in 10-14 years, 5.6% in 5-9 and 5.2% in 15-19 years.
These growing statistics underscore the urgency for the best medical insurance plan for families that provide coverage for early diagnosis, treatment accessibility and medication.
- Financial Security
Investing in a mediclaim policy provides financial commitment in an emergency by covering hospitalisation, domiciliary care, ambulance, nursing, and medicine costs. It ensures medical expenses for you and your loved ones.
For example, if your family member suffers from an accidental injury or a life-threatening disease, you may receive top-notch care without stressing about treatment costs.
- Access Quality Treatment
Investing in a family health insurance policy will allow each member to access quality clinical care and cashless hospitalisation in network hospitals across India. For example, insurance companies may have over 10000 network hospitals, and individuals have the right to choose a clinic on their own.
Conclusion
Remember, before choosing a mediclaim policy, consider key features like sum insured, waiting period, and coverage. Opt for a policy with minimal co-payments, quick claim settlement, and riders for alternative treatments to minimise out-of-pocket expenses. By considering these factors, you can select the best cashless health insurance that meets family needs and provides comprehensive coverage.
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