5 Health Insurance Secrets You Don’t Know About

  • As you must know how important health insurance is for your family, and in India there are various types of health insurance. Health insurance provides financial coverage on medical bills to the policy holder in case of any misfortunate event. But there are 5 health insurance secrets that you don’t know about.

    First of all, let’s understand the technicality of these secrets, Pre-existing diseases, and Waiting periods. On the basis of this many insurance claims were rejected, and are rejected even today.

    5 Health Insurance Secrets

    #1 Pre Existing Diseases

    The pre existing diseases used to be a very subjective term earlier but now Pre Existing Diseases have every insurance company defined it using its own terms. And it was defined as when you have already taken your insurance plans and you are going for a claim. and the company used to claim that you already had this condition, and you did not declare that prior.

    And because of this, you can no longer claim the insurance. what type of conditions are these? People may have any Heart conditions diabetes cancer or any surgery done in the past. for which you might have any ongoing treatment.

    If any insurance company has to pay constant claims to someone the company will try to avoid such cases. However, this definition has been standardized by IRDAI in 2020. Now companies can’t define Pre-existing diseases so, let’s see what is the latest definition.

    What is Pre Existing Disease?

    Pre Existing Disease means any condition, ailment or injury or related Latest Guidelines by IRDAI condition(s) for which there were signs or symptoms, and/or it was diagnosed, and/or for which medical advice/treatment was received within 48 months before the first policy issued by the insurer.

    The day you have taken or taking any policy If any disease is diagnosed 48 months before that or if there is any medical condition that you come to know, only that will be covered as your Pre-existing disease. So, it was a matter of pre-existing disease. Now, let’s see what is Waiting period?

    #2 Waiting Period

    What is a Waiting Period? whenever you go for any surgery or for any medical treatment for which you have to be hospitalized, And many Day care treatments are also covered under insurance. But there is some waiting period for every treatment.

    And this waiting period can vary from 30 months to 4 years depending on the disease and depending on the insurance company.

    So whenever we take a health plan, we have some waiting period for the pre-existing disease. This waiting period is normally 1 year to 4 years for any treatment.

    But If someone is a corporate employee and wants to transfer that health plan to an individual he or she can do it in many cases depending on what type of health insurance plan that company has taken.

    Top Up Plan

    A top up plan are additional coverage that is added to a health insurance plan, if you have a health insurance plan of Rs 5,00,000 you can add up an extra top up plan of Rs 5,00,000 or Rs 10,00,000 to add an extra coverage.

    If you are working in a corporate job, or have a pre-existing disease, or any surgery, or any disease then the existing waiting period is not applicable to you. And if you add that top up then that is, there will be no waiting period, and the continuity benefits will be included in this insurance plan.

    #3 Group Medical Cover

    If you are working in a corporate then Group Medical Cover could be a very good option under the Group medical cover, if you work in a corporate company and if you leave that job, or join any other company or if you are leaving the job for your start up then you can continue that group insurance as an individual policy if you get this option.

    This option could be a good one because you will not have any kind of waiting period here. Secondly what should you do for the Pre-existing diseases? First of all, you should not hide any pre-existing disease condition, because, if it is detected later when you are going for an insurance claim then there is a high chance that they will reject your claim.

    Second, if the insurance company insists you go for medical screenings or check-ups, to determine your existing medical condition. then you must go for it.

    Even if by any chance any pre-existing condition or illness is detected, so it will benefit you in a way that you know about it before hand, secondly, if you do not have any illness or disease, and you are in a healthy condition, so you will have a written document of the same.

    Whatever information you have, it will be available to you as well as the insurance company so they will not be able to reject any claim later.

    #4 Don’t Switch Your Health Plan

    You should never switch your health insurance plan because if you have already taken a health insurance plan if your waiting period is not over.

    Switch your health plan only after your waiting period is over even if you want to go with any other insurance company because then your continuity benefit will be continued. that means then your waiting period will not be applicable.

    But suppose if you switched the health plan after 1 year, then you will get a fresh waiting period In that case, you will not get any continuity benefits.

    #5 Group Medical Cover In Corporate

    The fourth and most important tip is if you are working in a company, and you have a cover of corporate insurance that is if you are covered under the Group medical cover. Then you should definitely take that option because there is no waiting period for any pre-existing disease under group insurance.

    There are a lot of individual options under Group Insurance this is where you can either top-up, or you can get options for top-up plans. this option is also available in some companies where you can also take add-on cover. Suppose your spouse and children are covered under that insurance so by paying an extra premium we can also cover our parents.

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