Several misconceptions about health insurance in people’s minds have created a fear to buy. Myths about Health Insurance have persisted for long, which is a challenge to clarify. But it is important to check the facts before relying on the information you might have heard from your friends or read somewhere. It is important to understand, who is asking and who is answering it.
During our survey, we found that 50 to 60% of working class population in India have Health Insurance, but there are very few who can comprehend its value.
There is a lot of information which is circulated by these agents and middlemen, only because they need to achieve their sales target and many of us, at some point, believe this information.
We shall be taking this opportunity to cast lights on these misconceptions about Health Insurance and elucidate some facts.
1. MYTH – It is required to be hospitalized for 24hrs for making a Claim?
FACT: ‘Recently I had been to the hospital to visit my Uncle and was astonished to find a woman forcing the doctor to hospitalize her son for 24hrs. When enquired the reason she said her “AGENT” had asked her to do so otherwise she won’t get a claim.’
It might be true that in many cases, but not always. Every illness does not require 24hrs of hospitalization. There are certain procedures like Cataract, Hernia, Piles, Radiotherapy, Chemotherapy and Kidney Stone Removal, etc. that are covered under Day Care Treatments. Every Health Insurance policy you buy has Day Care Treatments as Inbuilt cover. Rather than believing in what people say and creating an assumption on something that is not true it would be wise if you go through the list of Day Care Procedure covered in your Health Insurance Policy. 24hrs of Hospitalization is required only when it is “NECESSARY” as mentioned in the policy documents.
But you should also remember that “Everything cannot be paid under Health Insurance”. If there is a “WELL GROUNDED” reason for treatment which requires 24hrs of hospitalization, then the claim will be paid.
2. MYTH – I am FIT and Healthy why do I need Health Insurance?
FACT: ‘Few days back when I was surfing through Internet there was an old article that caught my eye. This Article was from the daily The Times of India – Dated – August 2nd, 2013 by Pratibha Masand, TNN – “Mumbai Doctors see marked rise under – 30 Heart Patients” – It clearly stated that in the past few months, doctors across the city have seen a steady stream of youngsters with heart problems. A cardiologist in Thane, for one, examined 15 such patients aged between 24 and 30 in the past 45 days alone.
It is not mandatory that if you are in your 20's or 30's and healthy, then you are not prone to any diseases. Illness like dengue, Malaria, food poisoning, etc. can be found in healthy and fit people too. Possibility of getting hospitalized is higher if precautions are not taken on time. Such ailments require hospitalization and only Health Insurance Policies pay for such treatments.
When it comes to health there cannot be perceptions like, 'Accidents can happen to anyone and anywhere'. Insurance has been designed to protect against these unforeseen accidents from the inception date of the Policy.
3. MYTH: All medical expenses, whether disclosed or not will be covered
FACT: There are certain Ailments/ Illnesses/ Diseases that are not covered under the policy and mentioned in the Policy Wordings. It is mandatory to declare all Ailments that already exist before taking the policy. Every Health Insurance company have a waiting period of 12 to 48 months for Pre-Existing Ailments. IRDA clearly states that, “In the event of misrepresentations or non-disclosure of material facts the policy shall be void, all premium paid thereon shall be forfeited and claim shall be denied.” In order to avoid such situations, it is mandatory to declare all material facts, that will ease out your concerns and will help in smoothly processing your claims in the future.
But there are few who avoid disclosing this information and presume that the claims will be paid. We need to keep in mind that you might hide information from the insurance company but when you submit the documents for claims, they won’t lie about your medical history and there is a thorough check done by Insurance companies before paying claims.
So it is mandatory and advisable to disclose all material facts when you are purchasing a policy.
4. MYTH: My Company has taken Insurance for me why should I buy a Separate Cover?
FACT: Company group insurance will cover till the time you are with that organization. There are a lot of limitations to these covers. When, you rely on such coverage you need to Check – 1. Are all your Family members covered under this Policy? 2. Is there is any capping or Limitations on Diseases/ Illness or on Room Rent/ ICU?
What I have gauged in these years is that, it is advisable to buy your own Health Insurance. There are 2 reasons
Every Group Insurance has a limited Sum Insured that varies from 1 Lac to 3 Lac which will be insufficient due to the increasing medical cost. In such a situation, you need to look for a Higher Cover to overcome these expenses.
When you plan to leave the organization or plan to retire and decide to buy a separate cover, then there are certain ailments that have a waiting period ranging from 12 to 48 months.
There is a high possibility that the Company Policies may change all of sudden or they may decide to modify certain Terms & Conditions. They might even plan not cover your Family. It would be advisable to buy a policy for yourself and your family members separately.
When you buy a separate Health Insurance cover it works like a security for your family, incase where your company decides to cut down certain benefits or if you leave the organization the separate cover will be beneficial.
5. MYTH: Need to check for Network Hospitals before you buy insurance
FACT: Network List of Hospitals in a Health Insurance changes time to time during your policy term. There are certain parameters that the hospital need to maintain to avoid being blacklisted from the network list. Every company on monthly basis uploads their latest Network Hospital List which is available on their website.
On the other side, even hospitals blacklist or refuse cashless claims for certain Insurance Companies/ TPA’s for delayed payments. Therefore, there is no fixed or contracted list of hospitals between your health insurance company and you.
To conclude: Before you plan for any hospitalization it is advisable to check the Network List. But never reject a policy only on the basis of a network list as it may be revised anytime.
6. MYTH: Room Rent Capping is a Big Deal
FACT: Capping on Room Rent is actually not a big deal. It depends on or is equivalent to the amount of premium you are paying, how much sum insured you have opted for and which policy you are buying.
Let us look at the below example to get a better understanding:
To Conclude: If you look at the above comparison then every Plan and Sum Insured has different Limitations for Room Rent & ICU Charges. Capping on Room Rent should not be one of the reasons to reject a Policy.
7. MYTH: Buying Health Insurance Online is RISKY
FACT: The biggest Myth about Health Insurance is about buying policy Online.
In this tech savvy generation, where we buy each and everything online. You can order gadgets, clothes, accessories and even grocery at a click of the button, then why should you follow the old fashion trend of walking to insurance company’s office or fixing an appointment with an agent. Today your agent is there, but can you predict about tomorrow? Today he has assured you of the benefits, features and services, but if he backs-out who will help you in this situation?
When you take Life Changing Decisions for yourself by just looking at the profile on matrimony website, then what withholds you from taking such an Important Decision of Buying Health Insurance, which will be helpful to overcome your financial losses?
- When you buy online nothing is hidden from you, everything is in black & white. If there is something being promised and not fullfilled, then you can go to the same page and verify the details.
- Your pain of filling the never-ending form is reduced.
- You can opt for making the payments online through various secure modes of transactions (Credit Card, Debit Card, and Net Banking)
- More Options and detailed comparison – You have the option of comparing and selecting the benefits as per your choice.
- There is no Dependency on any Individual. All Information that you want will be available online and you can get access to this information anytime.
- The best part is you Save Time while purchasing the Policy. You can buy the policy within 7 Mintues.
Conclusion: Every Story has something to teach you and every Article has a Conclusion. Give a thought to the points highlighted above as they are just a few. Buying Health Insurance is a Big Decision. You need to analyze the information that you receive or have heard from someone.
“We at Medimanage are here to provide you accurate information and help you in buying the right product that fits your requirement and your budget”