How To Avoid Common Health Insurance Distress

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How To Avoid Common Health Insurance Distress: A Health Insurance cover is meant to cover your medical treatment at the best of hospitals and keep you stress-free from the financial strain aspect. However, one may encounter some distress due to health insurance issues and such situations are difficult.

Let�s check out how you can avoid health insurance distress.

Not Getting Cashless Claim

People opt for a Health Insurance policy expecting they won�t be required to pay money under medical emergency. This being true to some extent, there are certain caveats attached to the cashless facility one should be aware of. You are allowed to claim cashless hospitalisation benefit if you get the treatment in the network hospital, which is mentioned in the policy document list.

Also, there are situations when the insurer may not be able to identify the insured on time, and the hospital may ask the insured to settle the bill from his/her own pocket. In this case, an exorbitant hospital bill can cause considerable stress.

To avoid such situation s, you must check whether the hospital is listed in the policy document for a cashless facility or not. It is always advisable to get a pre-approval from the insurance company to avoid any authorisation delay. Even after taking all precautions you are unable to avail a cashless facility shouldn�t be a big worry.

You can always get the money reimbursed by completing the procedure prescribed by the insurance company. Normally the money is reimbursed in 15 to 30 days of filing the request.

Premium Increase

The premium may increase due to change in the age slab or due to changes in the cost structure of the insurance company. After continuing the health policy for a long period if the insurance support arises but the premium has increased manifold, the cause of distress could considerably go up.

Normally, the insurance regulator restricts the insurance companies from spiking the insurance premium exorbitantly. However, even a moderate increase could be a burden on the insured person. In such a scenario, you can use the porting option and switch the policy to another insurance company which offers similar cover and charge a  lower premium. Normally, all the benefits such as no claim bonus and passed time to get cover for pre-existing diseases continue with the switched policy.

Also, Read Top 10 Factors Affecting Life Insurance Premium Costs

Change In Terms And Condition

Sometimes health insurance companies change the terms and conditions in their policy document. It may include or exclude particular disease from the list or add or remove a hospital from the network list.

If you find it difficult to accept the change in the terms and condition, then you can switch the insurance company by using the porting option. Sometimes, insurance companies include the cover disease s which were not allowed earlier, but at the same time increase the premium to that extent. In such a situation you must compare the policy once again with others available in the market and decide based on available merits and demerits.

Cover Not Allowed Due To Pre-existing Clause

Pre-existing ailments are not covered for a specified number of years. If the insured person forgets this clause, then they may need to pay all the treatment cost for such pre-existing diseases from their own pocket.

It is important that you clearly mention the pre-existing ailments at the time of purchasing the health policy. If you are buying health policy after an age of 45 years, then it is better to attach the health screening report with the application to avoid dispute in claim settlement in the future.

Paying From Pocket Despite Health Insurance Cover

Exclusion list may vary from one insurance company to another. If you have switched the insurance policy from one company to another through porting option, then your exclusion list may change as well. Suppose, your earlier insurance company may have allowed treatment of dental duduk perkara after a waiting period of 2 years, but after porting, the new insurance company may not allow dental treatment at all.

You must check the exclusion list before porting the policy and always check the exclusion list of the existing policy before you renew it.

Hence, performing due diligence before buying a health policy can help in reducing the chances of distress to minimal.

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Tips To Choose The Best Health Insurance

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Tips To Choose The Best Health Insurance: Cheap is a very relative term, especially when it comes to Health Insurance. It�s no secret that hospitals today charge room tariffs that can make 5-star hotels seem like budget hotels in comparison! And, God forbid if a small surgery is involved, your purse will feel lighter by a neat lakh or two.

Medical costs have skyrocketed so much in the recent times that it won�t be a surprise if ISRO and other space research communities start considering space technology to be cheaper. Your only option against such meteoric inflation in healthcare expenses is a Health Insurance plan.

But, choosing the right plan is as important as getting one. So, how do you zero in on the best plan? Here are the questions you should be asking yourself.

Am I adequately covered?

Getting adequate coverage is the first thing you need to consider. As you know, the more the sum assured, the more the premium will be. However, paying a slightly higher premium is better than saving on premium but paying ten times more for hospitalisation expenses. Moreover, the premium paid for Health Insurance brings you tax benefits of up to Rs. 75,000. This will apply if you buy plans for the whole family, including your parents.

So, what is the ideal sum assured? There are several parameters to consider, but as a rule of thumb, if you are young and healthy, a sum assured of Rs.5 lakhs will be a good start. As you renew the policies, take advantage of the No Claim Bonus and increase your sum assured proportionately.

Read Also Best Life Insurance Policies in 2018

Adequate cover and complete cover for your healthcare expenses are two different things. An optimum sum assured covers you adequately, whereas complete coverage includes other things that come within the ambit of medical expenses. This will include things like pre- and post-hospitalisation expenses, hospital room charges, nursing expenses, ambulance charges, etc.Am I completely covered?

Check if the plan you choose covers many of the related expenses. It may provide sufficient coverage in terms of the amount of sum assured but may not provide for the right kind of expenses. Compare across plans to see what expenses are provided for, assuming the sum assured is the same.

Who is the best provider?

This is a million dollar question or rather a crorepati question. IRDA, insurance regulator in India, has made it mandatory to have uniformity in case of health policies. This makes it easy to choose between options in the market. Yet, there are several parameters to consider when you choose an insurance provider.

The Claim Settlement Ratio (CSR) of the company is an important parameter. This gives you an idea of the probability of your claims being approved by the insurance company when you file a claim.

Next is the list of network hospitals in which the insurance company offers the cashless facility. Having the option of cashless reimbursement can make all the difference between quick and easy settlements as opposed to the tedious process of paying the hospitalisation expenses yourself, then submitting all those bills to the insurance provider and then waiting for them to respond.

Finally, there can be slight variations in the premiums of different insurance companies, so do your research to identify providers with lower premiums and the best features.

There are too many complex plans. How do I choose?

Apart from the basic indemnity plans, there are some benefit plans that can potentially confuse buyers. They include surgical protection plans, cardiac care covers, cancer care cover etc. that offer a higher coverage for specified conditions. The premium of such plans will be lower; about one-third of an indemnity plan, but one can make the best use of them only if an expense related to those specific conditions arises.

For instance, since surgeries are the most money-draining part of medical treatments, getting a special cover for it and a lower overall premium is the right thing to do. But, if you decide to opt for them, take them in addition to a basic plan, as most of them might not cover other regular hospital expenses.

Should I go for any riders?

Riders are worth considering if you are likely to undergo any medical treatments. Maternity cover riders, pre-existing disease cover, and critical illness riders are three of the most popular riders in Health Insurance. While the first two can be opted for depending upon your specific condition, you can give the third one a miss if you have a high sum insured for your basic plan.

Disease-specific plans such as a diabetic care plan are an alternative to critical illness riders. But, they come with a higher premium and are not sold as standard covers. Therefore, they can be included as additional protection only if required.

Should I opt for cover for treatments abroad?

Many policies today provide cover for treatment coverage abroad. Coverage for treatments abroad will mean a higher premium. But remember, it is applicable only when you travel abroad. And moreover, in most cases, you could take a Travel Insurance policy which would cover your hospital expenses abroad. Therefore, you can save on premium cost.

Here�s a quick cheat-sheet for buying Health Insurance:

• Go for a basic indemnity policy first. Other plans such as critical illness and disease-specific plans can be your next level of protection.
• Read the policy inclusions and exclusions carefully.
• Check the individual expense limits for different heads like hospital room rent, doctor�s fee etc. to see what is covered.
• Find out if there are any treatment-specific caps that limit the amount you can claim for some treatments such as those for pre-existing diseases.
• Check for the portability of the plan � whether the policy allows changing the provider without losing continuity benefits.
• As you grow older or as the number of dependents increases, you may need to increase your sum assured.
• Most importantly, buy plans as early as possible to take advantage of low premiums.

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How To Choose The Best Health Insurance Plan For Senior Citizens?

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Best Health Insurance for Senior Citizens: A senior citizen health insurance plan is designed to cater to the health-related needs of elderly people.  It serves as a financial guard against medical expenses that incur due to unforeseen medical emergencies. You only need to pay the premium each year to the insurer to get the sum insured which will meet high medical costs during hospitalization. This type of health plan can be availed by the ones who have acquired at least 60 years of age.

Choose the best Health Insurance Plan for Senior Citizens

Adequate sum insured: 

Due to ill health, senior citizens need frequent medical attention that increases medical bills. So when you are seeking a senior citizen health plan, it is essential to primarily assess the health condition of the person you are buying the plan and also consider the factor of health uncertainty while judging an adequate sum insured for a senior citizen. It is advisable to choose a right sum insured under the plan, considering health condition, treatment & surgery costs, medical inflation, etc.

Illnesses covered: 

People at an old age have higher chances to have some pre-existing illnesses. When going to buy a health plan for seniors, firstly you should get a medical screening to ascertain the illnesses they are suffering from and then check the number of illnesses that are covered under the health plan, you want to buy. Make sure the health plan you choose, offers coverage for all existing illnesses and major illnesses as well.

Age limit: 

Most of the insurers offer senior citizen health plan who are aged 61 years or above. Some insurance companies offer health plans for senior citizens aged up to 80 years. Some plans have restricted entry age and some plans put no age restriction for buying the health plan. It�s thus advisable to compare different health plans and choose the one which fulfills your criteria. You should choose a senior citizen health plan that offers coverage from your current age to the maximum number of years possible.

Renewal: 

For senior citizens, health policy renewal is a crucial factor that you should consider before buying. You need to check the age up to which the health plan you want to buy can be renewed. Different plans have different age limits for renewal. You need to choose the one, considering your age and health conditions. It�s advisable to pick a health plan that offers lifetime renewability, so you remain covered for your entire life.

Co-payment:

 It refers to a percentage of the claim amount that will be borne by the insured and the rest of the amount will be paid by the insurer. People usually opt for co-payment while buying the policy, as it will reduce the premium amount. However, with a co-payment clause, you might not get a complete coverage against specific illnesses.

Waiting period: 

Insurers usually offer coverage for pre-existing illnesses or other specified illnesses after some waiting period. When it comes to buying a health plan for senior citizens, you need to check the waiting period and pick a plan that has a lesser waiting period.

Read Also Tips To Choose The Best Health Insurance

Coverage under Senior Citizen Health Insurance:

In-patient hospitalization expenses: A senior citizen health plan offers coverage towards the medical expenses incurred upon hospitalization for more than 24 hours. It usually covers room rent, ICU charges, nursing, medical practitioner, surgical appliances, operation theater charges, etc.

Pre-hospitalization expenses: Expenses related to your medical treatment when incurred before the actual hospitalization is covered for 30 days to 60 days, as specified in the plan. It may include doctor�s visit, cost of medicines, laboratory tests, etc.

Post-hospitalization expenses: Expenses related to your medical treatment incurred after discharge from the hospital is covered for 60 days to 180 days, as specified in the plan. It usually includes follows up with doctor, medicines, diagnostic tests, etc.

Daycare procedures: Certain procedures/ treatments don�t require 24 hours of hospitalization because of technological innovation are also covered. Every insurer specifies the number of daycare treatments covered under the senior citizen health plan.

Domiciliary treatment: The medical treatment when taken at home under medical advice which otherwise requires hospitalization is covered under the senior citizen health plan.

Hospital daily cash: A fixed amount as hospital cash allowance is payable on a daily basis, depends on the policy terms. This cash benefit can be utilized to meet expenses that are not covered under the health plan.

Organ donor: Medical expenses incurred towards the treatment of the organ donor during an organ transplant are covered.

Ambulance cover: Expenses incurred towards ambulance service, when used to carry the insured to the hospital for hospitalization. The amount covered depends on the terms specified under the policy.

Tax Benefits under Senior Citizen Health Insurance Plan

Upon paying the premium amount under the senior citizen health plan, you can avail a tax deduction of Rs 50,000 (w.e.f 1st April 2018). Till the financial year 2017-18, this limit was Rs 30,000. If you are paying the premium for a senior citizen (yourself, spouse & parents), you are eligible to avail the tax benefit under section 80D of the Income Tax Act 1961.

Read Also How To Avoid Common Health Insurance Distress

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No-Claim Bonus?What To Do If Your Health Insurer Is Withdrawing

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No-Claim Bonus?What To Do If Your Health Insurer Is Withdrawing: A number of public-sector insurers are withdrawing no-claim bonus and other benefits on their insurance plans. Let�s find out what recourse you have in such a situation. 

Here you can find if Your "Health Insurer Is Withdrawing and No-Claim Bonus"

What is a no-claim bonus?

The no-claim bonus offered on a Health Insurance policy is in the form of a cumulative bonus. Insurers offer this on indemnity-based Health Insurance policies. The policyholder must meet the following conditions:

1. If one makes claims during overlapping periods of two Health Insurance policies, one will receive the benefit of the available sum insured. The cumulative bonus will also not reduce to zero.
2. The cumulative bonus will expire if the person does not renew the Health Insurance policy by the due date.
3. Each year the sum insured increase varies from 10%-50%.
4. The cumulative bonus that a policyholder is eligible to receive on his/her Health Insurance will be stated in the policy document.
5. Insurers apply the cumulative bonus to the sum assured for a 3-year period. This can help to renew the policy by the due date as well.
6. There is a progressive increase in the sum assured, by a value of at least 5%. This is the cumulative bonus accrued during one policy year in which no claim has been made by the insured. The cumulative bonus can be accumulated for a maximum period of 10 years.

Experts advise that people who are above 50 years of age, should consider switching to a health policy with no-claim bonus benefit. Although this will result in only a marginal increase in premium costs, the benefit is useful.

Read Also Tips To Choose The Best Health Insurance

Disbursement of no claim bonus:

An insurer can withdraw the no-claim bonus but it can also provide it to the policy-holder as a part of the sum insured after deducting the premium payable for the policy.

Renewal of Health Insurance policy:

The no-claim bonus will also act as a discount on premium payable for the Health Insurance policy at the time of renewal. Generally, in order to avail this benefit, one has to renew the policy within 30 days of the due date for renewal.

Good claim record incentives:

By maintaining a low claim record, one can avail a rebate on premium as well as enhanced protection.

Low-value claim:

When the policyholder files a low-value claim, he/she does not lose the entire No Claim Bonus. The insurer only deducts a small percentage from it.

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5 Things You Should Know About Health Savings Account Plans Must Read

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Things You Should Know About Health Savings Account Plans Must Read: A health savings account plan offers lower premiums and lower taxes for many individuals.  Before switching to an HSA plan, however, one would be well advised to seek the counsel of an experienced benefits specialist who is familiar with insurance companies offering high deductible policies that qualify for HSA account participation.

 In some situations, the lower costs anticipated may not be realized, or may not be worth trade-offs necessary to achieve those savings.

1. An HSA plan can cut healthcare costs by an average of 40% for many people.
Nevertheless, some people will not realize any net savings. Those most likely to realize significant savings are people who pay all of their own health insurance premiums, such as the self-employed, who are relatively healthy with few medical expenses. 


2. You must have a properly qualified high health insurance policy in place first before
you can open a health savings account. One of the biggest misconceptions about HSA plans is that any insurance policy with a high deductible will qualify the policyholder to establish an HSA account. IRS regulations, however, are quite specific.  Not just any policy with a so-called "high deductible" will suffice.  It is important to be certain that you are insured under a properly qualified policy.  Your best bet is to work with a qualified and duly licensed health insurance broker who is experienced in marketing properly qualified HSA plans.

Read Also Posible Reasons For Personal Loan Rejection Must Read

3. Although HSA insurance premiums are low, they are not always as low as you might expect.
This happens for one main reason. Simply stated, the underlying insurance policy is just that�a health insurance policy.  Although it has a "high" deductible, as required by law, the insurance company still must compensate for the risk it is assuming over the deductible amount, which it does by charging premiums.  Many companies offer policies with �one deductible� that all family members contribute toward.  With those plans, it is not uncommon for premiums for a 5000 family deductible with 100% coverage after the deductible to be comparable to a 2500 "per person" deductible plan with 80/20 coverage after the deductible.
Lower premiums represent just one element of the lower net cost achieved with an HSA plan.  The low net cost of an HSA plan is achieved after factoring in the benefits of lower taxes, made possible by the tax-deductible contribution to the HSA account. Thus, if obtaining the lowest possible gross premium is your main concern, you may wish to consider a high deductible, non-HSA policy, especially if you do not see the benefit to contributing to a tax-deductible savings account.


4. You must be insurable in order to qualify for the HSA-qualified health insurance policy.
Because most people do not have a properly qualified high deductible insurance policy, they will need to switch insurance plans in order to become HSA-eligible. Unless coverage is being offered under small group reform laws (generally groups with 2-49 employees), the new high deductible policy will be individually underwritten by an insurance company.  This means that some "pre-existing" conditions may not be fully covered.  Alternatively, some companies may opt to cover certain "pre-existing" conditions in exchange for slightly higher premiums. Unfortunately, some health conditions simply render an individual uninsurable (examples: diabetes, chron's disease, heart attack, etc.).  Underwriting requirements vary by state, which is another reason to rely on an experienced health plan broker.
You should not switch to a HSA plan when the management of existing medical expenses is more important than saving up-front medical insurance premiums. Do not change health plans: in the middle of ongoing medical treatments; after a major health issue has been diagnosed; or if any family member is pregnant.
Generally, it is relatively hassle-free to qualify, i.e. no medical exams, etc. Most insurance companies offering HSA coverage will issue based on your application answers, perhaps accompanied by a follow-up telephone interview. In some cases, medical records may be requested, and companies always reserve the right to order a paramed exam. 

Read Also Getting A Cash Advance Payday Loan Must Read

5. An HSA offers your best chance to keep a lid on health insurance rate increases.
Make no mistake-you will have rate increases with your HSA insurance policy. Because an HSA qualified policy is still a health insurance policy at heart, there is no logical reason to presuppose that an HSA policy would be immune to rate increases required by an insurer to keep paying claims and stay in business. But what you can expect is that the actual dollar amount of any future rate increases will be substantially lower compared to traditional health insurance plans (regular PPO and HMO plans).  This is true because insurers base increases on percentages, and the same percentage of a lower base premium results in a lower dollar increase. It's not a perfect solution-but it is the most cost-efficient solution for many qualified people.

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Everything You Need To Know About Mental Health Insurance

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Everything You Need To Know About Mental Health Insurance: There�s really nothing much that can be done to make a person suffering from mental illness feel better other than making an effort to understand their situation. Instead of saying things like��this is just a phase�, �don�t be depressed�, �I was sad too, I fought through it�, just listen to them. Every person is different and so is everyone�s struggle. Rather than comparing their problems to yours and trying to categorise them into a �big issue� and a �petty issue�, help them work through it

What Are The Drawbacks Of This Act?

Here are the main shortcomings of this act:

• It declares mental illnesses as a clinical duduk perkara that can be treated by merely the use of medicines and clinical procedures. There�s no emphasis on the prevention of these illnesses and even the importance of mental well-being has been neglected.
• The definition of a �mental health professional� hasn�t been made clear. The act fails to clearly list out the difference between a psychotherapist, psychoanalyst, psychiatris, and counsellor.
• Mental issues are considered to be a big taboo in our country. No provisions have been listed in the act to teach the society about the reality of mental illnesses.
• A complete list of treatment options is also not mentioned anywhere in the act that leads to confusion.
• No provision has been given for hearing of the cases that were submitted before the drafting of the bill.
• There are no options for the aftercare of patients.
• Since no provisions have been made for home-based treatment, the overall cost of treatment goes up.

Read Also How to choose the best Health Insurance Plan for Senior Citizens?

What Are The Important Features Of This Act?

Here are some of the most crucial features of the Mental Health Care Act, 2017:

• Mental health care should be available to everyone through both public and private services. Every person has the right to access these facilities which must be readily available and affordable.
• A person who needs mental health care has the right to choose the way of treatment, and in case they are incapable of doing so, they can nominate someone to do it on their behalf.
• Central and state mental health authorities are responsible for maintaining a record of all mental health establishments, developing quality service, pelatihan law enforcement officials and advice the government on matters of mental health.
• One of the major developments that this bill brought into effect was the decriminalisation of suicide. If anyone tries to commit suicide, they will no longer be punished under the Indian Penal Code. Instead, it will be the government�s duty to look after their proper treatment and care. This will help reduce their chances of re-attempting the same.
• Another significant development under the same bill is�the provision of insurance for people suffering from mental illnesses. Most health insurers will be asked to cover various mental illnesses under Health Insurance cover. The only drawback about this progressive move is that it�ll raise the premium rates.

There are some customised plans provided by Apollo Munich that already offer a cover for mental illnesses. However, in most other cases, these illnesses are treated on an out-patient basis. The most important question that rises here is�why do we need to fight to get mental illnesses covered under Health Insurance. Why can�t they be considered as serious as a physical health condition?
There are various reasons behind mental health still being a taboo in India and this indirectly results in no cover for mental illnesses under various Health Insurance plans.
It�s so important for people to gossip about the mental health of someone and call them names, that they forget how negatively it can affect a person. If someone trusts you and shares something about their mental health, it automatically becomes your responsibility to keep that a secret. Unless you�re ready to commit to keeping their secrets safe, don�t get involved with them. But once they trust you, don�t let them down.

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