Everything You Need to Know About Mediclaim Policy

1. Everything You Need to Know About Buying Mediclaim Policy Mediclaim policy has come into being to provide medical insurance cover to you and your family. A mediclaim policy covers costs for your medical treatment. It takes care of your medical expenses in the below scenarios Sudden illness or injury In case of accident Hospitalisation required due to surgery or illness or accident. Features of Mediclaim policy: Can be opted by anyone between the age of 91 days-65 years Pre-existing diseases are covered after a waiting period of 2-5 years It can be purchased online without any paperwork Can be opted as an individual or family floater plan Sum assured can be above 50 lakhs How is premium of a mediclaim policy determined? The premium for mediclaim policy is determined on the basis of Age Sum insured Geographical location Pre-existing medical condition Extent of coverage

2. Things to Consider While Buying a Mediclaim Policy Sum insured/coverage amount; Sum insured is the amount of medical coverage that your insurer will provide you at the time of hospitalisation. While choosing the sum insured, consider the rising healthcare costs and rate of inflation. Individual or family floater: Mediclaim policies are of two types: Individual-This type of policy provides coverage only to the policyholder. Family floater- This type of family floater of medical policy provides coverage to all the members of the family including you, your spouse and kids. Few plans also allow you to add your parents and in-laws. Sub-limit: An upper limit or maximum amount that your insurance company will pay on your medical insurance claim. Sub-limits are placed on items like room rent, doctor’s fees, ambulance charges, pre-planned medical procedures like cataract removal, knee ligament reconstruction, etc.. Co-payment: Co-payment is the percentage of total claim amount that a policyholder is required to pay at the time of claim settlement of the medical expenses. Having a high co-pay limit attracts low premium Network of hospitals: Insurers have a network of hospitals at which you can avail cashless treatment. Always check the number of hospitals covered under your hospitals network. More the number of hospitals covered, better for you. Exclusions: Check all the exclusions of your insurance policy to be aware of all the terms and conditions and also the list of diseases excluded. Few insurers do not cover conditions arising out of HIV infection, congenital disease, alcohol addiction or drugs, suicide attempt, etc. How to claim on mediclaim policy? You can claim on mediclaim policy by following the below steps

3. If you’re hospitalised at the hospital that falls/ comes under the network of your insurer then contact TPA (Third Party Administrator) at the time of admission at the hospital. You will have to submit all your medical reports to avail this facility. Availing cashless treatment facility means the insurer/ TPA directly settles your bills with the hospital. If you’re hospitalised at the hospital that does not come under your insurer’s network, then you’ll have to go through the reimbursement process where in you will have pay the hospital bills first and then your insurer will reimburse it.