What is covered under health insurance?

Posted on Jun, 2020

In today's world, having a health insurance policy is of paramount importance. Your health insurance policy serves as a great help during a medical emergency. The policy provides you with a financial security net and enables you to concentrate on getting the necessary treatment instead of worrying about the expenses. There are a wide range of health insurance plans you can choose from. However, before you decide which health insurance policy to invest in, you should do your research and take stock of all the services covered under the policy. Here's a look at the kind of coverage you can get if you invest in an all-round health insurance policy.

1. Inpatient Care

This includes expenses incurred during hospitalisation for at least 24 hours. The charges covered under this section include room cost, ICU charges, operation theatre cost, surgeon's fee, physician's fee, anaesthesia, oxygen, blood and so on.

2. Pre-hospitalisation Expenses

If you incur any medical expenses 30 to 60 days before hospitalisation, it will be covered under this section. The kinds of costs covered include health check-ups, diagnostic tests, reports, prescribed medication, investigative tests, etc.

3. Post-hospitalisation Expenses

This includes medical expenses incurred 60 to 180 days after hospitalisation. The types of expenses covered include doctor's charges on follow-up visits, additional blood and diagnostic tests, reports, prescribed medication, etc.

4. Day Care Procedures

Day-care procedures are those wherein a patient may not need hospitalisation for the entire 24-hour period, as a result of technological advancements. Common examples of day-care procedures include appendectomy, radiotherapy, chemotherapy, dialysis, cataract, angiography, hydrocele, lithotripsy, piles or fistula and other such procedures. However, you need to check the list of eligible day-care procedures as per your insurance policy.

5. Organ Donor Costs

Some health insurance policies also cover medical costs incurred by organ donors. This simply means that if someone is donating an organ to you, their medical expenses for the donation surgery will be covered under your health insurance policy.

6. Domiciliary Hospitalisation

Domiciliary hospitalisation refers to a situation in which the policyholder is considered as hospitalised, for a period exceeding three days. Patients needing extended treatment can choose to continue treatment either in the hospital or if hospital accommodation is unavailable, in their homes. Domiciliary hospitalisation expenses are covered under your health insurance plan under a few conditions. For instance, you can file a domiciliary hospitalisation claim for the treatment of any ailment for which you would generally need hospitalisation. The patient may also avail domiciliary treatment if they are not in the physical condition to be moved to a hospital or a nursing home.

7. Emergency Ambulance Cover

Your insurance policy also covers you against emergency ambulance Cover. Typically, the insurer mentions the maximum amount you can avail for ambulance coverage. In case the cost of ambulance services exceeds the limit set by the insurer, you need to pay for the remaining amount from your own pockets.

8. Annual health check-ups

Basis the type of plan you have chosen, you may get coverage on general or routine health check-ups done to prevent major healthcare problems. Depending on your insurance plan, you can undergo routine health check-ups once or twice a year.

9. Critical Illnesses

A majority of critical illnesses are covered under your general health insurance plans. However, since the treatment for such ailments is usually expensive and can last for an extended period of time, (for instance, chemotherapy for cancer patients) it is recommended that you invest in separate critical illness insurance policies. Such a policy covers you against various critical diseases such as heart attack, cancer, multiple sclerosis, Parkinson's, coronary artery disease, paralysis, loss of speech, motor neurone disease, encephalitis, meningitis, chronic lung disease, etc. Based on the plan you opt for; you can get coverage against ten to fifty critical illnesses. Also, these policies come with higher sums insured, thus enabling you to avail uninterrupted treatment.

At Pinc Insurance, we offer extensive solutions to your insurance needs. We can help you find the perfect insurance plans for yourself and your family, as per your requirements and budget. We also offer the necessary assistance you need at the time of filing insurance claims. Visit the Pinc Insurance website to get started with a comprehensive health insurance policy for you and your loved ones!