Understanding Mediclaim Policies: Key Benefits and How to Choose the Right One

Selecting the right health insurance can feel overwhelming, given all the options available. While we can't predict what health needs may arise, having coverage provides peace of mind. The choices become clearer as we look at key benefits like hospitalisation costs, pre-existing conditions, and claim processes.

Focusing on our budget, health history, and priorities helps determine the ideal Mediclaim policy for our situation. In the section below, we'll discuss the benefits of mediclaim policies and how to choose the right one.

Understanding Mediclaim Policy

A mediclaim policy is health insurance that pays for your medical treatment costs if you need to be hospitalised. It covers expenses like hospital room charges, ICU charges, surgeon fees, and medication costs up to a certain limit. These policies provide financial protection when you are ill or injured by paying your hospital bills so you don't have to bear the entire cost yourself. Premiums are paid yearly or monthly to keep the coverage active. Having mediclaim safeguards you from the high costs of some medical treatments.

Key Benefits of Mediclaim Policy

The benefits of mediclaim policy are as follows:

• Covers Hospitalisation Costs: Mediclaim policies pay for medical expenses if you need to be hospitalised for illnesses, injuries, or surgery. This includes room rent, ICU charges, surgeon fees, etc.

• Cashless Facility: Many policies provide cashless hospitalisation where you don't have to pay any bills upfront. The insurer directly pays the hospital.

• Pre and Post Hospitalisation: Some charges related to consultations, tests before and medication after hospital discharge are covered up to a certain number of days.

• Tax Benefit: The premium for mediclaim up to Rs 25,000 in a year is tax-exempt under Section 80D.

• No Claim Bonus: If you don't make any claims during the policy year, insurers offer bonuses that enhance your coverage for the next year.

• Lifelong Renewal: Policies can be renewed year after year with coverage as per renewable age criteria. Insurers cannot deny based on health conditions.
  
  

How to Choose the Right Mediclaim Policies

• Coverage Amount: Choose a high coverage of Rs. 3 to 5 lakh or more per year to ensure most hospital bills are sufficiently covered, as medical treatments and costs are rising.

• Inclusions & Exclusions: Closely examine which health conditions, tests, and procedures are specifically included or excluded from your policy to understand what you can and cannot claim fully.

• Network Hospitals: Check if your local or preferred hospitals and healthcare providers are part of the insurer's network so you can use the cashless facility.

• Premium Costs: Premiums for mediclaim policies vary by insurer based on coverage, terms, and your geographic location. So, you can use the health insurance calculator to compare costs over the long term before purchasing.

• Claim Settlement Ratio: Verify each insurer's claim settlement percentage. A higher ratio indicates the likelihood of your claim being approved. Choose ratios above 90%.

• Waiting Period: Some policies have an initial waiting period ranging from 30 days to 1 year before you can claim for certain illnesses, so be aware.

• Pre & Post Hospitalisation: Choose policies that cover your hospital expenses before admission and after discharge for longer periods (up to 60 days).
  
  

Conclusion

Finding the right mediclaim policy requires us to invest some time in understanding what's covered along with the claims process. While assessing options, focus on aspects like hospitalisation benefits, inclusions, network hospitals, claim settlement records, and waiting periods that matter most to our situation. Insurers like ACKO provide comprehensive mediclaim coverage and hassle-free claims. This knowledge helps us select adequate coverage that is aligned with our budget and health needs.