The most important part of a health insurance policy is the policy document that contains inclusions and exclusions of policy benefits. Those who have an in-depth knowledge of the health insurance plans, they know that devils lie under the fine prints of a policy document. If you miss them, you will be in a big problem at the time of claiming the amount.
A policy document focuses the fundamental attribute of a health insurance plan, giving a complete detail about the inclusions and exclusions of the policy. It is held as the primary source of information that helps a new policy holder understand what the policy is about.
A policy document consists of scheme details and discusses the most important factors of a health plan, including a claim process with authorization and settlement issues, payment options and documents required.
You must check the coverage befits on the fields like
Room rent limit
Room rent limit is the amount every company provides you when you get hospitalized. The amount is divided as per day and has a direct link to the sum assured. With this, you can reimburse your room rent fees as per the limit a policy company has on the health plan. You need to give attention while reading this detail because the reimbursement of room rent fees, in most of the cases, lowers the eligibility for other charges such as surgical fees, consultant charges and operation theatre charges.
Sublimit discusses other specific charges of the coverage such as doctors fees and surgical fees. The sublimit has been given on specific illnesses or diseases and it has a direct implication on the payout of the claim.
Copay and deductibles vary from companies to company. Copay is generally the percentage of the total claimed amount you pay to the insurance companies. On the other hand, a deductible is the amount needed to be paid by you to the companies before the insurance plan starts compensating you on the occurrence of illness. For deductible, you have to reach the stated amount mentioned by companies.
A few limited health insurance plans have a waiting period policy, especially those ones that relied on pre-stated illness and diseases. You cannot claim the sum insured if you are within a waiting period duration. Generally, 30 days after the commensuration of a policy is considered to be the waiting period of that health insurance. The waiting period may have 90 days term as per the policy.
Guidelines compel health insurance companies to offer life-long coverage to the insured. There are many companies, though, that have come up with benefits for a certain period of time.
These are a few factors that you need to take care of while buying a policy. Do not neglect the policy documents since it determines whether the coverage suits your needs or not.