What your health insurance does not cover?

What your health insurance does not cover?

Health insurance is becoming a necessity in life. With rising healthcare costs, families are expose to personal and financial risk in case of critical illness or emergency care requirement. Whether you are covered through your company’s group insurance policy or you have brought your own policy, it is important to have adequate protection. Some customers buy personal health insurance in addition to their corporate cover to meet their families need.

In either case, it is very important to know what your policy covers and  the true level of protection offered. It is very important to read the detailed policy wording available with your insurance agent or on IRDA website. While it is ideal to read before the policy is purchase, you do get a second chance in the first two weeks of the policy term. “Free look period” provides an option for the customer to redact the policy in case it does not meet their requirement.

You can buy health insurance from a web aggregator, from the insurers directly or through an agent. In all cases, the customer has the right to ask for policy details, key exclusions and terms for claims settlement. After all, if you are not able to make the full use of your insurance cover in the time of need due to the policy fine-print, you will not be a happy insurance consumer.

Pay attention to policy exclusions

It is helpful to understand exactly what is covered and what is not covered in your policy. For example, some policies don’t cover pre-existing diseases. Your policy may also include a “waiting period” in which you cannot avail policy benefits. In addition, some policies exclude certain diseases from the first year of coverage.

Most policies also exclude general healthcare items such as spectacles, contact lenses, hearing aids etc. Very few policies today include dental care such as treatment or surgery unless hospitalisation is required. Other common exclusions include drugs or alcohol related condition, diagnostic expenses, laboratory tests etc. Some of the may be allowed if related to a disease requiring hospitalisation. Maternity care or pregnancy related treatment may also be excluded. Young families or families expecting to have children should take special care. Sometime there is a waiting period for a new born child in the policy.

Needless to say that above exclusions can come as a surprise. It is therefore important to know exact policy terms and conditions while purchasing or during free look period.

Please look out for our upcoming products and services. TrueCover provides tools for consumers to help understand their policies and maximise their benefits.