There have been major developments in the insurance sector of India recently. Under the Union Budget 2019-2020, the government allowed 100% FDI in insurance intermediaries. Moreover, the Insurance Regulatory and Development Authority of India (IRDAI) plans to implement guidelines for initial public offering (IPO) for the insurance companies operating in India.
All these have been instrumental in bringing healthcare finance to the fore. However, there are certain aspects to an insurance plan that policyholders may not be aware of. It is crucial to know these aspects to make the most of such a policy in place.
Some of the lesser-known facts of healthcare insurance policies
While healthcare finance loan has been a critical part of the overall funding in the medical care sector, the contribution of insurance plans remains indispensable. It is the best, however, to remain aware of some of the lesser-known facts about these policies to derive all the available benefits.
Types of policies
Healthcare finance available as insurance policies can come in various formats such as individual plans, group health covers, family floater plans, senior citizen plans, etc.
Each of these plans has a different targeted demography. Individual health insurance plans primarily cover the health expenditure for insured individuals. It is the individual policyholder who is entitled to the sum assured.
Further, the senior citizen health insurance plan is for individuals who are 60 years of age or more. On the contrary, group health insurance coverage is usually bought by employers for their employees.
1. Top-up facility
A top-up facility in healthcare finance provides additional coverage for such policyholders who have limited health insurance coverage. It is a form of reimbursement of expenditure in case of occurrence of a single illness when the existing cover is insufficient or limited.
Consider thus, a regular healthcare finance plan may be of Rs.2 lakh and the top-up plan is Rs.4 lakh. If the claim arises for Rs.5 lakh, then the existing insurance plan will pay Rs.2 lakh and the remaining amount of Rs.3 lakh will be covered by the top-up policy.
The scope of overall healthcare finance also extends to business loans for doctors, wherein financing can be suitably met with options like Flexi Loan facilities.
3. Personal accident cover
Personal accident cover in healthcare insurance plans includes the policy that allows reimbursement of medical costs, compensation for disability, casualty, injury or any other unforeseen circumstances in case of accidents.
The benefits may be applicable for accidental death, permanent total disability, permanent partial disability, transportation benefit, and other benefits such as funeral costs, ambulance costs or vehicle alteration advantages.
4. Cashless claim in healthcare finance
A cashless claim by the policyholder and patient means that the individual does not need to clear the hospital bill, or perhaps, pay a nominal amount. The bill will be settled by the insurance company as part of claim settlement.
Such a facility is available through network hospitals. However, there may be instances where cashless claim may be denied. If the illness is not covered under the policy, or if there is insufficient information or if the pre-authorisation request is not sent in time, the insurance company may deny extending the cashless facility. The claim for reimbursement may be submitted subsequently.
Healthcare finance has become extremely important for financial assistance in case of unanticipated medical emergencies. Given that every individual has varying medical needs, it is important to choose such an insurance plan that meets the necessary requirements sufficiently.
Take note of whether you require a family floater policy or an individual health cover before proceeding. For medical professionals, a professional indemnity insurance policy is the insurance coverage more common for the risks involved in their practice.
The professionals can also eliminate their financing woes with funding options like loans for doctors provided by NBFCs like Bajaj Finserv.
These personal as well as business loans for doctors, alongside other loan options suitably fulfil the financing needs of medical professional without straining their budget.
The lender also brings pre-approved offers to make financing hassle-free and less time-consuming for customers. These offers are available on a range of financial products, like business loans, personal loans, etc. You can check your pre-approved offer by providing your name and contact details.
As for healthcare finance, it is advisable to take not of all essential aspects of funding before reaching out for a suitable option. It will help ensure that your healthcare funding needs are suitably met while keeping you free of unnecessary emergency financing woes.
Finally, cashless claims under healthcare insurance policies also alleviates the immediate burden that patients may have had to bear in case of hospitalisation. Given that there are a variety of features present in different healthcare insurance plans, one should carefully choose the one that is closest to the required criteria while offering maximum benefits.