What Are Some Important Aspects of a Mediclaim Policy?

Mediclaim policies or health insurance plans safeguard the insured members against financial strain from the high costs of hospitalisation or treatment for a pre-determined amount. It is a cost-effective means of securing health insurance and offers a wide variety of options ranging from individual policies, family floater plans, senior citizens plans, critical illness policies, and even group Mediclaim plans.

Let’s address some important aspects and features of a Mediclaim Policy for complete information:

Coverage Indemnified: Mediclaim policies ensure your hospitalisation expenses and indemnify policyholders up to a certain amount, either up to Sum Insured or a fixed sum as per the treatment sub-limited, as stated by the insurer.

Cashless Admission and Claim Settlement: If the insured is admitted to a network hospital, they can avail cashless treatment without having to worry about footing bills. The insurance company directly settles invoices with the hospital.

Reimbursement of Medical Expenses: In a Non-Network hospital, insured members can avail of treatment and submit medical bills to claim reimbursement of expenses.

Medical Coverage: Mediclaim policies offer numerous options for Sum Insured amount that can be chosen as per personal requirements. 

Hospitalisation Costs: Admission for more than 24 hours for treatment or surgery due to an illness or accident gets covered under Mediclaim policies. These include Room Rent, Doctor’s Fees, ICU Charges, Equipment Costs, etc.

Day-care Procedures: Technological advancement in various surgical interventions has allowed treatment to be provided within 24 hours, otherwise known as Day-care Procedures. These are also covered under Mediclaim policies.

Premium Payable: The premium amount is determined by a host of factors such as Sum Insured, number of members covered, location, age, and health conditions, and tenure. 

Tax Benefits: Mediclaim policies present tax benefits to policyholders on payments made towards Mediclaim insurance premiums under Section 80D of the Income Tax Act. The slabs are up to Rs 25,000 for individuals less than 60 years of age and Rs 50,000 for senior citizens above 60 years of age.

It is imperative to thoroughly understand terms and conditions mentioned in the Policy Wordings or Customer Information Sheet for complete knowledge of coverage, waiting periods, exclusions, and other important aspects before finalising a Mediclaim policy.

The author is Co-founder & Promoter, Sana Health Solutions.

DISCLAIMER: Views expressed are the author’s own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.