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No matter how young or old we are, how health conscious we are or aren’t; health risks can creep up any time. We may require sudden hospitalisation which brings with it a lot of emotional and financial stress. Instead of worrying about how finances can be managed in such stressful times, it is better to plan in advance and invest in a good, all-encompassing, health insurance policy that offers coverage against a host of conditions and diseases. Also, it is important to read the terms and conditions to understand what your insurance policy entails along with the list of diseases not covered under health insurance. Here’s all you need to know about what is and isn’t covered under your health insurance plan.
What is covered by health insurance?
Your health insurance policy typically covers you for medical expenses incurred as a result of the diagnosis of a diseases or a health condition. Generally, there is no specific list of diseases covered under medi-claim as most illnesses including heart diseases cancers, tumours, sudden heart attacks, bypass surgeries etc. are covered under your health insurance policy. Apart from medical expenses you are also entitled to:
What does long term health insurance cover?
Long term health policies typically cover the cost of hospitalisation in case one needs to be hospitalised for a longer duration. It also helps reduce costs associated with living in an assisted living or home assistance facility due to a prolonged illness. Such a policy typically comes to your aid when you have no one to look after you or take care of you, while you are also not in a position to look after yourself physically.
Diseases not covered under medi-claim policy
As mentioned above, there is no particular list of diseases not covered under health insurance. However, there are certain things for which you cannot claim medical insurance. These include
Health plans generally exclude the coverage of treatment of diseases that are related to the lifestyle of the policy holder. These include lung diseases or lung cancers resulting from smoking or liver diseases like cirrhosis caused due to excessive consumption of alcohol.
Most insurance policies only cover you for in-patient or allopathic treatments. You cannot claim coverage if you opt for alternative methods of treatment like Ayurveda, Unani, Naturopathy, acupressure, acupuncture, magnetic therapy and other such treatments.
This is a point that is included in disease covered in health insurance as well as those that are not. To get coverage for pre-existing conditions, you need to truthfully mention them when you apply for medical insurance and cannot encash the policy until the pre-determined waiting period ends.
While you become eligible for medically recommended plastic surgery procedures to treat injuries resulting for injuries or accidents, recreational cosmetic treatments such as plastic surgeries, nose jobs, face lifts, Botox and cosmetic implants are not covered.
Your health insurance also does not cover treatments related to reproductive challenges such as fertility challenges, in-vitro fertilisation, abortion and surrogacy. Most basic polices also do not cover you for pregnancy and child birth related expenses.
Almost insurance providers include Aids in the list of diseases not covered under health insurance.
If one is hospitalised as a result of attempted suicide, they cannot encash their health insurance policy to seek coverage. Whenever you purchase and even renew your health insurance policy, it is best to read the terms and conditions to understand what is and isn’t covered in the policy. This way there will be no confusion when you wish to file a claim.
Why and when should I buy long term health insurance?
That the cost of medical expenses is increasing with every passing year is no hidden secret. In the last few years, it has been reported that the cost of health-care has been on an upward trajectory with a 15% inflation rate, annually. As such, it is best to invest in a long-term health care policy as soon as possible.
While you can continue paying premiums for your regular health insurance policies until the age of 50, the moment you reach this mile-stone, you should start investing in long-term insurance policies, because your 60s are a time when chronic illnesses begin to crop-up out of nowhere. Also, most insurance companies do not prefer to provide long-term health insurance policies when one enters their retirement years. This is attributed to the fact that senior citizens are generally considered as high risk customers since their health is more likely to start deteriorating once they enter their 60s.
Reasons to consider a long-term health insurance policy
Now that you know What Is Covered By Health Insurance, let’s look at the essential reasons why you should consider investing in this type of policy.
The IRDAI has also issued a regulation that makes insurance companies provide the No-claims bonus benefit to long term health insurance policy holders as well. The no-claims bonus slabs are fixed by the IRDAI and the policy holder can receive these benefits in the guise of claim-related concessions. For instance, insurance companies may offer bonuses for every claim-free year even in the case of policies lasting for three years.
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