When should we take medi-claim policy?

Cost of quality healthcare in India has been sky-rocketing for the past decade or so. Hospitalization for a serious health condition can set you back by Rs 5 to 10 lakhs, depending on the severity of the condition and treatment options. Health insurance provides insurance cover for comprehensive hospitalization expenses related to accident and illness. It typically covers the following expenses:-

• Room, boarding expenses of the hospital bed
• Fees charged by physician, surgeon, anesthetist and other specialists
• Cost of medical procedures e.g. surgery, dialysis etc.
• Cost of medicines, medical equipments, consumables etc.
• Tests and procedures like X Ray, ECG, MRI, anesthesia etc

Some health insurance policies may also cover pre hospitalization medical expenses e.g. tests, diagnosis etc, up to the limit of your health insurance cover (sum insured). If your health insurance sum insured is Rs 5 lakhs and your hospital bill is Rs 6 lakhs, the health insurance company will pay Rs 5 lakhs and you will have to pay Rs 1 lakh.

Health insurance claims can be cashless or on a reimbursed basis. In a cashless claim, you do not have pay from your pocket. Your medical bills are settled directly by the insurance company to the hospital. In reimbursement, you have to settle the hospital bills and claim reimbursement from the insurer after submitting the bills. Obviously, cashless claims are much more convenient but for cashless claims you have to go to a hospital which is in the hospital network of the insurance company.

Health insurance claims can be cashless or on a reimbursed basis. In a cashless claim, you do not have pay from your pocket. Your medical bills are settled directly by the insurance company to the hospital. In reimbursement, you have to settle the hospital bills and claim reimbursement from the insurer after submitting the bills. Obviously, cashless claims are much more convenient but for cashless claims you have to go to a hospital which is in the hospital network of the insurance company.