The Fine Print of Mediclaim

In today's date when diseases are found to cross the human count, a Mediclaim is much needed. A Mediclaim is nothing but a type of health insurance that would help you during emergencies. Under this, a person's healthcare expenses are covered, as per the assured contract. A Mediclaim is different from health insurance. The difference between the two is that a Mediclaim merely covers hospital charges, whereas, in health insurance, along with the hospital charges, other miscellaneous expenses are also covered.

A Mediclaim provides reimbursement facilities, whereas health insurance provides a lump sum amount for critical illness along with the reimbursement facilities. Some certain terms and conditions are to be followed by you, listed by your insurer. These terms and conditions are pre-decided facts that bind you to the contract which differs from one policy to another offered by the insurer. But the most common terms that one should keep in mind while looking for a Mediclaim policy are premium, out of pocket medical expenses, claim period, waiting period and more. 

Coming to the first and foremost important thing- the premium. A premium is an amount that one needs to pay to the insurer periodically as per the given time frame to ensure their risks. The next thing that one should look out for is out-of-pocket expenses. Now different policies provide different areas of coverage. From this, you need to look out for the best option that suits you and would benefit you in covering up the expenses. While weighing the premium and out of pocket expenses, one should also look for the claim peculiarities. 

The claiming procedure of each policy differs. One can file a claim to the insurer to pay or reimburse for the services and expenses incurred for a healthcare professional. There's a fixed period when you can claim your benefits of the policy and this period is called the waiting period.

Generally, the waiting period for pre-existing conditions lasts for 4 years.  Also, in many cases, people with pre-existing conditions before signing the policy, are not covered with the benefits of that particular condition. For example, if you are diabetic and have already signed for a Mediclaim, then the policy won't cover the expenses incurred in any kind of treatment related to your pre-existing condition of diabetes.

To add on, if a person has taken up two policies, technically while abiding by the rules of a Mediclaim policy, they cannot claim both of them at the same time to cover their expense on the same condition. As the medication costs are increasing day by day, one should always choose a higher sum insured policy. 

Apart from the terms and conditions, there's a procedure on how one can file a claim. The very initial step is to submit the medical bills and invoice along with the verified documents of the patient and the insured for the verification of identity. Next, you need to fill up the claim form, get it stamped by the hospital authorities and attach the original relevant documents of the same. And lastly, after the completion of the form, one needs to send a copy of the file and documents to the insurer.

Under a Mediclaim, you benefit from unlimited claims throughout, until the sum assured is exhausted. Various Mediclaim policies also offer cashless treatment facilities to its insured. A Mediclaim policy, thus, cushions all the hospitalization costs that often pops up with no actual warning that would hamper your financial stability. Thus, having a Mediclaim policy helps you in situations like this.

Leave a Reply

Your email address will not be published. Required fields are marked *

We are glad you have chosen to leave a comment. Please keep in mind that comments are moderated according to our Comment Policy.

See other blogs by Wealthfare

Your fiscal cup of tea


About Us