The mediclaim plan is the insurance policy that will help in paying out the expenses incurred during the hospitalisation of the people who have been insured under the policy. The payout can be done depending upon the cashless or the reimbursement basis which will further depend upon the type of policy that the people have chosen. The policyholders will be submitting all the relevant bills once the hospitalisation is over to the concerned authorities so that they can settle the deal directly and can make the reimbursement of the expenses perfectly. The very basic motive of mediclaim policy in India is to facilitate the policyholders with proper scope of availing the cashless treatment in a very hassle-free manner.
Following are the things which the people need to know about the mediclaim policies in India:
- The treatment cost will be covered: This will include all the expenditures for treatment including the hospitalisation like medicines, operation theatre charges, X-ray expenses, blood expenses, oxygen expenses and the diagnostic procedures which are covered under the coverage.
- The charges for accommodation in the hospital will be covered: All the expenses for getting admitted into the basic wards or ICU will be covered under the mediclaim policy along with fees of the medical professionals as well.
- The reimbursement claim system: To make a successful reimbursement claim the individuals need to inform the hospital and ensure that they are keeping proper track of all the expenditures which have been incurred by keeping the bills in a single place. At the time of filing of the claim with the correct information and submitting everything along with bills of expenditure it is very much important for the people to ensure that there is no containing of any kind of false information otherwise the claim might get delayed or even rejected. So, a duly filed claim from the concerned people with all the necessary documents will always ensure that claim will be easily approved. In case the claim has been denied by the company then one can always ask for a proper explanation and it is also very important to ask the mediclaim policy provider to state the clauses on which basis the claim has been rejected.
- The cashless treatment claim: In this particular case the individuals will be no need of paying even a single penny to the hospital. First of all the individuals need to gather the information on the list of hospitals which is in the network of the mediclaim provider. After this people will be collecting the pre-authorisation form from the desk and include the exact information and submit it back to the desk. After this, it will be signed and stamped by the doctor and authorisation of the hospital and once all the formalities are over the form will be sent to the TPA of the mediclaim provider. If the insurer will settle the claim directly that the form will be sent to the mediclaim policy provider in India and finally the TPA will evaluate the form and grant a specific sum which the hospital authorities will receive through fax and will inform them that amount has been sanctioned to undergo the cashless treatment.
- The cashless claim in the emergency cases: It is very much understandable that people will not get time for filing the pre-authorisation form if the hospitalisation has to be undertaken on an emergency basis because of accidents. In all such cases, people will get four hours after the hospitalisation to fill up and send the pre-authorisation form and further it is crucial to carry ID proof of the mediclaim to the hospital.
- Things to be taken care of at the time of purchasing mediclaim policy: It is very much important for the people to be aware of the policy in terms of individual policy and the family mediclaim policy. Apart from this the individuals also need to be very much clear about the maximum age of renewal and because the age is directly linked with the chances of getting sick which are further helpful in terms of determining the amount to be covered. Apart from this, being aware of the renewal conditions is very much important on the behalf of people and further, they must have a clear-cut idea about the pre-existing conditions and coverage amount so that perfect decisions are always made.
Care health insurance is the best possible platform for all the mediclaim related policy and enquiries for the people so that they can get the best possible plans for their needs. This will also help in making sure that there will be no wastage of time and people will be getting the best possible offers on the mediclaim policies which will further help in fulfilling their overall needs and requirements in a hassle-free manner so that they can get the best treatment all the time.