8 Checks on your health insurance cover

Everybody has performed checks on health insurance covers after finding themselves in the throes of a pandemic. Have you looked for the right things?


1. Are you covered for Covid-19?

All health insurance policies offer coverage for Covid19, and treat it at par with any other illness or hospitalisation. 

Check specifically the medicines and other supplies which are covered and at what stage – before, during and after hospitalisation. 

Does it say something about oxygen cylinders, or injectibles like Remdesivir purchased from outside the hospital? What kind of receipts are required?

For how many days will the insurance company pay for ventilator support?

How are quarantine costs treated by the health insurance company?

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2. If you have recovered from Corona Virus Disease, perform a check on your health insurance cover

What is the policy for Covid recovered patients? What happens in case of a relapse?

If the health insurance policy is due for renewal, you may face a problem. It makes sense to do a health insurance comparison from various sites, do your own research and arrive at a conclusion, before you decide to buy a new policy.

Do intensive research for Health insurance plans for the family.

Read about health insurance policies for Covid-19 recovered patients here

3. Network hospitals

Which are the network hospitals covered by the health care insurance company in your vicinity, for cashless insurance cover? What is the reputation of those hospitals? Do they have beds available?

4. Third party administrator

Which company is the TPA appointed by the health care insurance provider, and what is its reputation in the market? Do they co-operate with customers?

5. Good hospitals

There may be good, reputed hospitals in your vicinity recommended, but which are not covered by your healthcare insurance provider. Check from someone what are their billing policies, and how do they treat patients not covered by insurance.

You will need to pay first, and claim reimbursement of bills later. 

  • Do they accept credit cards?
  • How much advance payment do they insist on? 
  • Do they insist that advance payment be made in cash?
  • How are the rates compared to other hospitals?

This will help you maintain adequate buffer in your emergency cash. 

6. Do they cover mental health? Check your health insurance cover

Health insurance definition did not provide for mental health treatment in the past. The matter has received attention since 2018. In August 2020, IRDAI (Insurance Regulatory Development Authority of India) made it mandatory for all health insurance companies to cover mental health. However, compliance levels amongst health insurance companies are reported to be low.

IRDAI has received a rap from the Finance Minister for overlooking tardiness on this account. Many insurance companies have shied away from providing a cover for treatment in mental health issues, citing lack of data about cost estimates and benchmarks in the area.

Many people suffer from depression or anxiety-related issues in the current scenario. Prolonged lockdown is likely to exacerbate problems. One may need counselling to overcome such problems, as it affects the family, much more than isolation for Covid-19 positive patients.

The companies known to cover mental illness are Max Bupa, Bharti Axa, Manipal Cigna, Star Health and HDFC Ergo.

Read more here

7. Are you covered by group health insurance provided by the employer?

If yes, seek clarity from HR on the intricacies of cover available. Exhaust the group health insurance cover first, so that you retain the no-claim benefit on the next premium of your personal health insurance.

In case some family members are not covered by the employer’s health insurance cover, ensure that they are adequately covered through other plans.

8. Are you planning to travel abroad?

It is imperative that you check coverage provided by your insurance providers. The cost of medical treatment in other countries can be prohibitive. 

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