Buying a medical insurance plan should involve some consideration on your part when it comes to the plan features and coverage options. Blindly buying a plan because your friend bought that too or your agent asked you to. Do we conduct any research and go through the checklist of health insurance FAQ when buying a policy or do we settle on whatever the agent pitches us?
Handy list of health insurance FAQ:
Q – Which are the network hospitals in your vicinity?
To avail a cashless settlement of your claim, you should be admitted in a network hospital. A company has a list of such hospitals and you need to find out whether the hospital in the company’s network is your preferred choice of hospital and/or located in your area.
Q – Is my policy valid Anywhere within the state?
This is a one of the most important health insurance questions to be considered because medical emergencies may arise anywhere. Usually, health plans cover treatments anywhere in India but you should make sure of this clause. Find out whether the claim settlement in your policy has any geographical limitations or not. There are some medical insurance plans that offer international coverage too.
Q – Will I get covered for my pre-existing illnesses?
Every insurer excludes coverage on the pre-existing illnesses for certain tenure at the starting of the policy. You need to find out what this waiting period for your pre-existing illness is and how soon can you be covered for your pre-existing illnesses. Basically, you need to understand whether your pre exiting condition is temporarily not covered or is it completely excluded from the scope of coverage.
Q – Whom do I call at the time of an emergency hospitalization?
An emergency situation involves a lot of stress and you don’t need the additional burden of finding out the claim settlement process. If your policy facilitates cashless settlement of claims, find out the policy of emergency hospitalization. Ask about the documentation and, most importantly, whom to contact at the time of such emergency hospitalization. Good brokers have a customer service desk or a specifically appointed representative who would help at the time of claim.
Q –What to do if I am admitted in a non-network hospital?
In an emergency situation, you might beadmitted in a non-network hospital and knowing the claim protocol at that timeis imperative. Always remember that treatment in a non-network hospital would be on a reimbursement basis only where you would have to shoulder the medical bills and then get them reimbursed from your insurer. So find out the reimbursement process, the documents required in this case, and the deadline for informing the insurance company, etc. for this situation.
Q — How long do I need to keep this health insurance policy? What if I don’t need it for very long?
Unlike employer-sponsored health insurance plans that might lock you into your coverage for a year, individual and family plans that you buy on your own can be cancelled at any time. You’ll typically pay for your coverage on a month-to-month basis. When you want to discontinue your coverage, contact your licensed agent or the insurance company directly.
Q — Can I buy a health insurance policy from one state and use it in another?
“Health insurance is regulated on a state-by-state basis and each state has its own health insurance market. Buying health insurance across state lines is not allowed at present – and the fact is that it wouldn’t make much sense to do so. Health insurance companies negotiate with doctors and hospitals in their state or local area to secure discounted priceson medical services for their members. That’s one of the basic benefits of health insurance. However, health insurance companies do not typically negotiate discounted rates with health care providers outside of their state. As a result,if you were to buy a plan in one state and use it in another, you would probably have to pay morefor your medical care than if you bought a health insurance policy for your own state.
Tips To Know on Health Insurance
* If you’re under age 26 and your parents are agreeable, you can stay enrolled in your family’s health insurance plan. A lot of young people do this, andif you live close to home and have access to network doctors, it may be your most affordable option.
* Choose plans that provide coverage for prescription drugs, which drugs are covered can vary significantly from one plan to another..Some health plans place different drugs in different coverage tiers, while others may excludecoverage for one drug butextend coverage for a second one when both are used to treat the same condition. If you’re someone who uses prescription drugs on a regular basis, you can potentially save a lot of money by knowing which plans will cover your personal prescription drug needs at the highest level.
* You should always double check whether or not a doctor accepts a particular coverage before you enroll. If you end up going to a doctor, who is outside of your provider network it can cost you substantially more than if that doctor was in your plans network. To verify coverage, don’t just simply call the doctor’s office, and assume they’re in your provider network if they say that they “accept” your plan. It’s always a good idea to confirm the doctors network status with a licensed agent or the insurance carrier.
If you are unsure about the insurance company you are dealing with, STOP before signing any paperwork or writing a check; CALL your state insurance department – easily reached by phone; and CONFIRM the company or agent offering insurance is legitimate and licensed in the state.