Monday, November 29, 1999

Let`s uncomplicate!

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Life is uncertain; medical emergencies do happen when you least expect them - accidents, injuries, critical illnesses, sickness are unavoidable. What ensues are exorbitant medical consultation bills, hospital and nursing invoices, medicine payouts, the list is endless and certainly leaves a hole in the pocket. So what is the safest way out?Just imagine an insurance company paying all your bills, medical charges and leaving you with the least amount of stress. That's not just a dream anymore, it is a reality. Health insurance covers are no longer limited to covering daily expenses when hospitalised or hospitalisation costs. Today, health insurance plans has evolved and they not only cover expenses incurred during hospitalisation but also take care of payouts during the pre- as well as post-hospitalisation stages. This may include the money spent towards conducting the innumerable medical examinations, seeking the best opinions and certainly all the prescribed medication at the extent of the sum insured.The Indian public at large understands that the cost of healthcare is rising, and access to quality healthcare facilities requires significant financial wherewithal. However, so far, not many have seen insurance as the logical way to defray this significant financial risk. While it was alright in earlier days to try to pay for healthcare needs from one's pocket, the rising cost of healthcare means that such a move can now put a significant dent in one's finances, and even wipe away years on savings in one go.The need for health insurance in India is a line of business that is often wrapped up in impenetrable jargon, difficult to understand wording, and not fully transparent conditions. When is the right time to buy health insurance? How much coverage should I buy? What is a TPA? Does health insurance cover pregnancy? Does a policy offer outpatient consultations on a cashless basis? Are dental and optical care covered? Is there a health insurance which is truly 100 per-cent cashless? If you are young and have high blood pressure and diabetes then which health insurance should you buy?The smartest way to protect your health without burning up all your savings is to purchase a health cover that covers all costs and is yet affordable.There are different types of health insurance policies available depending on one's requirement and budget. Begin by defining your needs, what you want to cover yourself against - is it just critical illness, or injuries resulting from an accident, hospitalisation expenses or OPD expenses as well. Arrive at a realistic estimate of the health care costs you are likely to incur, to determine the total amount of cover required. There are companies that offer products that cover pharmacy bills, diagnostic tests and annual health check-ups, as well as dental and optical care. Such plans not only cover expenses related to hospitalisation expenses, but also maternity charges and outpatient costs. There are family floater plans available that extend coverage for self, spouse and two children, under the same policy and sum insured level. Infant from day one gets coverage should you opt for a certain plan before the birth of your child. Hence it's all about selecting the right policy, in line with your needs.In this era of changing lifestyle dynamics and work-related stress, one also has a choice of critical illness plans which offer one-time benefits. These cover specific critical illnesses such as heart attacks, cancer, diabetes, kidney failure, organ transplant or even paralysis.Most importantly, it's important to read the fine print to understand what's covered and what's not by your health insurer. Check all the details of the expenses that will be reimbursed such as diagnostic and medication costs might not be covered under all health insurance policies. Due to rising costs of health care many insurers have enforced sub-limits on various kinds of expenses. So, check whether there is a maximum amount each plan will pay for a specific expense. It also helps to know if expenses arising for treatment due to war, riots or a terrorist attack are covered.An emerging global trend in the health insurance market is the combination of packages that not only cover curative expenses but also focus on preventive care such as diagnostic tests and health checkups. Such preventive measures and checks go a long way in assisting people in reducing their susceptibility to many diseases. Thus, lessening the need for serious hospitalisations in the future.The writer is chief executive officer at the Apollo Munich Health Insurance

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