In HEALTHCARE COSTS AND YOU – PART 1 I introduced you to the two ways of covering your medical bills, which are Mediclaim and Critical Illness policy. In this article we will try and understand our need for Mediclaim and what an ideal Mediclaim policy should be. Mediclaim should be in every home and all the family members should be covered by the plan. It is simply because, we would not like to be caught off-guard by a surprise attack of hospitalization on our finances. Mediclaim covers the hospitalization expenses and as such is an indispensible solution to protect our financial health in such a situation. What should be an ideal Mediclaim policy like? A Mediclaim policy should have:
- All expenses in the hospital covered. Hospital charges includes room rents, ICCU charges, doctor charges, operation theatre charges, all diagnostic charges in the hospital, all medicines, oxygen, blood transfusions, all therapy charges like chemotherapy, radiotherapy, etc.
- Maximum number of diseases should be covered.
- Some policies have a coverage limit of 10% – 70% of Sum Insured on certain specified diseases, the balance being payable by the insured person. This is known as co-pay. This is not desired as we are trying to have a comprehensive protection against all sort of disease-attack. Paying the balance amount ourselves can be a huge expense itself.
- High-costing day care procedures should be covered too as the costs can be considerable for certain type of day-care procedures.
- Cashless facility is absolutely must and hence maximum number of networked hospitals should be in the purview of the policy. We would not want to pay a huge hospital bill first, do we? What is the point in doing a Mediclaim if we are required to pay anyway?
- All pre and post hospitalization expenses should be covered as the cost of medicines and diagnosis can be considerable.
- There should not be any extra premium payable after a claim, commonly known as loading.
- Health check-up facility should be provided.
- It should provide tax benefits.
- There should be a discount on the premium if it is availed for the whole family.
An ideal Mediclaim policy should meet all the above criterions. We are trying to protect our finances and we should ensure that a huge medical bill do not ruin it. However, with some policies, some additional frills are provided, which are not really necessary. Although we may think of these facilities as a comprehensive coverage plan, these frills only add to a higher premium. These are:
- Ambulance Charges, which we may or may not need. If we need it at all, we can meet the expense on our own.
- Maternity benefits are excluded from most policies; however, some also provide it. It can be avoided if there is no need for it.
- Some policies also provide coverage for dental treatments, spectacles, etc., which are not provided by most policies. These expenses are not huge really and if avoided, premiums can come down.
- Some policies provide daily cash allowance, which can be utilized for shared accommodation and other similar expenses. Availing it means a higher premium too and at best should be avoided.
- Avoiding coverage for minor diseases like allergies, headaches, etc., can reduce the premium too.
Each policy has it’s own terms and conditions and you should read them all before buying one. I have discussed about the absolute musts in a Mediclaim policy and the frills that can be avoided. I am sure this will bring some clarity to our judgments and help in deciding a good policy. Watch out for Part 3 soon for more on “Healthcare Costs and You”.