Things to Keep in Mind While Claiming Health Insurance

With increasing medical costs, lifestyle diseases and stress, health insurance has become an expensive industry. It no longer remains the employee benefit or tax incentive it once was. Instead, it is now a necessity.

However, the major downside to health insurance is the time taken for the claiming process takes. This discourages several buyers since they do not have the patience and willpower requires to sit through this stressful and often frustrating process.

However, it is noteworthy that with a little planning and an understanding of the do(s) and don’t(s), this entire procedure is much easier and faster, making it completely efficient for the customer. In this article, we are giving you a quick run-down of the do(s) and don’t(s) when purchasing the policy and filing claims:

DO Provide Complete Information to Your Insurer

We cannot stress the importance of ensuring your insurer has all the information necessary. When you decide to purchase insurance, begin keeping exhaustive medical records disclosing past and present illnesses. A complete medical background is the only way your insurer can decide what your upper limit for medical expenses can be.

Dont Leave Paperwork to the Last Second

If you have a procedure planned, intimate your insurer about it as soon as possible by submitting the relevant paperwork 3-4 days in advance. If it is an emergency procedure, your company needs to know within the next 24 hours.

If you make your claim under a cashless arrangement or through reimbursements, the insurer needs the relevant paperwork.

Do Get Full Information in Case of Hospitalization

If you are planning to get hospitalized for an illness, you need to provide OPD consultation papers. Following that, you need to furnish all:

  • Bills
  • Prescriptions
  • Consultation Receipts
  • Medical Reports
  • The Letter from your Doctor Advising Hospitalization
  • Stamped Hospital Bills and Receipts

And, any other documents you may have from the hospital. If you opt for a reimbursement process, ensure you settle all the expenses yourself. Also, note that in the cashless claim, there is a possibility you need to bear some expenses out of your pocket.

If you choose a non-network hospital, obtain all the information about your procedure on the official letterhead of the hospital and submit it to your insurer.

Dont- Forget to Get Complete Information from Your Company

Therefore, we have established the importance of giving a complete medical background. However, it is just as important to have an equally extensive amount of information about your policy. This means you need to ask about:

  • Exclusions
  • Limits
  • Sub-limits

Also, remember to always read the fine print.

Ensure you know the policy inside-out when you sign off on it and always keep your health-card and any government ID card on hand during any procedure where insurance would be needed.

Do – Always Pay Your Premiums on Time

This is a great way of building rapport and establishing reliability and trust with your company. Ensuring your premiums are always paid up so that your policy does not lapse tells the company you are serious about your insurance.

These, along with ensuring they are always in the know about any health-related issues you may face guarantee a good relationship between you and your insurer.

Dont – Exceed Your Approved Upper Limit

Once you get an upper limit approved, staying within it during your procedures is paramount. This is the only way you ensure that your claims are trustworthy. If you constantly overshoot your limit, it fosters bad blood with your insurers as well as you bearing medical costs that insurance otherwise helps avoid.

Do – Keep Your Insurer in the Loop

Constant communication is key when it comes to health insurance. Intimating and updating your company and insurer of any relevant developments in your life ensures they trust you. It is also through establishing such a healthy relationship that there is a higher likelihood they grant you extensions to submit evidence.

The idea of health insurance is that you always have a plan to fall back on. By being insured, you have a guaranteed and reliable safety net so you never feel like your medical expenses or procedures are taking a huge financial toll on you. All you need for the perfect insurance experience is a little bit of foresight and planning.

You can find the best insurance consultants for your needs at Cover 360. Our goal is finding you a plan ideal for your needs. We stay up-to-date on all the latest insurance plans so we can save you all that research time! Instead, all you need to do is contact us – and we’re available 24/7 – and get the perfect plan for you!

Read More About : Health Insurance Claim

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