Recent changes in health insurance have been sweeping and rapid.
So, our parents may not be able to differentiate between myths and facts about health insurance. How about you, though? Do you know if these are myths or facts?
Let’s debunk some common Health Insurance Myths:
24 Hour Hospitalisation is Essential for Claiming Health Insurance
This statement used to be true a few years ago. Daycare procedures are those where you can walk out of the hospitals within hours of walking in. They do not require you to be hospitalised for 24 hours.
Certain eye surgeries, dialysis, chemotherapy etc., are examples of daycare procedures. Modern health insurance covers these daycare procedures.
Dental treatment is not generally considered a daycare procedure. Hence it is not covered by most health insurance policies. So, while you no longer need to be hospitalised for 24 hours to claim health insurance.
It is not true that any and every procedure requiring less than 24 hours is covered. Check your policy document to know about the inclusions and exclusions.
All Benefits are Lost if you Renew the Policy after the Due Date
This is another common myth. Ideally, you should always renew your policy before the due date to get all renewal benefits. However, insurance companies do allow a 30 day grace period after the expiry date. If you renew within 30 days of expiry, you can still avail of the renewal benefits.
Smokers are not Eligible for Health Insurance
Insurers need you to declare pre-existing conditions, i.e. diseases or illnesses that you already have like diabetes or hypertension. They also require you to come clean about your habits. They may adjust the premium considering the higher risk based on the details that you provide. But they do not deny you insurance because of your habits or diseases.
The Insured Person is Covered for All Hospitalisations Right after Buying Health Insurance
Not entirely true. Insurers will ask you about any pre-existing conditions or diseases, like diabetes or a cardiac ailment. You will have to list them while buying the health insurance policy. Most insurers prescribe waiting periods of about 2 to 3 years for pre-existing conditions. These waiting periods for pre-existing conditions are described in the policy document.
Suppose you are hospitalised for any of the pre-existing conditions before the waiting period. Then the policy will not cover the hospitalisation. However, hospitalisations for pre-existing conditions after the waiting period are covered.
Health Insurance will Cover your Entire Hospitalisation Bill All the Time
This, too, is a myth. Health insurance has certain inclusions, exclusions and caps on expense categories. So, all of your hospitalisation bills may not always be covered.
For example, most policies do not cover consumables like syringes, oxygen masks, gloves, face masks etc. You will have to pay for them out of your own pocket. Also, policies have specific predefined caps or limits. Like on room rent, a policy may have a certain cap on daily room rent. It will only cover the room rent until the daily limit. You will have to pay for any daily room rent over and above this limit.
Health insurance Doesn’t Cover Maternity
This is not true. Most health insurance policies cover maternity. They also cover pre-hospitalisation and post-hospitalisation expenses for maternity. Just as they would for the hospitalisation for any other condition. However, there may be certain conditions that the policy prescribes like:
- Coverage only for the first pregnancy.
- Coverage for only the first and second pregnancy.
- Certain waiting periods between pregnancies.
You don’t need Health Insurance if you are Young and Healthy
This is certainly not true. You simply cannot predict what ailment you or anyone can incur and at what age. Especially nowadays when lifestyle diseases are starting to be quite common. Even among the young and the healthy.
Also, there are many advantages to buying health insurance when you are younger: Your premium will be lower because of your lower age. Since you are healthier, you will have lesser or no pre-existing conditions. This also translates to a lower premium. Also, even if you have any pre-existing conditions, you can wait through the waiting period.
Be Informed and Aware
These are some of the most common myths about health insurance. It’s always a good idea to speak to an insurance advisor and ask about them. The insurance advisor can separate the myths from the realities. Another great idea is to read the policy document and check all these points yourself. Yet another good idea is to compare various insurance policies online.
Make the Right Choice
Referring to all of these sources will make you well informed and aware of health insurance. You can then choose the policy that best addresses your specific insurance needs.
Now that your myths are cleared, you can read about the Fundamentals of applying for health insurance in India here.