Things to know about Mediclaim insurance

By | October 12, 2016

Mediclaim insurance is a hospitalization advantage that is provided by both private and public sector insurance companies. This insurance policy take cares of expenditures following hospitalization in case of following conditions:

  • In case of mishap
  • In case of sudden illness
  • In case of surgery during the tenure

Features of Mediclaim insurance:

  • It has a wider scope than serious illness because it covers hospitalization and cure toward mishap
  • It repays the actual medical expenditures.
  • The plan is taken to pay the expenses of hospitalization

Working of Mediclaim insurance:

There are mainly two types of claims which are there under the Mediclaim insurance. These are cashless procedure and Reimbursement.

  • Cashless procedure:

Cashless is a method wherein a patient is treated in a network hospital the insurance corporation settles either the entire or part of the claim with the hospital. This means, a patient does not need to compensate the money for the treatment to the hospital.

There are some ways which you need to follow for ensuring the claim process in a smooth way. Firstly, all empanelled hospitals will have an insurance desk in their place. An insured person has to get the pre authorization from the desk of hospital which has to be filled with accurate information because if he makes a mistake then it will delay the whole process. The filled form requires to be stamped by the hospital and the doctor has to be faxed it across the insurance company or third party administrator.

  • Reimbursement:

In this case, it is necessary to inform your insurer that a hospitalization has been taken place or likely take place in a near future. You can repay it by sending an email and by calling them. To get repay, you need to put forward all the receipts of payments, which also include all the bills of those medicines also which you have bought from outside chemist. You need to make ensure that original discharge card, final bills and payment receipts should be in one position, so that they can be presented to the insurer to get the repayment.

Things to check prior to purchasing a Mediclaim plan:

If you are planning to buy mediclaim insurance then it is advisable to check certain factors before buying it. These are as following:

Renewability age:

The policy provides coverage for one year only but in real, it is a relation between the insurance company and you. So, your health insurance plan should cover as your age because it is difficult to get insurance at that age. If your plan does not provide you coverage at that point of time then buying such a plan will not give peace of mind.

Individual and family floater:

In individual plan, each person is insured for a precise amount whereas in family floater the entire family is insured for a sum assured which is fixed. In case of family floater, when the main person demise or reaches a precise age the plan is closed even other members who are still younger cannot renew the policy.


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