Posts Tagged ‘health insurance’

5 Health Insurance Myths that may put you at risk

Health insurance or mediclaim is a labyrinth full of exclusions, room rate caps, pre-existing illnesses, loading, no claim bonus etc. While we do not decode all of these, we do attack some common myths that exist in the minds of the customer. Often the broker is also clueless or prefers to act dumb. The health insurance field is very much “buyers beware”, so read on.

 1.    When I buy health insurance, all I need to do is price comparisons, all plan features are essentially the same

Price is just the first comparison point for health insurance policies. Other important touch points where the polices will differ must be compared:

  • Room rent sub limits – the public insurers sub limits are usually capped at 1% of the sum assured or Rs 5000 whichever is lower. The room sub limit also restricts the reimbursement you will get for other expenses to the same category.
  • Insurance co-pay – It means that the expenses you claim will be divided between the insurer and you. So if there is a co-pay clause of 20% then for a claim of Rs.1,00,000, the insurer will cover only Rs.80,000/-
  • Renewable age: Many insurance companies will not renew your insurance policy once you are past 60 and need it the most. Do watch out for this since there are insurers which will give you insurance even at 80 years.

2.    Once I have brought the policy, I can blindly renew it the next year

Expect changes in your policy every year. The policy pricing and terms will change according to your age, claims made throughout the year, the insurers’ loading policy and the insurers’ internal policy changes. The insurance policy contract is an annual contract (at times two or three years’ contract), hence it is free to change over time. Besides there may be some framework changes from IRDA, the insurance regulator. Do ask your agent clearly about what changes have occurred.

3.    You need a minimum 24-hour hospitalisation to be claim health insurance

While this was true till a few years ago, 24-hour hospitalisation is not a criterion for making a claim. Due to advancement in medicine and better awareness, many overnight procedures can now be completed within a shorter period. Infact many insurers use the number of day care procedure offered as a selling point.

4.    The policy covering the maximum procedures / having the most day care procedures and pre-existing illness covered is the better policy

So which policy would you buy, one which covers a 160 day care procedures or one which covers 85 procedures? Well you might be making a mistake if you buy the first one. Often insurers list all possible variations of procedure make the numbers swell and also to exclude procedure. For instance one insurer mentions 4 different type of Tonsils procedure while another just mentions Tonsils and covers all variations of the treatment (which are likely to be more than 4).

Most insurers will cover pre-existing illness after a delay of 3-5 years. If an insurer is covering this with a first time buyer, then he will load it up in the cost.

  1. 5.    Since my policy offers cashless facilities, I do not need a medical emergency fund

In a cashless system, when you get hospitalized with an approved network hospital, the Insurance Company or  TPA co-ordinates with the hospital and settles the bill without you having to pay first. This however is subject to an approval for the procedure. In case of an emergency hospitalisation, the authorisation may take a few hours or it may even take a day if the insured is admitted on a holiday.

The hospital is likely to ask you to deposit cash before starting any procedure. Hence a medical emergency fund is a must even if you enjoy cashless health insurance facilities.


Will health insurance in New Orleans rise too?

Fox News reports that there are serious long term health effects of Hurricane gustav

Will we see a rise in health insurance rates in New Orleans and other places which have chronic problems like earthquakes in California or snow storms in Alaska

Below are some of the possible hort term and long term health effects of Gustav

1. Exposure to toxic contaminants. As adults and children crowd into homes and shelters, one of the biggest threats is exposure to toxic substances such as carbon monoxide, Alvarez said.

This threat stems from the use of indoor portable generators, charcoal grills, or camp stoves during power outages.

“One has to be careful because carbon monoxide is a silent killer,” Alvarez said.

According to the Centers for Disease Control and Prevention, there were 51 cases of carbon monoxide poisoning, including five deaths, in Alabama, Louisiana and Mississippi during and after Hurricane Katrina.

Carbon monoxide poisoning is hard to diagnose but known symptoms include headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion, according to the CDC.

It should be noted that medical experts recommend not using devices powered by charcoal, gasoline and kerosene indoors. These devices should only be used in well-ventilated areas.

2. Increased risk for West Nile virus. Louisiana and other Gulf Coast regions are hotbeds for this mosquito-borne illness. And the standing water left after a hurricane is breeding ground for mosquitoes and only leaves residents more vulnerable to this potentially fatal virus, Alvarez said.

“The disease has the potential to effect dozens of people after the hurricane, possibly killing some,” he said.

The CDC reported a 2-fold increase in West Nile cases in the Gulf Coast region following Hurricane Katrina.

West Nile is transmitted through the mosquito bites. There is no vaccine. The disease is usually symptomless but can result in encephalitis or swelling of the brain, which can be fatal. Residents who remain in the Gulf Coast region following Gustav should remove any pools of standing water from their living areas and use mosquito repellent to minimize their chances of being bitten.

3. Contaminated water. The flooding caused by Hurricane Gustav has the potential contaminate water supplies with fecal matter. Drinking and bathing in water contaminated with fecal matter can result in the spread of e. coli and the norovirus, which can result in diarrhea, stomach cramping, nausea and dehydration.

Residents should only drink bottled water. Tap water can be disinfected by adding 1/8 teaspoon unscented chlorine bleach per gallon of clear water or 1/4 teaspoon per gallon of cloudy water. Toys and other items that come into contact with contaminated water should be disinfected before use. Alcohol-based sanitizers may be used to clean hands in absence of clean tap water.

4. Mental health. Many residents in the Gulf Coast are experiencing the effects of a hurricane for the second time in three years.

“Depression is still a chronic public health issue for residents who experienced the devastating effects of Hurricane Katrina,” he said. “And this is something that really needs to be monitored this time around.”

Residents, especially children, should be watched and provided with medical assistance for symptoms of depression, anxiety and post-traumatic stress disorder, Alvarez said.

5. Child asthma. The high winds of Hurricane Gustav will cause both toxic and non-toxic chemicals and gases to fill the air around the Gulf Coast. This can be especially harmful to children who suffer from asthma. Alavarez recommended that parents and rescue workers monitor children for signs of asthma and to ensure that asthma medication is readily available to youths.