Health Insurance- Handling emergency hospitalisation

Mediclaim policies offer cashless option at high-end hospitals, it is tempting for the insured to indulge in the best of medical treatment   even for non-life-threatening procedures. But remember, there can be a   huge variation in costs among different hospitals for the same procedures. While you, the insured, may not worry, as you may look at claims at as ‘payback time’ for getting benefits of premium payment   over a period of time, this may be tough in case of emergency hospitalisation. Thus, it is in the best interests for you and your family to be prepared and handle emergency hospitalisation in an organised manner. Here are a few tips:
 
  • Know your insurer/TPA, broker/agent closely. Keep all their contact details ready. Confirm with the intermediary the role they will play in case of your medical emergency.
 
  • Understand what is covered and not covered. Ideally, find out things when there is no emergency! Ensure that there is no change in policy wording during renewal.
 
  • Keep mediclaim policy documents, policy ID card, updated cashless hospitals list, insurer/TPA phone numbers, email and postal address in a place accessible to your family at home and even during travel. The postal address is needed for pre-and post-hospitalisation expenses reimbursement for cashless treatment.
 
  • Photo identity proof (passport, drivers’ licence, PAN card) of the insured are needed during cashless application and reimbursement claim submission.
 
  • Research the local hospitals and nursing homes. Narrow down to one or two hospitals which offer cashless as well as facilitate most of the medical procedures. Check the TPA desk at these hospitals and get their contact information.
 
  • Keep all medical reports, pharmacy bills, lab/diagnostic bills, etc, to establish a trail for your medical need. It is required for cashless approval and claims reimbursement. Keep photocopies of all the documents before submitting originals to insurer/TPA.
 
  • Be ready to pay for incidentals (that may or may not be reimbursed).
  Keep emergency cash at home as it may be needed even for cashless treatment.
  Registration and non-medical expenses are not covered.
 
The last thing, and the only one that you cannot physically train for, is the psychological preparation. Talk about emergency hospitalisation to your family and kids to make them aware of such situations and the reactions and steps required when facing an eventuality.

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