Health Insurance plans can be complicated. Often employees are unaware of the several benefits they can avail through the health insurance provided to them by their employer. Here are such health insurance benefits that employees should be well aware of.
1. Many day-care procedures are covered by health insurance.
It is a common misconception that health insurance in India only covers charges for in-patient hospitalisation or procedures which require hospitalization for more than 24 hours.
People are unaware of the fact that many health insurance policies also cover day care procedures, which is a separate category comprising over 150 procedures such as lithotripsy (kidney stone treatment), chemotherapy, cataract and many others.
Such was the case with an employee who ended up paying Rs30,000 from his own pocket for a medical procedure that was covered under the health insurance provided by his company.
Also Read: COVID Impact: 15% rise in bills for all medical procedures
With the same mindset that health insurance only covers payments involving procedures that require hospitalization for more than 24 hours, the employee paid for his lithotripsy, which required a one-hour visit to the hospital without filing for reimbursement.
2. Look up insurer network hospital list
Another common misunderstanding is that the policy will ensure cashless payment. This might not be applicable if the employee is admitted in a hospital that is not covered under their policy’s cashless hospital network.
This means that if the employee is getting treated in a hospital which does not fall under the network of hospitals of his/her insurance company, they will not be able to make a cashless payment. All employees should be well informed of the list of hospitals their insurance covers in order to not make an error during the time of an emergency.
Also Read: How to choose between Floater and Non-Floater Health Policy
3. Withholding information regarding pre-existing diseases
Another common mistake made by employees at the time of obtaining their policy is withholding information regarding existing diseases. Many employees have the misconception that if they hide their pre-existing ailments they will not have to go through the waiting period before making use of the policy to cover costs of treating such ailments. This is not true.
At the time of a claim, the insurer can get hold of the employee’s undisclosed medical history and deny the claim.
Therefore, it is better to reveal pre-existing ailments in order to avail benefits for them after the initial waiting period.
This goes to show how unaware employees usually are of the list of benefits that is provided to them through their health insurance.
It also highlights the need for proper communication when it comes to explaining the various components of health insurance to employees to ensure that they are able to fully utilise their insurance plan.
(Saransh Garg is Co-founder of Nova Benefits – a one-stop tech platform for providing the best health and wellness benefits to employees.)
Also Read: Why it’s imperative to have a personal health insurance
