Business & Finance

Health Insurances and its Complexities: According to Monika Halan

Author : Dr Deepthi N.S.

This article is inspired from the book by Monika Halan titled “Let’s Talk Money- You’ve Worked for It, Now Make It Work for You”.

This book is an eye opener for sure. With its simple language Halan’s book stands apart as it is one of the few ‘Self-Help Finance’ books out there written with a relatable Indian context. In the chapter dedicated exclusively to health insurance, she mentions being surprised when she discovers that even the CEOs of the most elite companies did not have health insurances or worse lived under the false shroud of having a ‘company-insurance cover’ and frankly speaking I’m surprised too. I shouldn’t be though considering most doctors I know learn about the intricate golden web that insurance companies have weaved into our lives very late in their careers when they end up on a hospital bed themselves in spite of dealing with insurances as a part of their work on a daily basis. You can get in but you sure as hell can’t get out (with a good deal).

So I had to come up here and write this article as I pretty much sum up 8 crucial tips that she swears by for selecting a suitable health insurance. Note that I haven’t said ‘best health insurance’ because no insurance is the best for you, sure they may be the best at their game and when it comes to providing you full body cover these sharks in disguise might in that process tear a limb or two.  

So here are Halan’s 8 tips to watch out for while selecting your invisible body armour – The Health insurance Policy

  1. Co-Pay Clause – Sticking true to its name it means that you and the insurance company share the costs of a bill. What’s the point of an insurance then? As unfair as it sounds this clause exists especially when senior citizens need cover as no insurance company would in their right mind would voluntarily cover whole expenses of this age group.
  2. Disease Waiting Period – Don’t get an insurance cover thinking that you’ll be protected from the very next day onwards. Most policies have a waiting period of thirty to ninety days even for emergency admissions and treatments.
  3. Sub-Limits – Hidden in your policy might be this clause that basically says yes you can rent out that private suite during hospital admission but we cover till only twin-bed sharing rooms. Some policies straight up mention the category of rooms or may limit in terms of room rent e.g. maximum cover for room rent up to 4000 rupees.  
  4. Pre Existing Disease Clause – You have been pre diagnosed with gall stones? Well we cover you only after four years! Pro tip do not hide your past medical history, trust me they have a way to refuse claims.
  5. Check for Exclusions – Pregnancy costs are not covered with most insurance policies. Check your document to make a list of diseases that are not covered.
  6. Costs before AND after hospitalization – Check the exact time and amount your policy covers costs for long term ailments e.g. physiotherapy after a hip replacement surgery.
  7. Day Care Procedures – Check on what day care cases are covered, how much is covered and do you have to stay for 24 hours to make claim?
  8. No Claims Bonus Feature– If you haven’t used your insurance policy in a year, a certain amount gets added as ‘bonus’ for the next year thereby increasing your cover. Find out if you have the NCB feature and what percentage of the ‘unused’ cover is added on to your next year’s cover.

The insurance policies are a complicated bunch of documents and I would be lying if I said selecting one for myself was a cake walk. So take your time but definitely look into the clauses and read all documents carefully before finalizing your health insurance cover.

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