Mediclaim Insurance

by IFFCO Tokio

WHAT IS MEDICLAIM INSURANCE

The basic Mediclaim policy provides reimbursement for treatments that require hospitalization. Some day care procedures are also covered, which may not require admission to a hospital.

WHY YOU NEED HEALTH INSURANCE

• You might not fall ill often, but that doesn’t imply that you never will• Life is unpredictable• Lifestyles are increasingly sedentary these days• Healthcare increases in price each year• If admitted, you’d want to concentrate on getting better and not on the

financial constraints• Cashless facilities at major hospitals• Coverage for a number of illnesses and day care procedures

THINGS TO KNOW

• Sum Assured• Co-Payment• Hospital Network• Exclusions

SUM ASSURED

The sum assured is the total amount that a policy holder may claim under their Mediclaim policy, over a period of a year.

• Individual plans: These plans are capped at a total sum, which can be claimed only by the individual covered.

• Family Floater: This type of plan has a total sum assured for everyone covered under the policy. Anyone who is covered can make a claim for an amount that will be deducted from the total sum assured for that policy term.

CO-PAYMENT

In Mediclaim policies, a co-payment amount is a fixed amount that you pay for receiving covered services, typically when you avail the service.

• On your Mediclaim plan, certain services may have a copayment amount

• You will need to pay that amount, when you get that service. The insurerwill pick up the difference

• At times, there might be a limit on the total number of times you can avail a service at a particular copayment amount

HOSPITAL NETWORK

The hospital network consists of a list of hospitals that are authorized to provide cashless services to Mediclaim holders. Things you should look for in the network hospital list:

• Whether your family doctors, or frequented hospitals are on the list• Look through the ratings and reviews for the nearby hospitals on the list• Do the nearby hospitals have ample facilities?• How far does this network exist? Will you be covered while travelling?

EXCLUSIONS

The hospital network consists of a list of hospitals that are authorized to provide cashless services to Mediclaim holders. Things you should look for in the network hospital list:

• Whether your family doctors, or frequented hospitals are on the list• Look through the ratings and reviews for the nearby hospitals on the list• Do the nearby hospitals have ample facilities?• How far does this network exist? Will you be covered while travelling?

4 IMPORTANT DETAILS YOU MUST KNOW BEFORE BUYING MEDICLAIM

• Pre-existing Diseases: Know if your policy covers pre-existing diseases and disclose any that you are suffering from.

• Sub-Limits and Daily Limits: Apart from the sum assured, there may be other limits at play in your policy.

• Exclusions: More than what is included, go through the exclusions in your policy.

• Renewals: No-claim bonus is mostly transferrable, so before renewing, always compare policies for better benefits.

HOW TO AVAIL MEDICLAIM INSURANCE ? There are two main ways of availing Mediclaim insurance -

• If a disease is diagnosed and you are eligible for a claim, you may get an approval for hospitalization, before getting admitted; or the hospital may send a request for approval right after admission (in emergency cases).

Here, the insurance provider will give the hospital or clinic a go ahead, with a maximum amount approval. The reimbursed amount will be paid directly to the hospital or healthcare center.

• The insured may make the payment to the hospital out of his pocket and then put in a claim to the insurance provider for reimbursement of the amount. In this case, the amount will be paid put to the insured.

BUY MEDICLAIM INSURANCE WITH IFFCO Tokio

IFFCO Tokio is a general insurance company that is 100% committed to providing insurance that can suit all your needs. With a number of specially tailored Mediclaim policies, IFFCO Tokio puts the needs of its customers first, and that is reflected in the wide array of insurance policies that are offered specifically to ensure the health and well-being of your family and you. The customized covers and personalized services help create insurance products that are a complete value for money and suited for all needs.

IFFCO-TOKIO

Corporate Office, IFFCO Tower,

Plot No. 3, Sector 29, Gurgaon -122001 Haryana(India)