How to Get the Maximum Benefit from Your Health Insurance Policy

You are smart, you are savvy – you know how important it is to have adequate insurance cover. You have done your homework, compared policies and their benefits, and chosen the best possible plan for yourself and your family.

Sounds good, so far.

But every now and then, do you feel that are not able to take full advantage of your health insurance policy? Are you spending a good bit of money out of your pocket every time you fall sick, in spite of that health insurance policy that seems to just sit pretty in your drawer? To be able to utilize your health insurance policy in the best possible way, you need to put in some effort and educate yourself about your plan, and how it works.

Here’s how to get the maximum benefit from your health insurance policy:

Educate Yourself about Your Entitlements

Right at the time of buying your health insurance policy, go through the fine print. Find out what you are entitled to and understand what all you are covered for. Read the “Terms and Conditions” carefully, and if you are confused, or do not understand any clause, ask your agent to explain things. Most of us feel embarrassed about asking questions for fear of looking like ignoramuses, but it is better to push your ego aside and ask if you are not clear about anything.

Maintain a List of Empanelled Hospitals

If you do not know which hospitals your insurance company has tied up with when you are well, you will face problems when you are sick. Consider a scenario – out of the blue, you feel a shooting pain radiating through your left arm, you are sweating, and gasping for breath. In a tizzy, your spouse rushes you to the nearest hospital, trying hard to recollect which hospitals your insurance company has listed. But the mind blanks out. Not bothered about empanelled hospitals at that moment, your spouse just wants to reach a hospital – any hospital – as soon as possible. As things calm down, you realize that you are not at an empanelled hospital, and will have to cough up the hefty medical bill.

The best way to avoid this possibility is to make sure that you have a list of empanelled hospitals handy, and you know how to reach those hospitals. If you take a little trouble during your wellness, you will find it worth the while in your sickness.

Go for the Free Medical Check-ups

Do you know that most health insurance policies entitle policyholders to a free medical check-up once every four claim-free years? In fact, some insurance companies offer this facility every year, even if you have filed a claim. Chances are you do not. You are not the only one – most people do not know about this facility and, sadly, most insurance agents neglect to inform their clients about this provision. Even those who know about it are not sure how to take advantage of it, fearing that their premium might go up, should the test reveal any bad news.

It is important to understand that you will not be charged a higher premium at the time of renewal if your test result shows a condition you did not have at the time of buying the policy. So, what are you waiting for, go for that free medical check-up.

Buy Additional Cover

In these days of soaring medical costs, it is better to take additional cover, which is over and above your existing health insurance policy. If you want a larger cover, once you have taken a regular policy, it is advisable to buy a top-up policy, than expand your existing policy. With a top-up policy, you can save your regular policy for general claims, while using the top-up to cater to that one-time high hospital bill. And yes, it is perfectly alright to have more than one health insurance policy.

Pay Your Premium in Time

Hard to believe as this might be, a disproportionately large number of people forget to pay their premium in time. In fact, many forget to pay it at all. People get busy, or they go through some crisis, or they go abroad, and forget about the premium.

However, it is very important to pay your premium in time throughout the life of the policy. If your existing policy lapses because you did not pay your premium, you will have to pay a higher premium for a new policy. You will also forego the free check-up that you are entitled to every four claim-free years.

As they say, your health is in your hands. So is squeezing the maximum out of your health plan.

Suneeta Kaul is a journalist, a writer, and a blogger. She tracks the economy, the corporate sector and the stock markets, and is a keen follower of current events. Having started her career with The Economic Times, she has worked for publications such as The Asian Age, Business India, and Thomson-Reuters, among others.