By Prasun Sikdar
I am 64 years and have an individual health insurance plan. I plan to undertake a cataract surgery. My insurer says it will pay a fixed amount which is half of the amount that the hospital will charge. What should I do?
This varies as per the product guidelines of the insurance firm. There are some who have a capping when it comes to procedures like cataract. There are some who apply a mandatory age-based co-pay at the age of 64 and there are some who honour the full claim without any co-pay. I would request you to refer to the terms and conditions document in your policy kit and understand the benefit better.
I, along with my spouse and two children, are holding a mediclaim policy. My 81-year-old father-in-law does not have any health cover. Can he be included in our policy?
In case your policy is an individual policy with four members in it then your father-in-law can be added at renewals. In case it is a family floater, then you will have to purchase a separate policy for your father-in-law. Declare his pre-existing medical conditions while opting for this cover. He may be asked to undergo pre-policy medical check-up. Also check the applicable conditions like maximum entry age, co-pay, sub-limits.
I had a family health insurance floater policy about seven years ago. I went to Dubai and my family had a cover from the employer. I have lost my job and we are back in India. Can I revive the policy and get the benefits?
This is kind of difficult as the maximum grace period generally allowed for renewing a health insurance policy is 30 days. In all probabilities you will have to opt for a fresh cover.
What is co-pay in a health insurance and will it reduce the premium?
There are different kinds of co-pay such as mandatory co-pay basis entry age, voluntary co-pay, etc. The one which reduces premium is called voluntary co-pay where you agree to bear a per cent of the admissible claim and hence get the premium reduced as per the terms of the product. One takes a call on opting for voluntary co-pay, considering age, health status and possibility of claim etc.
The writer is MD & CEO, ManipalCigna Health Insurance. Send your queries to email@example.com