10 Health Insurance Myths Busted

Health insurance is often a misunderstood financial product stemming from general lack of understanding and the complex fine print it comes with.

Since, health insurance is not so easy to understand by people, they tend to believe notions that are false.

Lack of understanding gives rise to myths around health insurance that people believe to be true.

Only if a little effort is made to understand the policy wordings and health insurance in general, these myths can be busted!

If you believed even any one of the below to be true, let’s get you going on busting some health insurance myths!

• Health insurance isn’t required when you’re young & fine

You know how lifestyle changes have made most of us prone to diseases and easily getting sick. Meaning, it’s not only elderly at risk of requiring medical help. Being young isn’t a guarantee to always being fit or disease free.

Thus, no matter the age, we all should be covered under health insurance to avoid uncertain medical expenses

• Employer provided health insurance is enough

It’s great that your employer provided you with health insurance. But is your corporate policy enough? Most of the time, the answer is no.

Corporate policies do not have an extensive sum insured. The coverage is not specific to your needs as it is common for the whole organization.

Another point to note here is that the moment you leave the organization, you cannot use your employer provided health policy, it expires.

Hence, it is wise to have your own individual health policy that is tailored to your needs.

• Minimum 24 hours of hospitalization is mandatory for insurance claims

Yes, this is true for most claims but not all.

With technical advancements, the time taken to perform certain surgeries and procedures has been reduced. There are procedures where a patient is discharged the same day surgery is performed - not requiring mandatory 24 hours of hospitalization. For example, eye surgery, chemotherapy, dialysis, etc.

Health policies today cover many day care procedures and hence you can file a claim for the same.

• Health insurance doesn’t cover pregnancy

Many of you might think that pregnancy is not covered by health insurance. Yes, that was the case years ago when insurers considered pregnancy a sure-shot event thus not providing coverage for the same.

But now most health policies cover maternity expenses that include expenses related to childbirth and even pre-post delivery expenses.

• Policy benefits begin from Day 1

Did you also think that if you bought a policy today, you can file a claim tomorrow?
Well, that’s not the case. You can’t file a claim for usually 30 days from the date of policy commencement except for accidental cases.

• You get full reimbursement of the cost of treatment

Whenever a claim is filed against the billed amount, there are certain expenses that insurance doesn’t cover. Also, insurance companies may have additional deductions in case of a reimbursement claim as treatment was not undertaken in the insurer’s network hospital.

Therefore, the amount reimbursed is generally less than the actual cost of treatment.

• Purchasing health policy online is unsafe

In an advancing technological era, when everything is going digital - one can easily search online to discover plans according to their needs and make a purchase instantly with least formalities.

This is a quick, convenient and safe process.

• Health insurance doesn’t cover pre-existing conditions

Pre-existing conditions are covered under health insurance but only after a certain specified period is over. Most policies cover pre-existing diseases after a waiting period of 4 years.

If you file a claim for a pre-existing disease in the waiting period, then it will be rejected.

• Bill amount = Amount your insurer pays

You might believe that if you’ve got a bill amount less than your sum insured then the whole amount will be payable by insurance. This isn’t true in most cases.

Certain expenses are not directly medical expenses. These are categorized as non-medical expenses which your insurer is not liable to pay.

Thus, there is some amount that goes out of your pocket which can increase if there’s applicability of copay and proportionate in your policy.

• Initial approval = Final approval

The approval that your insurer gives at admission during hospitalization is initial approval which is just an affirmation from the insurance company that treatment is covered up to a mentioned estimated amount.

People take this initial amount to be the final approved amount which is not the case. Final approval is given by insurance company only when they receive all final bills and treatment details.

Policy clauses vary from insurer to insurer and plan to plan. Thus, being aware of your health policy keeps you informed and you don’t end up believing the myths around.