What is health insurance and how can you benefit from it as a caregiver?
Caring for a person living with mental illness can be physically and emotionally exhausting and take a financial toll. As a caregiver, it is important to be aware of what financial support is available to you in India.
What is health insurance?
Health insurance is an insurance product that covers the medical and surgical expenses of the person who is insured. It is offered in the form of:
Reimbursement of the expenses that were incurred due to illness or injury
Cashless payments transferred directly to the hospital or clinic, where the person has undergone treatment.
To avail these, the person has to pay an annual sum or amount, known as premium. Health insurance is usually taken for future health emergencies that may or may not arise.
What is the need for health insurance?
Medical costs are rising every year. If a person has not saved enough money for emergencies, arranging for funds at the eleventh hour can be daunting. Having health insurance helps us be prepared for a medical emergency that may occur in the future—for instance, during old age.
What does health insurance cover?
Each healthcare policy has different terms and conditions. Usually, the premium covers medical costs of hospitalization, surgery, and any other major medical intervention that the person may incur in the future.
What is not covered under health insurance?
Each health insurance scheme lists the illnesses and surgical procedures that are covered as per its terms and conditions. There are some costs that may not covered by them, for example:
Plastic surgery, dermatological procedures that improve the external appearance of a person
Expensive meals or stay for the patient, their family members
Miscellaneous charges such as needles, syringes.
How much is an insurance premium?
The policy premium depends on the type of policy, life cover (the lump sum of money received upon the death of the person), the person's age and medical condition.
The premium must be paid until the policy term lasts, and renewed annually or once in two years, depending on what the scheme’s terms and conditions are.
What happens if one forgets to pay the premium?
If a person with insurance cover forgets to pay the premium and/or if the insurance policy lapses, they will not get back previous premium payments made.
Does the insurance cover have to be used up within the year?
The payment of the premium does not mean that the person should use their insurance cover every year, or, that they should exhaust every rupee from it.
Insurance policies are designed for potential medical conditions that may arise in the future.
What is the process of getting health insurance?
Before you enrol for a health insurance plan, make sure you have done enough research on the different schemes available, and find the one that is most suitable for you. Take into consideration factors such as pre-existing medical conditions, insurance owner’s annual income, eligibility criteria to sign up for the plan, and premium costs.
Once you have made an informed choice, enrol with the organization providing the insurance scheme. How, will depend on their process—signing up online through their website, or by visiting their nearest branch office.
Are there health insurance plans for people with mental illness?
In May of 2018, the Mental Healthcare Act 2017, came into effect. This stipulates that every health insurance plan should provide insurance for the treatment of mental illness. The insurance covers mental illnesses listed under the World Health Organisation ICD (International Classification of Diseases).