When it comes to health insurance, ignorance is not bliss. What you don’t know can be turned against you at the time claim settlement.
Hence, it is very important to have a thorough knowledge of mediclaim plans. While you can read up the policy details on the policy documents, there are certain things that your health insurance company won’t tell you. Knowing these things will certainly help you understand the policy better and help you avoid problems later.
You Can Get Coverage for Out-Of-Network Hospitals
Whether you have enrolled in a regular health insurance online or a critical illness insurance plan, you can get coverage even if you choose to get treatment from an out-of-network hospital. You can deliberately choose to seek treatment from your preferred healthcare provider, even if it is not listed on your insurance company network. So if you already know that you will opt for an out-of-network provider, you can ask your insurance company for a written contract about the same. Taking the written contract is essential, as the insurance company cannot deny the claim at any cost.
You Can Seek the Doctor’s Help for Claim Denial
If your claim has been denied for the wrong reason, you always have the choice to appeal to it. You can turn to your doctor, who can explain to the insurance company about why the treatment was necessary. If the doctor is well established or reputed, you have increased chances of getting your claim through this approach. Asking your doctor to write a letter will make it hard for the insurance company to deny your claim. If nothing works, you can file a lawsuit against the insurance company.
Make Sure to Get Pre-Authorization
Unless it’s an emergency, make sure to get pre-authorization or approval from your insurance company before undergoing treatment. When you get the treatment pre-approved, you can be sure that your claim will be settled. Pre-authorization is especially important if you are opting for expensive procedures such as surgery.
Therapy Is Not Covered
Many people assume that mental therapies are covered under health insurance plans. This is because insurance companies won’t spell it out directly in their policy documents. Most of the insurance companies do not cover mental therapy related to substance abuse or depression. So if you are planning to attend any expensive therapy sessions, don’t expect the insurance companies to cover your claims.
The Cheapest Plan May Cost You More
It is the natural tendency of people to look for the cheapest health insurance online in hope of saving money. But at times, even the cheapest plans can cost you more. While you may be paying low premiums, the deductible can be quite high. So eventually you will have to shell out more from your pocket.