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Benefits of health plan Research Team | Posted On Monday, July 20,2015, 01:14 PM

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Benefits of health plan



You have just bought a new smart phone. It has a number of applications and you don’t know how to use most of them.
Have you bothered to know what most of these applications do?
Your health plan is no different than a smart phone. It has a number of features which you might not have bothered to find out.Know the benefits of health plan before availing it.

The free health check up provided in your health plan:

Your health plan might provide you a free health checkup once every four years. Your health plan needs to be renewed in time and there should be no medical claims on the health plan, in the four years you have availed it.
Your health plan might also provide you a free health check up once every year, even if you have made a claim depending on the type of health plan you have availed.

Your health check up is conducted in an empanelled center (Medical center or a clinical laboratory) which has a tie-up with your health Insurer.
You will be subject to standard medical tests (blood test, urine test, chest x-ray, general physical checkup and a check on your lipid profile (Obesity tests).The tests might be decided/specified by your health insurer.
The cost of these tests is settled by your health Insurer and you do not have to pay for these tests if they are conducted at medical centers where your health insurer has a tie up. These are benefits of a health plan.


What happens if your health check up is conducted at a medical center near your home (place of your preference where your health insurer does not have a tie up)?

The medical tests are conducted at the medical center of your preference and you have to pay for these tests. You are then reimbursed the expenses of these medical tests. (Your health insurer pays back the expenses of your medical tests).

There might be a sublimit in these health plans (You might be reimbursed 1% of your average basic sum assured over the 4 years you have availed the health policy). If you have availed a health plan with an average sum assured of INR 2 Lakhs over 4 years, then you will be reimbursed up to INR 2000 for your medical tests.

Expenses of a donor for an organ transplant:

What if you need an organ transplant?
If you are diagnosed with a medical condition for which you require an organ transplant, then the cost of treatment of the donor (donor’s hospitalization expenses), are also covered under the health plan.

What if you need traditional forms of medical treatment such as Ayurveda, Unani or homeopathy?
If you require treatment for a medical condition under Ayurveda, Unani or homeopathy then you are reimbursed up to 25% of these expenses depending on the type of health plan you avail. You need to undergo this treatment in a government hospital.

You have paid a premium (your hard earned money) for the health plan and you must avail the maximum benefit from it. So study that health plan and get benefits of the health plan.


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