What Does Your Family Health Insurance Not Cover?

Mr. X buys a family health cover of 4 lacs for his family. After a year, Mr. X’s son encounters a strange pain in his stomach and ends up in the hospital.

Being covered with insurance policy, Mr. X is relieved about hospital bills, however, his claim gets rejected as his son has stone in his biliary system and the health cover does not include its treatment.

hdfc dual benefit

Such a situation leads to endless agony and financial crisis. To avoid situations like these, it is advisable to know exactly what is covered what is not covered under your family health plan.

Not just that, most Indian households do not even have a health cover at the first place. Just this year, MedIndia reported a survey conducted by the Praja Foundation, an NGO, which found that 71% of households in Mumbai did not have health insurance.

The need for good coverage was clearly there, however: in Mumbai, the average household spends INR 48,321 every year.

Fortunately, awareness of the need and availability of a health plan is finally driving more and more young people to seek out coverage in urban India.

70% of Indians currently looking to buy health policy want to make sure their children have coverage. A further 66% want to cover their spouse, and the average age of new purchasers is 32: young people hoping to start a family.

Raising awareness is good, even as health insurance becomes more common there are still some dangerous misconceptions that may set up new parents for an unpleasant surprise.

Chief among these is the belief that a health plan will cover all their medical expenses.

Why purchase family health coverage?

These days, six out of ten families in Mumbai prefer health coverage to life insurance: they’re hoping to provide preventative care and health services to their children and spouses, not just ensure their future in the event of a tragedy.

Surveys of health insurance awareness in areas like Delhi and Mumbai have turned up some contradictory data. MedIndia found that 69%of Indians expect their health insurance to cover all expenses, but the Economic Times of India reported that 52% of respondents to their survey believed that insurance only pays for hospitalization.

Neither one of these misconceptions is true, but with the right insurance package, you can make sure that common emergencies norare family costs covered. The secret? OPD benefits.

What are OPD benefits?

OPD stands for Outpatient Department benefits, and they cover numerous minor medical expenses that will crop up time and again for families with children.

22 health insurance companies in India will pay for day-care hospitalization: short hospital stays that are not overnight, or are only one night. However, only nine of those 22 offer OPD benefits.

OPD benefits include day-to-day expenses like dental care, eye exams, glasses or contact lenses, and hearing aids. They also cover some preventative care, like vaccines, consultations, and diagnostics, all expenses that add up quickly for new parents.

If your family plan does not include outpatient department benefits, your family could be picking up all those costs on your own.

Family plans with OPD benefits aren’t just important for couples with children: they’re essential for family planning as well. 30 percent of young Indian couples planning a family want health insurance.

However, only OPD plans will cover pregnancy, childbirth, and natal care as well as vaccinations and preventative care.

Who offers Outpatient Department benefits?

Now-a-days, the competition in the health insurance industry has led to viability of almost all the features with every insurance provider.

For instance, ICICI Lombard’s family health plan offers outpatient benefits at a price most young families can afford; they offer benefits like a daily cash allowance to keep a family afloat if a provider is hospitalized.

Even if you don’t have immediate plans to start a family, the earlier you buy a health coverage plan, the better off you’re likely to be.

There’s a good reason 32 is the average age to buy a family plan: younger people tend to be in better health, which means a lower premium and more benefits.

Buying a health policy young is the best way to ensure you can afford all the benefits you need to keep your family healthy and well cared for as soon as you need them!

Curated from What Does Your Family Health Insurance Not Cover?

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