Did your advisor gave you the impression that your insurance company covers every last penny billed by their network hospital ? Well, you have the wrong idea. There is a list of 199 items grouped under the Non-Payables or Non-Admissible expenses by IRDA, and are not covered under your basic Health Insurance Policy.
Check out the full list of exclusions published by IRDA, when it comes to an IP Bill;
List of Non-Admissible Expenses by IRDA
When most of the insured people already know this, they do not understand the gravity of the real underlying problem here and
For a regular treatment for a 1 lakh bill you may have to pay upto 5% for disposables, handrub, diet meals etc, which comes under exclusions. But when you take the case of COVID treatment at a private hospital, an average bill comes to 6-7 Lakhs (as per reported Claims settled in Delhi) for 13 days COVID treatment. Out of which upto 20% (ie, approx 1 lakh) comes under the exclusion like, PPE Kit used by all the caregivers and doctors of the patient, Sanetization, Syringes, Diet Suppliments etc, and so not payable by the Insurance company.
Now you can solve this with 2 simple options;
1) Port to a Policy with Protection rider as in a HDFC-ERGO Optima Restore where you get "the most satisfying claim settlement experience" . It covers everything including non-payables and you literally get 100% cashless settlement with a Zero payable bill.
2) You can also opt for a Cash Benefit Rider, which is an add-on feature where you pay an additional premium to get a daily benefit of upto Rs 3000 per day and thus making you whole while paying the exclusion bill amount which comes after the claim settlement.
Feel free to comment your Insurance Company name and your Age to know whether your Policy covers the Non-Admissible Expenses.
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