An indemnity health plan offers plenty of benefits. Here is a description of each of them:
If you read through the inclusions of this type of policy, you will realise that it has an extensive scope for treatment expenses. It covers you for a claim on the actual hospital bills for a maximum limit of the sum insured. This coverage includes room rent, diagnostic test and ICU room charges, medicines, treatment expenses, and other costs.
An indemnity-based plan holder can opt for cashless treatment at one of the network hospitals. In a cashless claim, the insurer directly settles the medical bill with the hospital. In this case, the policyholder does not need to pay anything except deductible or other costs not included in the policy.
Insurance companies offering the indemnity health policy have hospitals in their network. Most policyholders like to choose a preferred doctor or hospital for treatment, making this benefit essential. Moreover, you can avail of cashless facilities at these hospitals without stressing about the bills.
Before undergoing surgery, check with the hospital’s information desk or TPA department if it has a tie-up with your insurance company. The TPA desk can help you file a cashless claim before hospitalisation. Submit all the essential documents to acquire insurance approval before admission.
The premium outflow is a vital consideration to buy health insurance. An indemnity plan has a deductible that a policyholder needs to pay during the claim process. As a result, the insurance company’s risk is reduced, and they can offer a lower premium to the policyholder.
Co-payment is a feature of health insurance wherein a part of the medical bill is paid by the policyholder instead of the insurer. The policy terms define it as a fixed amount or percentage of the treatment expense.
Generally, indemnity health plans have a co-payment option. If the co-pay component of the plan is higher, the premium payout requirement is lower.
For example, imagine your health insurance policy provides a health cover of ₹7 lakh, with a co-payment of ₹70,000. You have a medical emergency requiring hospitalisation, and your medical bills are worth ₹7 lakh. Out of the total bill of ₹7 lakh, you pay ₹70,000, and the insurer pays ₹6.3 lakh.