Restoration Benefits in Health Insurance
The growing number of chronic diseases and rapidly increasing healthcare costs must have often left you thinking aloud whether your health insurance coverage is enough or not.
What would happen if the sum insured of the health plan falls short? How can the sum insured be increased without burning a hole in the pocket? If you have these questions in mind, take a look at the restoration benefit in health insurance.
Restoration benefit is an add-on cover to enhance your health cover if required. As the name suggests, it restores or replenishes your original sum insured if you have exhausted it due to hospitalisation or other expenses.
It can be seen as a recharge of your sum insured amount so that your health insurance policy provides you ample coverage in case you need hospitalisation twice within a policy year.
For example, you have a health policy with a sum insured of Rs. 5 lakh. You fell ill and had to undergo a sudden surgery. Your hospital bill was over and above Rs. 5 lakh and you ended up consuming all your sum insured.
A few months later during the same year, you were hospitalised again for a treatment, paying a bill of Rs. 2 lakh this time. If you would have the add-on restoration benefit cover, then your sum insured would be reinstated to Rs. 5 lakh. And your policy would be able to cover your second hospitalisation as well.
Without the restoration benefit, your policy would fail to provide you any financial assistance as you have already used your sum insured. So, you will pay the hospital bill from your pocket.
It is important to note here that the restoration benefit can increase the premium price of your health policy since it is an add-on cover. But the additional premium is less compared to what you would have paid if you wanted to double the sum insured you already have.
Why would anyone buy a health policy with higher sum insured when they can simply opt for lower sum insured with restoration benefits by paying a little extra premium?
That’s because restoration benefit comes with certain conditions that you should be aware of:
-- Restoration benefit cannot be used for your first claim during the year. It means that even if your sum insured is completely exhausted during your first hospitalisation and you need more money to pay the bills, the restoration benefit would not help. It will cover you only for the second hospitalisation or future claims within the same policy year.
-- In most cases, restoration benefit is only available for future claims that are not related to the illness for which a claim has already been paid during the same year. Some insurers have relaxed this condition, but they still demand that the two hospitalisations should be 30-45 days apart to get the restoration benefit.
-- The sum insured restored cannot be carried forward to the next policy year if you have not consumed it completely within the same year.
Complete exhaustion: This type of restoration benefit comes into play only when the entire sum insured is exhausted up to the last penny. So, even if you have just Rs. 10,000 left from the sum insured of Rs. 5 lakh after your first hospitalisation, you cannot get the restoration benefit for your second hospitalisation.
Partial exhaustion: This type of restoration benefit is more helpful for policyholders as it can restore the entire sum insured even on partial exhaustion of the base sum insured.
Conclusion:
Restoration benefit is an extremely useful add-on cover for your health insurance policy, especially if you have a family floater plan. If any one family member gets hospitalised and uses the entire sum insured, having a restoration benefit replenishes the sum insured amount and protects the other family members for the rest of the year. This benefit would help you keep your premium expenses in check while providing you maximum possible coverage.
Disclaimer:
The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
AYUSH Cover in Health Insurance – An Introductory Guide
Long before allopathic medicines and treatment became the norm, alternative medicine like Ayurveda and Homoeopathy dominated the Indian medicine industry. Health experts also believed that yoga could cure various types of physical ailments. So, in 2013, when the Insurance Regulatory Development Authority of India (IRDAI) instructed insurance companies to introduce AYUSH treatment insurance, insurance buyers wholeheartedly welcomed the change. This article explains AYUSH treatment cover in health insurance.
What is AYUSH Cover?An acronym for Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy, AYUSH represents a health care system focused on alternative medicine or treatment. These alternative treatments are traditionally less expensive than allopathy and cause fewer side effects.
The Government of India introduced the AYUSH ministry to promote and develop traditional and alternative medicine. The government further mandated general and standalone health insurance companies to provide health insurance to people who prefer these conventional courses of treatment.
Individuals who opt for treatment through AYUSH medicine can undergo various kinds of drug therapies to treat illnesses using their AYUSH cover.
AYUSH Treatment Insurance – Inclusions and ExclusionsHealth insurance which covers AYUSH comes with its own list of inclusions and exclusions. They are as under:
The InclusionsYou can file a claim for the following expenses under the AYUSH treatment cover:
The insurance provider is not obligated to cover the expenses associated with the following under your AYUSH treatment insurance.
The following are the advantages of opting for a medical insurance policy with AYUSH cover:
Despite the IRDAI guidelines, only a few health insurance companies in India currently offer the AYUSH treatment cover. However, it helps to have both an AYUSH policy and a regular medical insurance plan. You must research and compare the coverage offered under both AYUSH and general health insurance policies before purchasing them.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.What Is a Cashless Hospitalization Facility in Health Insurance?
In times of medical emergencies, financial burdens are often the last thing anyone wants to face. This is where the cashless hospitalization facility in health insurance plays a vital role, offering individuals and families financial relief by enabling them to access hospital care without the immediate need for out-of-pocket payments. This article explains how cashless hospitalization works, its benefits, and how to select the best cashless health insurance policy.
Is Cataract Surgery Covered Under Health Insurance?
An Overview of Leprosy
Leprosy is one of the most ancient diseases. It is also called Hansen’s Disease, after the Norwegian physician Gerhard Henrik Armauer Hansen who discovered the bacteria that causes leprosy. In 2020, the World Health Organization noted 127558 new leprosy cases globally. As leprosy is a bacterial disease, it is known to affect the skin and lead to the appearance of external lesions and sores. Leprosy also affects the nerves and muscles. If left untreated, this disease can disfigure the patient.
Let’s take a closer look at what causes leprosy, examine the symptoms, and explore treatment options.
Leprosy is caused by the Mycobacterium Leprae Bacterium. As a disease, leprosy is not highly contagious. It only spreads through close contact with a patient who already has the condition. Studies show that Mycobacterium leprae bacteria can spread through sneeze or cough droplets from an infected patient to others.
There is a lot of stigma around leprosy. Patients are often shunned from society and forced to live in isolation. It is, therefore, important to note that leprosy does not spread if you sit next to an infected person in public transport or shake hands with them once. To actually spread the disease, there has to be close and repeated contact with a patient. Once a patient has begun treatment, they can no longer pass on the infection to others.
Expectant mothers cannot transmit leprosy to an unborn child.
Types of leprosy
Leprosy is broadly classified into two main types. These are lepromatous and tuberculoid. Tuberculoid is a milder form of the disease and relatively less contagious. Lepromatous is very contagious and affects the kidneys apart from causing major disfigurement and hair loss.
There is also a third type of leprosy which is called borderline. Borderline is a type in which the patient exhibits symptoms of both the lepromatous and tuberculoid forms.
Several years may pass before a patient exhibits noticeable signs of leprosy. In fact, some studies indicate that symptoms may even appear anywhere between 5 and 20 years after the initial infection.
Symptoms to note include light-coloured skin lesions, muscle weakness, lumps on the skin, dry skin, and a loss of sensation in the limbs.
Leprosy can also lead to nerve damage, blindness, kidney failure, hair loss, and loss of use of hands and feet. There is a common misconception that leprosy causes fingers to fall off. This is untrue. What really happens is that the bacterial infection leads to a loss of sensation in the affected areas. This loss of sensation means that burns, cuts, and other wounds go unnoticed until they eventually lead to infection that causes permanent damage.
If a skin sore is suspected to be a sign of a leprosy infection, the patient will be advised to undergo a biopsy. In a skin biopsy, a small sample of the affected area will be taken and sent for testing. The patient may also be advised to undergo a skin smear test or a lepromin test.
The diagnostic tests aim to identify the type of bacteria and type of leprosy. Upon proper identification of the type of leprosy, the course of treatment can be decided.
The good news is that leprosy can be cured. Treatment for leprosy involves multi-drug therapy which has been developed by the World Health Organization.
Patients need to take prescribed medication for an extended period of time that can range anywhere from a few months to a year. The medication is usually a combination of antibiotics for the bacteria and steroids for inflammation. Certain medicines used to treat leprosy might not be suitable for pregnant women as they may cause birth defects. If an expectant mother is undergoing treatment, her doctor may avoid prescribing certain medicines.
Living with leprosy
Patients living with leprosy are often isolated and excluded. This happens due to a lack of awareness among the masses on the exact nature of the disease. Once a patient has begun their course of multi-drug therapy, they can live normally with their family without worry of infecting them. They can attend office, shop for their necessities, and follow their normal routine. Proper education and awareness among the masses will help reduce the social ostracization faced by people living with leprosy.
These days, medical procedures can run into lakhs of rupees. And it is not wise to deplete one’s savings in paying for medical costs. A health insurance plan is the only way to afford the rising cost of healthcare. Health insurance covers hospitalisation expenses as well as charges incurred pre- and post-hospitalisation within limits specified by the insurer. It is much easier to pay a premium each year than pay an actual hospital bill each time you fall ill.
Does health insurance cover leprosy?
Insurers in the country are known to include coverage for leprosy under a critical illness cover. A critical illness cover is a rider that you can add to your health insurance plan for an extra premium. Most riders are affordably priced and so it does seem advisable to add as much coverage as you can to your base health insurance plan. This way, you can enjoy peace of mind with the knowledge that you are covered. Do bear in mind that health insurance policy inclusions can vary between insurance providers. You must read the fine print and ask your insurer what extent of coverage is offered before you buy insurance.
SBI General offers a range of medical insurance plans that are designed to offer holistic coverage when you fall ill. These plans include coverage for hospitalisation expenses (room rent, nursing costs, etc.), doctor’s fees, charges for anaesthesia and oxygen, procedural costs, and ambulance charges. Patients can also make a claim for day care procedures. SBI General offers its policyholders access to over 6000 cashless hospitals in India for cashless treatment. There is also a benefit of a free health check-up once in every four claim-free years.
Apply for health insurance today with SBI General to enjoy true peace of mind.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.