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Pre-existing disease coverage: Other vital parameters
There's more to pre-existing illness fine print and it helps you know these before you make your decisions.
Sub- limits: Here the overall coverage is broken down into the maximum payable for a particular kind of expense. For example, a few insurance companies now provide that room rent cannot exceed one per cent of the covered amount or that doctors/consultants fees cannot exceed 20 or 25 per cent of the covered amount.
Co-pay requirements: Quite a few companies now require that the insured bear a certain percentage of the eligible expenses either unconditionally or under certain conditions. Some companies provide a discount in premium if you agree to co-pay. Others might want co-pay if you choose to get treated in a non-network hospital or others may have co-pay for choosing a single air conditioned room or for getting treated in a hospital in a higher cost city. The co-pay feature is built in to ensure that the insured chooses the appropriate hospital/room/doctor level relevant to his economic status and also watches the reasonableness of the charges levied by the hospital to ensure that there is no overspend or overcharge just because of the existence of a person owns a mediclaim policy.
Specific exclusions: Almost all policies have general exclusions such as costs incurred for AIDS / sexually transmitted diseases or congenital diseases, etc. Watch out for exclusions if it affects you.
Maximum coverage amount: This is important, as a particular policy that suits you may not be available for coverage that you seek.
Maximum age at entry: Particularly relevant for senior citizens as quite a few policies may not be available to them.
Renewability up to what age: Relevant for senior citizens as well as people in their 50s since they need to be able to enjoy the benefit of their track record.
Also see: 10 financial decisions you should not make now
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