Q.
What documents
should we obtain before discharge from the hospital in case of cash
less facility availed ?
Ans: All bills in original and a discharge certificate are to be left
with the hospital providing cashless treatment. The patient has to
countersign all bills and fill the claim form and also leave the same
with the hospital at the time of discharge.
A copy of the bills & Discharge Summary can be carried by the patient
for his records and for submission along with Pre & Post
Hospitalization bills.
Q:
Is there any
exclusion in the first year ?
Ans: Yes. mediclaim policy does not cover a few disease which have
occurred within one year of policy commencement.
Diseases which are not payable during the first year of the operation
of insurance cover are :
- Cataract Benign Prosthetic
Hypertrophy
- Hysterectomy for Menorhegia or
Fibromioma
- Hernia, Hydrocele
- Congenital, Internal Diseases
- Fistula in anus, Piles, Sinusitis .
Q:
I want to
increase my Sum Insured and also add another family member to the
policy. Please Advise.
Ans: You will need to contact your Insurance Company for any addition
/ deletion of the above type. Once we get a notification from them,
we will update our records similarly.
Q:
Can I lodge more
than one claim for the same disease ?.
Ans: Yes. your mediclaim policy covers 30 days
Pre-hospitalization expense reimbursement and 60 days
Post-hospitalization expenses. You may lodge your
Pre-hospitalization claim along with hospitalization claim.The
Post-hospitalization claim may be lodged after 60 days
of the hospitalization. However, please quote your Claim Number for
easy referral and sorting .
Q:
During the
course of my treatment, can I change the hospitals ?
Ans: Yes it is possible to shift to another hospital for reasons of
requirement of better medical procedure. However, this will be
evaluated on the merits of the case and as per policy terms and
conditions.
Q:
Can I get
outpatient treatment using my TPA Card ?
Ans: No. The TPA Card is issued to you against your mediclaim policy
which only covers hospitalization expenses. The outpatient /
domiciliary expenses pertaining to the treatment of disease which is
the cause of hospitalization is however covered (Please see Pre &
Post Hospitalization benefits)
Q:
I have received
my policy, however, I have not yet received my ID Card. Please
advise.
Ans: There could be a chance that the Insurance Company has still not
forwarded your details to us. Also there is a possibility that your
card has been dispatched and you have not received the same.
You can call our call center and they will guide you suitably.
Alternatively, you can enter the policy number at our website
( Medsave.in )
and you can get your card status.
Q:
I went to one of
your network hospitals and they did not entertain me. How should I
proceed ?
Ans: You may immediately call our call center, giving details of such
hospitals/medical providers. Our network department will immediately
contact the concerned medical provider and sort out the matter.
Q:
I am not keen to
avail of Cash Less facility. Can I go in for reimbursement ?
Ans: Yes. Under the Mediclaim Policy, you can opt for Cash Less as
well as Reimbursement. We would advise that in case you are taking
treatment from a network hospital, then you should avail of the Cash
Less facility. This will give you the financial advantage of not
paying for your hospital treatment and also gives you more cushion to
meet your post-hospitalization expenses.
Q:
I have taken Mediclaim from Insurance at Delhi
and I have been posted to Mumbai. can I still avail of
Medsave 's
service ?
Ans: Yes. The TPA service is of All-India nature. you can access any
of our offices and in the event of a hospitalization, use the
services of any network hospital spread across the country. |