Health Insurance- Sum Insured- Hospital Billing process
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Hello Guys
We are planning to upgrade our HDFC Health insurance this renewal. We are confused between two options:
1. HDFC Optima Restore with unlimited restore.
This offers you unlimited restore benefits, even for same/related illness. But the single claim cannot be more than the SI+NCB(5L in our case).
Are the hospitals allowed by the insurers/Govt to generate multiple bills/claims for the same treatment for non-package/regular admissions? For Example they admit the patient for let's say 5 days and discharge him and settle the bill with insurer for those 5 days. And then again admit him for 5 days and discharge and the cycle continues.
I have heard that many hospitals are very cooperative in this matter, but never experienced this personally.
This method sadly will perhaps fail for treatments, where hospitals have packaged rates where it can go up to 20L for some cardiac/transplant surgeries and up to 50L for some neurosurgeries where some head injury is involved.
2. HDFC Optima Secure with 2X base cover from the start.
We can also increase the SI now, but would have to bear fresh waiting periods of 2/3 years for the increased SI, which is not desirable.
So guys please share your valuable inputs and experiences.
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talk to the hospital billing manager and tell them the situation, and they will submit the bill to the insurer in such a way it will not get rejected.
Please get the answer, if you have any links.
Better take super topups
Sometimes, supertop ups have room rent limit and this will add additional burden on us.Â
please check pm, need health insurance.Â
Now hospitals may co-operate, later they may not. Or maybe insurance company will ban them from cashless mode. No insurance company is a fool to pay insurance in admission dates 1-5,5-10,10-14. They will come to know...
1. I don't know where you heard such practice. Major hospitals or doctors won't entertain such tricks. Probably lower rung hosp in cities or towns may agree so they can eat away the insurance amount. Even then won't insurer ask why was the patient discharged in the first place? Search for blacklisted hospitals list by insurance companies on internet.
HDFC Optima Secure with 2X base cover from the start.
We can also increase the SI now, but would have to bear fresh waiting periods of 2/3 years for the increased SI, which is not desirable.
That's for the increased sum protection. 🙂 Say your sum insured is 5 lakhs. For waiting periods next 5 lakhs have to be used. But that's okay naa. In Optima Restore you are stuck with 5 lakhs. And for every redemption your NCB will not attract any penalty in Optima Secure. But premiums ll increase every year in increments. That's a downside. In Optima restore you have premiums based on age Bands.Â
Don't go with ditto they are severely biased towards hdfc n care. Don't go with policy bazaar just because you can pay via Amazon balance.Â
Go with a proper broker. Cheap is not always the best option .
I am considering HDFC Optima Restore too.
From what I was informed by Ditto, the unlimited restore is applicable for same illness only when there is a minimum gap of 45 days so clarify this point again once.