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While we talk a lot about health insurance in personal finance and how it can protect the wealth creation of the family . It’s important to have accurate information about health insurance to make informed decisions and important to burst the most common myths associated with health insurance. 

Myth: With sufficient savings, health insurance is redundant.

Fact: Some argue that personal savings make health insurance unnecessary. However, even large savings might prove insufficient to cover substantial medical costs, such as major surgeries or long-term hospital care. These costs may run into lakhs and with time spent in hospitalization of your near ones, you might face financial crunch. 

Myth: Health insurance is only for older people or I am young i do not need health cover

Fact: Medical emergencies can happen to anyone at any age. Purchasing health insurance early can provide financial protection against unexpected medical bills. Younger individuals may also benefit from lower premiums and shorter waiting periods.

Myth : You get coverage as soon as you buy the plan:

Fact:  Medical insurance plans often have waiting periods before certain illnesses are covered. Therefore, carefully read the policy wording when buying a plan to understand the claim eligibility timeline. A typical initial cooling period is 30 days, and longer waiting periods may apply to pre-existing and specified diseases. ( We will let you know what waiting periods are applicable to book your free consultation.)

Myth: Employer-provided health insurance is enough. 

Fact: Employer-sponsored group health insurance often has limited coverage, less flexibility, and may not include add-ons. It also ceases when you leave the company. An individual health insurance plan can offer broader coverage tailored to your specific needs.

Myth: The cheapest plan is the best option

Fact: Beware of the biggest medical insurance myth: that price equals coverage. You can’t simply choose a plan based on how cheap it is; you must understand its features. Cheap plan may not cover even the basic features required. Health needs are personal, so your insurance should match your specific requirements. Aim for an affordable plan, but don’t equate the lowest price with the best value.

Myth:  Insurance companies cover all expenses in the event of hospitalisation: 

Fact: Don’t assume your health insurance will fully cover all hospital costs. Policies often have exclusions, co-payments, and waiting periods for pre-existing conditions. Moreover, insurers may only pay partially due to sub-limits. This can include caps on room rent (e.g., a percentage of the sum insured) and also apply to other expenses, such as non-admissible medicine purchases. Policyholders might also need to pay for incidental expenses. To avoid surprises, carefully review all policy details, including exclusions and all types of sub-limits. ( Do not worry we have done it for you , book you free consultation).

Myth: Health insurance only covers hospitalization costs or Hospitalization is a must

Fact: Unlike traditional plans, modern health insurance policies provide broad coverage encompassing more than just hospitalization. This includes pre- and post-hospitalization expenses, daycare treatments, diagnostic tests, and even alternative medicine options like Ayurveda and homeopathy. Notably, many policies now cover procedures like chemotherapy, radiotherapy, lithotripsy, dialysis, and eye surgery – often referred to as daycare procedures because they don’t necessitate a 24-hour hospital stay for claiming benefits.

Myth : People who smoke and drink are not eligible for health insurance: 

Fact: The widespread belief that smokers and alcohol consumers are ineligible for health insurance is false. Insurance companies do provide coverage to these individuals. However, due to the increased health risks associated with these habits, they usually face higher premium costs and must undergo thorough medical check-ups before a policy is issued.

Myth :  Failing to renew health insurance on time will mean the loss of all benefits

Fact : Health insurance policies usually offer a 15-30 day grace period for renewal without penalty, ensuring continuous benefits like pre-existing condition coverage and no new waiting periods. However, any medical treatment during the gap between expiration and renewal will not be covered.

Myth: All health insurance policies are the same. 

Fact: Each health insurance policy differs in its inclusions, exclusions, coverage scope, and premium. It’s crucial to compare plans and choose one that aligns with your individual healthcare needs and budget.

Myth: Pre-existing conditions are never covered. 

Fact: While there may be a waiting period (usually 1 to 4 years), most health insurance policies cover pre-existing conditions after this period. It’s essential to disclose any pre-existing conditions to your insurer during policy purchase to avoid claim rejections later.

Myth : Network hospitals can only be found in big cities:

Fact: Health insurance hospital networks are not just in major cities. Most providers have extensive networks reaching smaller cities and towns nationwide, offering cashless treatment options. Reimbursement is also typically available for covered services at non-network hospitals.

Myth : Hiding pre-existing illnesses can help get insurance:

Fact : Hiding pre-existing illnesses from insurance providers is not advisable. Insurance companies require their disclosure during policy purchase. If an undisclosed condition is found later during a claim, coverage may be denied.

Myth: Filing a health insurance claim is a hassle. 

Fact: With increasing digitization, many insurers offer online claim submission processes. Additionally, cashless treatment at network hospitals eliminates the need for upfront payments and claim filing for those expenses.

Myth: Maternity coverage is automatically included.

Fact: Standard health insurance policies usually do not include maternity expenses. However, some plans offer maternity coverage as an add-on or as part of a family floater plan, often with a waiting period.

Myth :Once You Have Insurance, You’re All Set

Fact : It’s wrong to think of health insurance as a one-time purchase. Because health needs change over time, policyholders should periodically review their coverage to ensure it remains suitable. This might involve increasing the insured sum, adding riders, or changing policies to better fit their health goals, ensuring ongoing and sufficient protection.

Myth : Policy documents can be discarded after the expiry of the policy

Fact: Keep your expired health insurance documents safe. Third-Party Administrators (TPAs) often study your past policies during claim approval, and you or your agent might need copies.As it might be used to establish continuous cover. This is crucial for a smooth claims settlement. 

Myth: Health insurance is too expensive. 

Fact: The premium for health insurance depends on factors like age, number of people covered, medical history, and the chosen coverage. Various affordable plans are available, and tax benefits under Section 80D of the Income Tax Act can further reduce the financial burden.

Conclusion : 

Health insurance can seem complex, but arming yourself with the truth is the first step towards financial security and healthcare access. We hope this breakdown of common myths has been insightful. Remember to always do your due diligence and seek professional advice when making decisions about your health coverage. For a personalised discussion, don’t hesitate to book a free consultation.