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What treatment does my insurance cover?


Many people prefer alternative treatments to allopathy. Are such treatments covered under health insurance policies? Are these also offered under cashless claim facilities at their network hospitals also?

—Name withheld on request

Most of the insurance companies offer coverage on alternative treatments to allopathy like Ayurvedic, Unani, Siddha and Homeopathy (Ayush) as well under the health insurance policy. Ayush treatment taken in a government hospital or in any institute recognized by government and/or accredited by quality council of India/national accreditation board on health is covered under most of the health indemnity policies.

If such recognized hospitals are empanelled by the insurance companies, then they may offer cashless services for the treatment undertaken in such hospitals. Cashless facility is a service that is offered by the insurance company and not a feature of the policy.

My husband and I have a corporate health insurance cover from our respective employer of 3 lakh each . Is the cover adequate or do we need to have a separate health insurance cover?

—Name withheld on request

The cover from your employer of 3 lakh for each member may not be adequate considering the uncertain times that we live in where the cost of medical procedures and hospitalization cost is rising every day.

As an alternate safety net, today, there are requisite health insurance top-up plans available where the additional cover can be availed at a lower premium with the deductible equivalent to the cover provided by employers.

For example: In a situation where a person has a liability of 10 lakh for hospitalization, and if he has a health top up plan for 10 lakh over and above the base health plan with a deductible of 3 lakh, then the hospitalization bill will be paid by a combination of both policies i.e. 3 lakh from the base policy of the corporate (in this example) plus 7 lakh from the health top-up plan. Such covers are available at very affordable premium rates.

However, with the cost of medical procedures and hospitalization increasing, it is vital to have a higher coverage policy.

Shreeraj Deshpande is head of health businesses, SBI General Insurance.

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