Why should you steer clear of Health Insurance Policies with Sub-Limits ?

Health insurance policies are becoming increasingly important for the common mass. With the advent of internet, there is no dearth of of health insurance plans and one has to compare insurance to find out the best health insurance in India. There are many components on which you need to compare insurance such as coverage for the whole family, protection against critical illness. Waiting period, co-pay, pre and post-hospitalization coverage, network of hospitals with cashless facilities. Among all the parameters, sub-limit is the most vital one. Almost all health insurance policies come with sub limits and you have to compare insurance to pick the best health insurance in India in terms of this aspect of medical insurance.

To steer clear of any complexities regarding the sub-limit clause, you need to go through the fine prints of health insurance policies and compare insurance after understanding this clause well. If you compare insurance you will see that the sub-limits are of two types; sub-limits on specific treatments and sub-limit on room rent. Let’s start with sub-limit on specific treatments.

Sub limit on treatments

Sub limit for specific treatments stand for certain amount beyond which providers of health insurance policies don’t pay for certain ailments. You can compare insurance in terms of diseases that come with sub-limits. These ailments include, sinus, kidney stone, piles, cataract and many more. Companies that provide health insurance policies come up with such restrictions to reduce their burden in time of a claim and make the insured pay of their pocket while treating such diseases for the remaining part of the claim. If you compare insurance you will find that the sub-limits vary from one insurer to another. An example can make things clear.

Suppose you need to undergo cataract operation which will cost you Rs. 2 Lakhs. Your medical cover is one of those health insurance polices that impose Rs. 50,000 sub-limit on the cataract treatment. Hence, even though you pay premium for a coverage of Rs. 3 Lakh you can only claim up to Rs. 50,000 for your treatment. The rest of the Rs. 2,50,000 needs to be paid by you. This is how sub-limits defeats the purpose of availing health insurance policies. You should compare insurance to find out a plan that doesn’t come with such sub-limits.

Sub Limits on Room Rents

Many health insurance policies put a cap of a certain percentage of Sum Insured on the rent of hospital rooms. If the health insurance policies come with 1% cap on Rs. 3 Lakhs you will have coverage of room rent worth Rs. 3000. If you choose a room with rent of Rs. 5,000 you will not only have to pay the remaining Rs. 2,000 out of your pocket but the portion of the rest of the treatment costs in the same proportion. The cost of the entire treatment depend on the chosen room. So, if you choose a room beyond the sub-limit and think that you can pay the difference you will make a costly mistake. As health insurance policies with sub-limits on room rent will force to pay a hefty amount. The key is to compare insurance and look for a plan without such limits.

You should avoid both types of sub-limits and compare insurance to find health insurance policies that don’t impose sub-limits.