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Why is knowing the sub-limit clause necessary before buying Health Insurance
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Why is knowing the sub-limit clause necessary before buying Health Insurance?

A medical emergency may occur anytime in a person’s life, leading to high expenses after admission to a hospital. In addition, most people face difficulties in managing medical treatment costs during emergencies. As a result, insurance companies offer different types of health plans for both individuals and families. However, anyone who wants to buy a health insurance policy should know more about the features in detail that will help a lot to get coverage accordingly. Not only that, policy buyers should know how to claim insurance amounts from various sources that will help accomplish goals to a large extent.

While buying a new insurance policy, customers should keep certain things in mind to reduce the burden significantly. Moreover, it provides ways to select a plan which satisfies the requirements of a policyholder. Most insurers offer plans with the latest features, allowing policyholders to get the best treatments in listed hospitals. However, it is imperative to evaluate them with more attention to select the right one. Buying the best plan allows a policyholder to ensure better coverage for health illnesses.

What is sub-limit and its importance in a Health Insurance Plan?

Sub-limit is a cap put by health insurers in a policy for various medical treatments. It can limit the insurer’s liability, and policyholders should understand the clause in detail. The sub-limits are a fixed value determined by an insurer for a particular illness. Some insurance companies include a sub-limit as a percentage of the total sum insured amount. Policyholders have to pay extra amounts from their pockets when they exceed the sub-limits. 

Policy buyers should evaluate the sub-limits with more attention because they can affect the claim significantly. On the other hand, insurance policies without sub-limits cost more which will result in additional expenses. In addition, some of them make sub-limits electives, allowing policy buyers to select them based on their choices. 

What are the two types of sub-limits available in a Health Insurance Plan?

Most health insurance plans come with two types of sub-limits, and policyholders should know them in detail. This will help a lot to make the right decision while purchasing a plan from an insurer.

  1. Sub-limit on room rent 

Under the room rent sub-limit option, policyholders can get coverage for room rent per day for a limited period. Moreover, insurance policies will have a cap on the type of room in a hospital after getting admission. For example, a policyholder has to pay extra amounts when he/she needs a private room. This is because most policies will cover amounts only for a general room or semi-private room. 

Additionally, an insurance plan links hospital charges with the type of room opted by an insured person. It means that the charges may vary for surgical procedures, physician consultations, and operations, depending on the kind of stay. Hence, a policy buyer should avoid confusion during the hospitalization process or filing a claim. 

  1. Sub-limit on specific treatments

Insurers add a sub-limit clause to specific treatments, and a policyholder has to pay extra amounts. It might not allow a policyholder to claim the entire hospitalization expenses due to the sub-limit clause. For instance, insurance companies have a cap on cataract treatment and other medical procedures. If the total sum insured amount is Rs 10 lakhs, then a policyholder can’t claim an amount more than Rs 5 lakhs when the sub-limit is 50% on the comprehensive coverage. Some other sub-limits to look at in a policy include ICU charges, parental sum insured, and main surgical procedures.

How to pick sub-limits wisely while buying a health insurance plan?

Anyone who wants to buy health insurance plans from an insurer should know the restrictions wisely. This, in turn, gives ways to overcome the financial burden while getting treatment in a hospital. While buying a policy, customers should evaluate the sub-limit clause in detail. It is better to have a policy with minimum restrictions that will help to overcome unwanted problems.

Some ailments require treatment even after discharge from a hospital. Many insurers will have a sub-limit on post-hospitalization expenses, and insured persons must pay the extra amount from their pockets. Therefore, it is essential to know the health insurance cover in detail that helps meet crucial needs in the claim process.

Policy buyers should assess their medical needs and budgets before investing money in a plan. Not only that, they should check the enlisted diseases or ailments that come under the sub-limit clause. Besides that, customers can consult with insurance experts to get more ideas about insurance coverage.

Is it wise to buy a comprehensive policy with high sum insured amounts?

Buying a comprehensive policy with high sum insured amounts will help insured persons ensure maximum coverage. Some insurance companies offer plans with minimum sub-limits that don’t cause any trouble to a policyholder. On the other hand, insured persons should check the list of network hospitals when they buy a policy with a high sum insured amount. It is imperative to read reviews of top health insurance companies online that will help make the buying process a simple one. Also, insured persons can ensure peace of mind when they want to claim the amounts.

What are the factors that will influence health insurance costs?

Before purchasing a health insurance policy, customers should know the factors that will influence the premium costs. This will help a lot to invest money based on the choices and other factors. Some include location, age, income, sum insured amount, number of dependents, etc. In addition, policy buyers should compare the prices of insurance plans online before buying a plan. 

Moreover, they can choose a plan that comes with the best prices. A new policy buyer should calculate the premium amounts online by entering essential details to help pick the right one. Many insurance companies offer plans with the best features that satisfy the requirements of a policyholder. They even show methods to find a plan at affordable rates to get high protection from medical inflation.

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