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Know About Mediclaim Policy & Deduction Under Section 80D

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Know About Mediclaim Policy & Deduction Under Section 80D. Deduction for Medical Insurance Premium 2016 U/s 80D,  Things You Should Know About A Mediclaim Policy & Deduction Under Section 80D. Mediclaim policies are the talk of the day. They help you financially when you fall ill. But, you also need to know details about the mediclaim policy. Here, we will try to understand that & also the deduction which is available under Chapter VI A of The Income Tax Act, 1961. Recently we provide very special article for CA IPCC Result May 2016 and Now we provide complete details for “Know About Mediclaim Policy & Deduction Under Section 80D” check all details from below…

Know About Mediclaim Policy & Deduction Under Section 80D

Know About Mediclaim Policy & Deduction Under Section 80D

Mediclaim policy is a policy which takes care of medical or hospitalization expenses incurred by us.

Dear all, we often ask others what is the best investment, how can we reap good returns etc. I would like to say that even a Mediclaim is the best investment indeed. Mediclaim policy has no lock in period like other investments have. A Mediclaim policy will be useful when it is most needed. Dear friends, we have no idea of when we will need medical assistance. Some people can afford medical expenses but not all of us can. An emergency may even sometime require Lakhs of rupees. Mediclaim may not save your life but it will definitely provide you financial assistance. People often go for life insurance, but forget about Mediclaim, even though it is equally important. You are required to pay around Rs. 5,000/to Rs. 10,000/- only to get a health cover of around Rs. 300,000/-.

But , before taking a Mediclaim policy, you should know all the points regarding Mediclaim. Here I will explain you everything that you should ask your agent.

Which illnesses are not covered??

  • Generally Cosmetic, plastic surgery expenses are not allowed
  • Some diseases like Piles, Hernia, Hydrocele and Fistula in anus will have one year waiting period i.e. they will be entertained only if one year has elapsed.
  • Dental Treatment expenses may not be allowed
  • Spectacles or contact lens expenses may not be allowed
  • Medical treatment for Drugs/ Alcohol abuse will not be allowed
  • Naturopathy Treatment
  • Pre existing illness for a period of one/two year etc.
  • However there may be further exclusions too depending upon your policy and premium.

For How much time A person needs to be hospitalized??

  • Some policy requires hospitalization for a minimum period of 24 hrs. So it becomes necessary to confirm before taking a policy.

Do you get Cashless Facility? If yes, tell us about the hospital covered in your network.

Expenses incurred by you can either be reimbursed or you can avail a cashless policy. In cashless mode, you have to inform to the hospital, third party administrator and the insurance company about the hospitalization of insured person. The hospital then sends an initial claim that may be incurred followed by a final claim. Here settlement takes place before you leave the hospital.

Ex:  Mr. X has been admitted to hospital for a particular disease. Hospital believes they will require a sum of Rs. 80,000/- for the treatment. Now they will ask the TPA for Rs. 80,000/-. Suppose TPA passes Rs. 55,000/- initially. Now before the patient is discharged, the final bill is out for Rs. 65,000/-. Hospital will inform TPA about the final bill and now TPA will pass the final claim say Rs. 62,000/-. This is how cashless works. The waiting time is comparatively lower as compared to reimbursement process. Insurer should also ask about the hospital covered in the network, since cashless facility can only be availed if the hospital is in their network.

Will you get reimbursement of Pre-hospitalization expenses?

Pre-hospitalization means expenses incurred few days before the patient is hospitalized.

Some insurer may provide 30 days pre-hospitalization expenses, while some others may provide 60 days expenses.

Post-hospitalization means expenses incurred after hospitalization.

Some insurer may provide Post-hospitalization expenses for 60 days while some others may provide Post-hospitalization for 90 days.

Within how much time, should we inform about the hospitalization to the insurer?

Generally, we can find a clause in the policy that in case of planned hospitalization, Insurance Company should be informed beforehand and in case of emergency hospitalization Insurance Company may be informed within 24 hrs of hospitalization.

 Is there any waiting period??

Generally, there might be a waiting period of say 30 days after which the policy becomes operative.

Dear friends I would kindly request you all to take a Mediclaim policy as early as possible. This can be helpful in case of any medical emergency. Find out the best policy for you and your family.

Also, you get a “Know About Mediclaim Policy & Deduction Under Section 80D” paid by you. Details of the deduction can be read on –  http://caknowledge.in/last-minute-things-save-tax-per-new-budget/

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About CA Ridhi Dhoot

The writer is a Chartered Accountant & a Licentiate Company Secretary. You can reach out to her at [email protected]

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