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Health Insurance - Do I Qualify?

Updated On Nov 23, 2021

Choosing a health insurance can be hectic as there are numerous options that are available in the insurance market and it can be confusing to pick the best plan out of the given ones. Therefore, you must analyze your medical requirements before investing in a certain insurance policy. You must go through its eligibility terms and conditions to make sure that the plan will be of use in the long term and then buy the best health insurance policy.

Before investing in a particular plan you must make sure that you fall under the eligibility criterion of the policy. Generally, health insurance plans can be bought by anyone. But, there are certain terms and conditions that apply to the individuals investing in health insurance plans. You must confirm your eligibility from the health insurance provider or check the terms of desired health insurance policy over the internet.

Health Insurance - Do I Qualify?

Eligibility Criteria For A Health Insurance Plan

Health insurance plan can be bought by any individual but there are certain eligibility factors that can affect your purchase of a health insurance policy:

  • Entry Age

The minimum entry age for buying a health insurance plan is generally 16 days to 18 years for children and 18 years to 65 years for an adult. The upper age limit can be extended to 70 years depending on the insurer. There is no standard minimum entry age as it can change with the change in insurer and type of plans. Therefore, you must go through the policy conditions to check the age criteria for your desired health insurance plan before investing in it.

Must Read; Things to Consider When Making Health Insurance Claim

  • Pre-Existing Medical Conditions

People above the age of 45 years have to undergo pre-medical screening before buying a health insurance plan, and people below the age of 45 years must submit a declaration of their pre-existing medical conditions, if any. Depending on your pre-medical conditions, your eligibility to buy a health insurance plan will be determined. The plans for pre-existing medical conditions are provided after a certain waiting period that can range between 2 to 4 years.

Myths About Eligibility To Buy A Health Insurance Plan

Let us look at some of the common misconceptions that people have with regard to the eligibility for buying a health insurance policy:

  • Smoking Makes You Ineligible For Health Insurance Plans

This is a misconception that people who smoke cannot buy a health insurance plan. People who smoke can invest in a health insurance plan freely after revealing their smoking habits and accordingly paying the premiums decided under their purchased plan. There are different categories of smokers, based on which the premium of health insurance plans are decided.

  • Pregnancy Is Not Eligible Under Any Health Insurance Cover

There are several health insurance plans that cover the pregnancies. However, there can be certain terms like the number of pregnancies covered, waiting period before availing the plan, and much more. Therefore you must make sure that your pregnancy coverage under a plan meets your medical needs.

  • Your Entire Medical Bill Is Covered Under The Health Insurance Plan

Health insurance plans have limited coverage and therefore it is confined to the terms and conditions of the policy bought. Certain consumables like gloves, bandages, oxygen masks, etc. are not included under any health insurance plan. There are sub-limits on the room rents that are compensated by the health insurance providers.

  • You Can Make Claims Only After 24 Hours of Hospitalization

There are several treatments like cataract surgery, chemotherapy, etc. that take a few hours to be conducted. In such cases, you can avail the daycare treatment coverage of your purchased health insurance plan.

Conclusion

To make sure that you completely qualify for a certain health insurance plan, you must thoroughly read its fine print. You can consult your health insurer regarding the grievances or doubts related to your purchased policy.

Also Read: Important Lessons to Learn From COVID-19 Pandemic


Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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