Thursday, November 21, 2024

Are OPD expenses incurred abroad covered in travel insurance?

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If I come down with a high fever while abroad, can I claim this under my travel insurance plan? What if I am not hospitalised and the entire treatment happens at an OPD (outpatient department)? Can I include X-rays, doctor consultation and medicines in my claim?

– Name withheld on request

Most travel insurance plans cover both hospitalisation and OPD medical expenses. Some have a separate, lower limit for OPD expenses. OPD expenses incurred towards consultation, diagnosis and medication are payable. Often, medical coverage is accompanied by a deductible. This is the initial threshold of expenses that is not payable under the plan. So, only OPD expenses incurred above the deductible will be reimbursed.

Do note that only emergency medical expenses are covered under travel insurance. These include expenses for acute incidence of conditions such as high fever. So your claim would be admissible.

I got married in March 2024. I already have an comprehensive individual health plan from a standalone health insurer. My husband has one from another top insurer. My policy is due for renewal in two weeks and we want to buy a family floater policy now. If my husband adds my name to his policy, will I lose my policy continuance benefits? We also want sufficient coverage for cancer treatment. Should we buy a super top-up plan or any cancer-specific plan? Or should we simply buy a critical illness rider with our term insurance plans?

– Name withheld on request

You can port your health insurance plan from one insurer to another. This allows you to carry forward the waiting period lapsed for pre-existing diseases under the old plan to the new plan. You can port your existing plan to your husband’s plan. This will allow you to have a single plan under your husband’s name without losing any continuity benefits. You will not get a fresh waiting period. If there is any residual waiting period left from the previous plan, it will apply.

For comprehensive coverage on cancer, you can consider two plans – an indemnity plan and a fixed benefit plan. Your current health insurance is indemnity-based. Such plans reimburse actual out-of-pocket expenses incurred towards treatment, primarily hospitalisation. If you have a sufficient sum assured under this plan, you do not need to buy separate top-up health insurance. I would recommend a sum assured of between 40 lakh to 50 lakh for adequate cancer coverage.

You should also buy a fixed benefit plan. Here, it makes sense to buy a fixed benefit plan that covers other critical illnesses as well. Most term insurance plans offer a critical illness rider that pays a fixed sum upon diagnosis of the covered ailment. Such riders generally include cancer. However, I would recommend buying a standalone critical illness plan instead of a rider as it will cover a much longer list of illnesses.

Abhishek Bondia is principal officer and managing director at SecureNow.in





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