How to Avail Free Medical Check-ups under Your Health Cover?

Introduction

Imagine this - You are a 25-year-old who has been rushed to the nearest hospital from your office owing to sudden dizzy feelings, general discomfort, shortness of pain and intense headaches. The very first thing the doctor does is check your blood pressure. And unfortunately enough, it is pretty high. He tells you that such high blood pressure can’t occur overnight and should have been caught earlier considering how it can affect your heart and brain. He also says, that if diagnosed earlier, a proper and balanced diet would have been the way, but now, you are in for a long-time medication course.

And now, you are wondering “Where did I go wrong?”

Well, here’s the answer - you neglected an annual health check-up that would have helped in the early diagnosis of your condition! Maybe because you thought you were too young for any serious health scares, or were worried about the impending expenses that it might fetch.

But you should have just fallen back on your trusted health insurance plan from a reputed insurer that offers free medical check-ups! Now, what would these check-ups entail? Which health insurance plans would come with such a lucrative perk? How can you avail of such benefits from your insurer?

Let’s find out!

What are Annual Medical Check-ups in Health Insurance Plans?

Annual medical check-ups in health insurance policies refer to a list of medical tests/ procedures (that have been listed out by the insurer and are instrumental in tracking one’s physical well-being) that you, the policyholder, can undergo in a pre-decided medical facility without spending a penny (once a year), considering your top-notch insurer pays for it. And this free annual health check-up funding has no impact on your policy’s total sum insured.

The medical treatments covered vary from one insurer to another and from one policy to another. So, when you are handed over your health insurance policy document, do remember to check out the details of the medical check-up coverage - treatments, assigned sum insured that determines the procedures covered, etc.

P.S. Please remember that such annual free health check-ups are at times imbibed in the plan itself, and at other times can be availed over health insurance add-ons.

I. What is Covered by the Medical Check-ups in Health Insurance Policies?

Annual free medical check-up coverage depends on multiple factors -

• Health insurers,
• Health insurance policies,
• The availed sum insured, and
• The age of the policyholder (whether you are above or below 18)

Now, despite the variation, here is a list of procedures that are commonly covered by almost all health insurance policies -

1. Complete Blood Count (CBC)
2. Physical check-ups (Height, Weight, Body Mass Index or BMI, Eye Examination, Dental Examination and Scoring, Growth Charting, Doctor Consultation, Urine Examination - Routine and Microscopic)
3. Fast Blood Sugar testing,
4. Cholesterol,
5. ABO Group & Rh Type,
6. Liver Function Test
7. Kidney Function Test
8. Lung Function Test
9. Cardiac Markers
10. Diabetes Markers,
11. Imaging Tests,
12. Tests for Vitamin Deficiencies,
13. Pap Smears, and more.

II. Why are Free Medical Check-ups in Health Insurance considered important?

1. PREVENTION IS BETTER THAN CURE

Annual medical check-ups are the ideal way to detect any ailment at its earliest stage. Once diagnosed, any ailment, however, chronic or critical in nature can be managed optimally to mitigate the ill effects it has on an individual’s health.

Needless to say, such early diagnosis would also help to cut down on the charges involved in the treatment procedure, and thereby lighten the financial load on one’s savings.

2. SPIKED COSTS FOR MEDICAL TESTS

While we can continue reiterating the importance of annual medical check-ups that would ultimately prove to be a healthy habit for all, irrespective of age and gender, what we can’t deny are the involved charges in undergoing such check-ups. This is more true considering the recent spike in medical inflation and its auxiliary procedures.

So, a comprehensive health insurance policy that offers free medical check-ups on an annual basis can be just the solution that you seek. It offers funding to cover multiple medical procedures that would help monitor your health.

3. SCARY CHARGES FOR TREATMENTS

If any ailment, irrespective of its degree of fatality, is diagnosed at a later stage, the chances of a permanent negative impact/effect on your health are extensive and might quite possibly lead to requirements of costly and long-term treatment procedures.

Such medical treatment means you are looking at scary hospital invoices and higher chances of long-term damage to your body. Even with the best health insurance policies at your disposal, you will be spending substantially from your sum insured, which could otherwise have been used for medical emergencies.

4. CHANCES AT MITIGATED PREMIUMS

Via the annual medical health check-ups that can be availed free of cost through top health insurance policies, ailments can be detected at the earliest.

Such early diagnosis, followed by proper management can often cure the disease, which means you will be looking at a no pre-existing ailment situation. Subsequently, you will have a low premium for your health insurance plan.

III. Things To Remember About Free Medical Check-ups in Health Insurance Policies

Whether you are looking at complete blood cultures, liver/kidney/lung function tests, sugar tests, cholesterol tests, X-rays, or USG – you are easily looking at INR 5000 - 10,000. Spending this substantial amount despite holding a health insurance plan, does not make your plan premiums worth their while. Hence, the introduction of free health check-ups once a year.

However, such a major perk does not come without its sets of restrictions and limitations. Here, take a look -

(a) Expect a waiting period

Insurers offer access to the free medical check-up privilege after a predetermined waiting period.

This is a financial security measure on behalf of the underwriting team of an insurer that ensures minimum chances of fraud and unnecessary risks. This waiting period may extend from 1 - 2 years, based on the health insurer you approach.

(b) Take a look at the coverage for the check-up

Free medical check-ups come with a disease-wise sub-limit whose cap is determined by the insurer based on the total sum insured you have opted for.

For example:

• Person A has availed of a health insurance policy of INR 5 lakhs. The free health check-up is capped at INR 5,000/year.
• Person B availed of the same health insurance plan but for coverage of INR 15 lakhs. The free health check-up in this case is capped at INR 7,500/year.

As the coverage availed increases, so does the maximum limit that is assigned for the free health check-up. If the medical bill for the annual check-up surpasses this capped amount, you, the policyholder have to pay off the residual amount from your own pocket.

(c) For some policies cashless might be the only option

As of now, to boost the penetration and ease of access to health insurance policies, both reimbursement and cashless modes of claim settlement are offered.

However, with some specific perks, like free annual medical check-ups, a majority of the reputed insurers prefer that you approach a network hospital and avail of the check-up so that the perk offered can be settled via cashless mode.

However, reimbursements are also offered to settle the billed amount up to the predetermined limit. Only, in this case, you have to send up requests seeking prior approval for the medical procedure that you will undergo, among other such formalities.

(d) Mandatory for senior citizens/freelancers

Health check-ups are crucial for all. This is because ailments don’t really discriminate and early diagnosis of diabetes, high blood pressure, cardiac concerns, etc. is important for all.

However, when it comes to people with low/irregular income and senior citizens, this medical check-up is pivotal.

In the case of both senior citizens and freelancers, income is interrupted or low, and for them to support such expenses is a major hurdle. Thus, they must use free health insurance policy comparison tools to spot the best health insurance plans that offer free health check-ups on an annual basis which offers maximum coverage and ailments.

(e) A Common Myth About Health Check-ups in Health Insurance

“Diagnosis from free medical check-ups affect insurance premiums”

Well, NO! Pre-existing ailments diagnosed during the time of health insurance policy purchase are taken into account. And even if any diagnosis is detected in an annual check-up after a certain period of the policy purchase, the waiting period to offer coverage for the specific disease would have been covered. So, even if the insurer considers this diagnosis, you have already been offered coverage.

(f) Tax Benefits and Annual Health Check-ups

Health insurance premiums are subjected to tax deductions under Section 80D, in general. The amounts are capped at

• INR 25,000 for policyholders below 60 years of age
• INR 50,000 for senior citizens

These include a capped amount of INR 5,000 for preventive care/ annual medical check-ups.

(P.S. As senior citizens, you can also claim tax deductions under Section 80D for any preventive care measures, even without a health insurance policy in place.)

IV. How to Avail of Free Medical Check-ups in Your Health Insurance Plan?

1. FOR CASHLESS CLAIM SETTLEMENT

STEP 1: Inform the health insurance provider via their contact details about the health check-up that you plan to undergo.

STEP 2: Schedule the checkup with your insurer at your preferred network medical facility. Wait for the insurers to provide you with a date and time that is available and suits your requirements as well.

STEP 3: Get the authorisation letter required for the free health check-up that you need to carry to your diagnostic centre along with your health insurance card.

2. FOR REIMBURSEMENT CLAIM SETTLEMENT

STEP 1: Inform the health insurance provider about your intention to undergo a complete health check-up.

STEP 2: Let them know about the reasons why you can’t approach a network/partner medical facility for the test profile. And let them know about the diagnostic facility that you plan to approach.

STEP 3: Complete the tests and imaging. Collect all the bills for the preventive care procedures and the respective charges incurred.

STEP 4: Pay off the amount from your own pocket, approach the insurer with the bills and wait for the collective amount to be disbursed to your account.

Best Health Insurance Plans with Free Medical Check-ups?

Conclusion

Availing of free health check-ups in a policy is pivotal and is one of the most important perks. It ensures continued healthy living sans many medical complications and the early detection of any ailment if acquired. So, make sure to prioritise this as a determining factor while choosing a health insurance policy.