United Insurance Family Medicare is an okay policy. And while it does cover some bases, it has a few restrictions. For one they don't offer the full cover for several diseases and they make you wait 4 years before covering complications arising out of pre-existing illnesses. So you might want to check out other alternatives.
What's good here?
You most likely don't have to split the bill
If you bought this policy after you turned 61, you have to pay 10% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
You always have full cover irrespective of the disease
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
What's bad here?
Restrictions on the rooms you can pick and much more
Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here
Long waiting period for pre-existing diseases
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems only after 4 long years. It could be much shorter you know? Like 2 years perhaps!
No coverage if you are forced to hospitalize at home
The insurer will not cover the costs if you are forced to hospitalize at home due to a medical condition. In insurance lingo, they call this a policy with no domiciliary cover.
Pre & Post hospitalization expenses covered up to a certain limit
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount upto 10% of sum insured for about 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Some Cover for Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will pay up to ₹15,000 of the cover in case you’re availing these treatments.
What's lacking here?
No Restoration Benefit
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
No Bonus for being healthy and not claiming insurance
Some policies offer you extra cover if you go an entire year without claiming your insurance. This policy, however, offers no such benefit.
No free Health Checkups unless you wait 3 years
If you’re planning on getting a full body checkup just to make sure you’re in fine working condition, the insurer will cover the cost once in 3 years. However, just so you know, most insurance policies offer free yearly health checkups.
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