Bohot saari Health Insurance policies mein ab AYUSH cover milta hai, par claim reject hona ek common problem hai. Log aksar sub-limits aur documentation ke chakkar mein phas jaate hain.
Aajkal health insurance mein Ayurveda, Yoga, Naturopathy, Unani, Siddha, aur Homeopathy (AYUSH) ka option toh mil raha hai, lekin claim settle karte waqt policyholders ko kaafi dikkat aati hai.
Sub-limits ka bada khel
Sabse badi problem hai 'Sub-limits'. Log sochte hain ki AYUSH treatment bhi normal surgery ki tarah full cover hoga, par aisa nahi hai. Zyadatar policies mein AYUSH treatment par 20% ya usse bhi kam ka cap hota hai. Agar aapka bill limit se upar gaya, toh baaki ka paisa aapko apni jeb se bharna padega.
Hospital accreditation check karein
Har clinic ya wellness center insurance ke liye valid nahi hota. Insurers sirf unhi hospitals ko cover karte hain jo registered hain aur jahan proper in-patient department (IPD) facility hai. Agar aap kisi aise center mein treatment le rahe hain jo sirf spa ya rejuvenation retreat hai, toh claim seedha reject ho sakta hai.
IRDAI ke guidelines aur documentation
IRDAI ki koshish hai ki process transparent rahe, par claim tabhi milega jab treatment kisi bimari ke liye 'medically necessary' ho. Lifestyle ya preventative treatment ke naam par claims aksar contest hote hain.
Claim kaise handle karein?
- Network Hospitals: Koshish karein ki hamesha insurer ke network hospitals mein hi treatment lein, wahan cashless process smooth hota hai.
- Paperwork: Discharge summary aur bills mein koi bhi galti claim delay kar sakti hai.
- Policy Review: Treatment lene se pehle apni policy document mein 'AYUSH sub-limit' zarur check karein.
Thodi si alertness aapko bad mein hone wale bade financial shock se bacha sakti hai.