Trustworthy and high-quality medical treatment is becoming more expensive year by year. For every aspect of the medical process, starting from diagnosis to treatment, one has to pay a large amount of money. Most often, the doctor will tell you to get a test done so that your problem can be diagnosed correctly. The use of basic diagnostic tools such as MRI, X-ray, ultrasound, CT scans, blood samples, etc., which we need as patients from time to time, also end up being really expensive in the private hospitals offering these services. Let’s delve into the details of these diagnostic tools and find out whether or not your health insurance policy covers the cost of them.
Most Common Diagnostic Tools
First, let us look at the most common diagnostic tests used in India:
- MRI (Magnetic Resonance Imaging) — This is often used to study the brain, eyes and ear vessels, spinal cord as well as knees and shoulder injuries.
- X-rays — X-rays are most often used to check for fractures in your skeletal system.
- Mammogram — This is a type of x-ray used to check breast cancer.
- Ultrasound — An ultrasound is most commonly used during pregnancy, to view the foetus; it is also used for imaging other organs such as the brain, heart, etc.
- CT (computed tomography) Scans — These scans are typically used for identifying internal bleeding and injuries, and for brain tumours.
- Blood Samples — These are very common tests requested by all kinds of doctors to check if your different organs such as kidneys, liver, thyroid, heart are functioning at the optimum level.
- Fluoroscopy — This test is used typically to view the urinary and gastrointestinal tracts.
- Biopsy — This procedure involves removing some tissue or other cells from your body, typically to detect cancer.
- PET (Positron Emission Tomography) Scans — PET scans are also a test used to detect various cancers.
These tests can cost between a few hundred rupees to several thousands, depending on the test and the diagnostic lab you plan to visit. This expenditure is high if you have one or many family members who are ageing or have a chronic illness.
Does My Policy Cover Diagnostic Charges?
In most medical plans, to be able to file your health insurance claim and get reimbursement for diagnostic charges, the policyholder needs to be hospitalised for at least 24 hours. Health insurance plans in India typically cover all pre-hospitalisation (30 days) and post-hospitalisation (60 days) expenses such as tests, treatment, therapy, aftercare, but only if you have been hospitalised for a minimum of one day. In case you only visit the OPD (outpatient department), where the disease or illness is not considered serious enough to hospitalise you, these costs are not covered under a health insurance plan. However, there are certain ways you can claim the money spent on tests.
OPD Cover Add-on
Some health insurance companies have started offering an OPD cover as an add-on to the basic policy. This means that the add-on will cover non-hospital spending such as diagnostic tools, medicines bought at pharmacies, consultation fees, etc. All of this depends on which insurer you choose, so you have to research well and look at the network of doctors associated with the company. The OPD cover has the additional benefit of enabling you to claim reimbursement more than once during the tenure of your health insurance policy.
Preventive Health Checkups
Upon renewal of your health insurance, your policy could offer free medical checkups. If you perform a regular health checkup for yourself and your family members, this could avoid any expenditure spent on diagnostic checks otherwise. Health experts recommend that every family member should have an annual overall health checkup, especially for senior citizens.
To Sum Up
If you’d like your health insurance policy to cover your diagnostic expenses even if you’re not hospitalised, research about policies that have the add-on of OPD coverage. Other than not having to worry about large hospital bills in times of emergency, buying health insurance will also give benefits and exemptions while paying tax; so, you save more money than you think in the long run. Make sure to dig into the details and look into the pros and cons of health insurance online.
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