How to Check the Status of Your Health Insurance Policy?


How to Check the Status of Your Health Insurance Policy?

As a policyholder, making a claim is the most vital aspect of your health insurance policy. It allows you access to financial support during medical emergencies. It is through the claim process that you get coverage for treatments, thereby reducing the burden of healthcare expenses and ensuring timely access to necessary medical care. However, when making a claim, there are a number of things that you need to do. Only raising a claim or filling out the claim form is not enough. Understanding the claim process and following the required steps will help you get the required coverage without any trouble or hassle.

If you have raised a claim and want to know how to check the status of your health insurance policy, you are at the right place. Read on as we answer all your questions, such as how to check my mediclaim policy status, how to check mediclaim status online and offline and what things to keep in mind when raising a claim.

Understand the Claim Process

Before  you ask how can I check my mediclaim policy status, let us first discuss the claim process. In case an insured individual requires hospitalisation, there are two types of hospitals that you can go to- network hospitals and non-network hospitals. 

1. Network Hospitals

These hospitals are the hospitals and health centres that have a collaboration with your insurance provider. At such hospitals, you can avail the benefit of cashless hospitalisation. This means that once the admission is validated, your  treatment cost is taken care of by your insurance company or the appointed TPA. The company pays for all medical bills directly to the hospital.

For example, if you seek treatment at any of the 22900+ healthcare providers, Care Health Insurance will pay for all of your covered medical expenses. You would only have to pay for those expenses that are not covered by your health insurance policy. You will easily save yourself from running around arranging funds and also from all the paperwork involved.

2. Non-network Hospitals

At a non-network hospital, when you seek treatment, you need to pay the medical bills upfront. After your discharge, you can file for reimbursement by filling out the claim form and submitting all the treatment-related paperwork. Once these formalities are completed, your health insurance company will reimburse you for the covered expenses. The money will be transferred to your bank account.

The time taken for reimbursement depends on company to company. Things also depend on your paperwork. If you leave out some important details, the insurer will ask you to do what is required.

How Can I Check My Mediclaim Status?

When you seek treatment at a network hospital, your insurer simultaneously looks after the billing. However, things may take a little time when you make a reimbursement claim. You may have to wait for a few days  to get the amount reimbursed . Now, you may wonder how can I check my mediclaim status of the claim that has been raised.

There are 2 ways in which you can check your health insurance policy status: online and offline. Let’s  have a look on both the process:

How to Check Mediclaim Status Online?

Health insurtance companies  offer a well-illustrated portal that makes it easier to carry out the procedures related to your health insurance policy. Typically, you would need to follow the steps given below:

  • Visit the official website of your health insurance company.
  • Go to the health insurance page and click on ‘Claims’
  • Enter your policy details and the claim application number if provided
  • The status of your claim  will be shown to you.

How to Check Mediclaim Status Offline?

Let us now find out how to check mediclaim policy status using the offline way. For this, you would have to visit your insurance company’s office. Mostly, insurance providers offer a branch locater on their website where you can search for a branch office. Let’s say,to locate a Care Health Insurance branch office near you, you can click here. Make sure to carry all your treatment-related documents and your policy papers/ health card with you when you visit the branch.

You can also get in touch with a customer care executive with whom you can clear all your doubts regarding  how to check my mediclaim policy status?. Keep your policy documents handy, as the executive may need your policy details to tell you about the policy status.

>> Also Read: Story Behind Health Insurance Evolution in India

Things to Remember When Raising a Claim

When it is time for you to raise a claim, keeping the following things in mind can help ensure an easier and smoother claim settlement. 

1. In case of a Planned Hospitalisation

When seeking a planned treatment, it is highly recommended that you inform your health insurance provider at least  48 hours in advance.

2. In case of an Emergency Hospitalisation

If, for some reason, you could not inform the insurance company before the hospitalisation, make sure to do so in the first 24 hours of hospitalisation. When you take treatment at a non-network hospital, you have to submit the claim documents within 7 days of discharge.

3. Understand the TAT

It is suggested that you keep a note of the general TAT, and turnaround time, taken by your insurance provider.

4. Be Careful with the Paperwork

When making a reimbursement claim, it is crucial that you are diligent with the paperwork. Missing any information will lead to a delay in the disbursal of the amount.

Over to You

Facing troubles in raising a claim or getting a late reimbursement can be a bitter experience. Make sure you follow the claim procedure properly so that the claim can be settled in a hassle-free way. At Care Health Insurance, we strive to offer you the best possible services so that your claim requests can be dealt with at the earliest.

For any kind of assistance, get in touch with us through our website or customer care, or visit us at a nearby branch.

Disclaimers: The above information is for reference purposes only: Policy Assurance and Claims at the underwriter's discretion.


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