Is It Possible To Claim Health Insurance From Two Companies?
Health insurance is the type of insurance coverage that provides financial protection against medical expenses and healthcare costs. It helps you to manage the financial burden from diagnosis to cure, such as medical treatment, hospital stays, doctor visits, prescription medications, and other healthcare service costs.
Possessing multiple health insurance policies is advantageous while filing health insurance claims. So the answer to this question, can we use two mediclaim policies is 'Yes'. Let us understand how.
Can we Claim Medical Insurance from Two Companies?
Possessing multiple health insurance policies is advantageous while filing health insurance claims. So the answer to this question, can we use two mediclaim policies is 'Yes'.
Let us understand with Rahul's Story
Rahul is an IT guy who is working with an MNC, who provided him with health insurance of Rs 50 thousand coverage. He also had health insurance coverage of Rs 1 lakh, which he got 10 years back from company A. After a few years, Rahul was diagnosed with a critical illness and he had to undergo by surgery. The total cost of his medical procedure was around Rs 1.2 Lakh. Now what he will do is, he will claim his Rs 1 lakh from Company A, and after showing the documents and settlement certificate he will get another Rs 20k.
All in all, it gives us an increase in coverage, flexible claims, and a lot of savings. But, you also need to be aware of the guidelines and considerations:
- Coordination of Benefits These benefits help you to determine which insurance company is primarily responsible for covering your medical expenses. COB makes sure that you do not receive more benefits than the total cost of medical treatment.
- Claim Submission While filing the claim, you need to first file with your primary coverage, and then only you can move ahead to the secondary.
- Reimbursement and Deductibles The secondary insurance company covers some or all of the remaining cost that was not covered by the primary insurance. This can include deductibles, co-payments, and co-insurance.
- Policy Terms It is crucial to review both insurance policies carefully. Understanding all the terms and conditions helps you to avoid any conflict in the future.
- Documentation Keep all the medical bills and other relevant documentation for both insurance companies. You might need to provide these documents as a part of the claim process.
It is important to openly communicate with both insurance providers about your coverage to avoid any misunderstanding. Keep in mind that when you have two insurance policies, you are double-secured with more comprehensive coverage.
How to Claim Medical Insurance from Two Companies?
Claiming medical insurance benefits from two different insurance companies, also known as dual insurance requires careful navigation to ensure a smooth process. Here is the step-by-step guide that can help you through the process:
- Understand your Coverage You need to review both insurance policies to understand the coverage, deductibles, copayment, and coinsurance for each plan. Identify the policy that should be your primary and which one is secondary.
- Initiate the Claim After undergoing medical treatment, provide your primary insurance information to the healthcare provider. Pay the deductibles, copayments, or coinsurance required by the primary insurance plans.
- Submit the Claim to Primary Insurance Get the Explanation of Benefits statement from the primary insurance company after the claim has been processed. Keep a copy of the EOB for your future records.
- Submit the Claim to Secondary Insurance Once you collect the EOB from 1st insurance company, and you want to claim from the second, submit your claim. Provide all the required documents, including bills, receipts, and EOBs that you have collected from the hospital and primary insurance provider. Add a cover letter explaining your claim benefits from both insurance policies.
- Secondary Insurance Processing The secondary insurance company will process the claim and determine the additional benefits they will cover.
- Reimbursement or Direct Payment The Company either reimburses you for the out-of-pocket expenses paid to the primary insurer or makes direct payments to the healthcare provider. Keep all the records and data of the reimbursements.
- Coordinate with your healthcare provider Inform your healthcare provider about the dual insurance coverage and provide them with the required insurance information. Make sure that they bill both insurance companies correctly to avoid any delays or complications.
- Follow-up and Documents Keep detailed records of all the communication, for follow-up in case of delay.
- Compliance with the Policy Term Be aware of any terms and conditions in both insurance policies that can affect the coordination of benefits or claims.
Bottom Line
Always remember that each insurance company might have its procedures and requirements for dual insurance claims. So it is essential to communicate openly with both primary and secondary insurers and provide accurate information. Also, you need to keep all your documents organized to ensure a smooth and easy claim process.