Health Insurance

Going Abroad For Medical Treatments? Key Things You Should Know About Health Coverages

A lot of people assume that once insurance is involved, they won't have to worry about money. That's rarely the case. Some insurance plans may also have hidden terms like co-payment clauses (where the patient pays a part of the treatment cost) or sub-limits on certain procedures

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Not long ago, going overseas for surgery or specialised medical treatment was something only a few Indians could dream of. Today, it's different as with the help of health insurance, in addition to affluent Indians, others can also seek necessary treatments abroad. Whether it is for a complicated procedure, advanced cancer therapy, or an urgent intervention, many families are willing to cross borders in search of better healthcare.

But in the middle of arranging doctors, hospitals, and air tickets, one critical detail often gets overlooked, does your health insurance cover you outside India?

"Standard health insurance policies typically do not offer global coverage," says Priya Deshmukh, Head, Health Products, Operations and Services, ICICI Lombard. If you're planning treatment abroad, you will either need a plan that comes with global coverage or an add-on that specifically extends protection overseas.

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In the last few years, insurance companies have started offering options that allow policyholders to get treated internationally, sometimes up to very high coverage limits. But just because something is offered does not mean it's automatically available. You still have to sign up for it and, in many cases, wait a few years before the benefit kicks in.

Planned Treatments Are Also Covered If You Follow the Rules

It's not just emergencies that qualify. Planned surgeries and treatments abroad can be covered under health insurance today.

But it's not as simple as booking a hospital appointment and flying out. You need to stick to some rules.

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First, the hospital or clinic where you plan to get treated must be part of the insurer's empanelled network in that country. Second, you have to inform your insurer well in advance, at least a week before your treatment date, and get their formal approval.

"Prior intimation is required at least 7 days in advance. This is necessary to make sure the insurer reviews the treatment plan and gives pre-authorisation," says Deshmukh. Missing this step could mean you end up having to pay from your own pocket despite having a global coverage clause.

There Are Costs Your Insurance Won't Pay

A lot of people assume that once insurance is involved, they won't have to worry about money. That's rarely the case.

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While hospital admission charges, surgeries, and procedures are usually covered, expenses like air tickets, hotel stays, meals, and even local transport are often left to the patient. Unless your policy clearly says otherwise, you should plan to handle these costs yourself.

Some insurance plans may also have hidden terms like co-payment clauses (where the patient pays a part of the treatment cost) or sub-limits on certain procedures.

Deshmukh points out that there's often a waiting period of two to three years before international coverage becomes active. Also, some policies might list out specific countries or treatments that are excluded.

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"It's important to read the policy document carefully to understand additional costs, waiting periods, and exclusions. These may include non-covered treatments, specific countries that are excluded, or procedures specifically excluded under global treatment," she states.

It's wise to spend a few hours reading your policy document carefully; it could save you lakhs later.

Cashless Treatments Abroad Are Possible But Not Everywhere

Traditionally, patients paid for overseas treatments out of pocket and then filed for reimbursement after returning to India, a process that could be long and stressful.

Now, cashless arrangements are slowly becoming more common. Insurers have started tying up with international hospital networks to provide this convenience.

Still, don't take it for granted. "You should always confirm in advance whether your insurer offers cashless facilities at your chosen hospital," advises Deshmukh. Otherwise, you might find yourself scrambling for funds in a foreign land.

What Happens After You Return?

Getting treated abroad is one thing. But what about recovery? Follow-up consultations, diagnostic tests, and therapy sessions are crucial parts of the healing process.

If your overseas treatment was pre-approved by your insurer, most good policies will cover post-treatment care back in India, provided you submit all the necessary medical paperwork from the foreign hospital.

Services like teleconsultations and rehabilitation support are often included.

To Sum Up

Medical travel can open the door to world-class treatment options but it also brings a financial risk if you might not be prepared to handle.

Before you get on that flight, it is essential to know exactly what your insurance will cover, what steps you must follow, and what costs you'll have to bear yourself.

A little homework today can save you a great deal of stress tomorrow.

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