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<Prudent Strategies in Taking Out Medical Insurance> pdf (Chinese Version only)
Smart Tips |
Why are there excluded items? The premium of medical insurance is collected to form a pool for paying the medical expenses of policyholders which are unexpected. The insurance company will withdraw funds from the pool to pay for the policyholders’ medical expenses. This is the principle of insurance to protect the policyholders from unexpected risks. Since pre-existing conditions and non-medically necessary items are within policyholders’ expectation, they should not included in the covered items of a policy, and they shouldl be listed under “excluded items” in detail. (All insurance contracts carry excluded items. Policyholders must read them carefully.) |
Be Smart
- Read the Terms in Details and Understand Your Scope of Cover
After you have bought a new outfit, you will take a good look at it at home or try it on to see if it fits. In fact, taking out medical insurance cover is the same. After you have received the policy, you should immediately read thoroughly all the terms and conditions, especially the coverage and excluded items. By doing so, you can avoid unnecessary future dispute with the insurance company and ensure your insured interests under the policy are protected.
Pre-existing conditions not covered
Ms Choy had frequently consulted doctor because of abdominal pain. She was aware that she might need treatment in the future so she took out a medical insurance early this year. After one month, she was admitted to a hospital because of abdominal pain and blood in her faeces. Ms Choy said reluctantly: "I am diagnosed of having a tumour in my colon after examination, which is estimated to have existed for a few months. An operation must be carried out to remove it. I thought I could claim under the in-patient plan of my medical insurance. But on reading the policy, I found out that it was clearly stated that pre-existing conditions, non-medically necessary surgery and body check-up were excluded. Though this operation is not covered in my medical plan, I received the medical treatment all the same. But the unexpected medical cost did leave me a bit off balance."
Read carefully the excluded items
Coverage and excluded items are clearly listed in the policy. “Pre-existing conditions” are commonly excluded items in most medical insurance policies. That is to say, the policy will not cover diseases or injuries already in existence, existing or with symptoms showing on an applicant before the inception of a policy.
Besides, a policy will also clearly state that no cover will be provided for consultations related to non-emergency or non-medically necessary diagnosis, examination, surgery or laboratory tests , for example, cosmetic surgery or plastic operation, physical check-up etc. Policyholders are recommended to read the policy to understand the coverage and excluded items.