Traveling This Festive Season? How Your Health Insurance Can Keep You Protected
For any travel, and particularly long distance journeys, the single most important layer of coverage, beyond taking your usual medication, is your health insurance policy.
By Arun Ramamurthy
The celebratory season in India lasts from Navratri, through Diwali to Christmas, and is generally a time for festivities, family gathering and travel. Millions will be on the road, train or in the air, and often, to their ancestral hometown or for a much-awarded trip away. It is a happy time of year, but the increased activity, locations congested with people, shifts in diet and routine can increase your risk unexpectedly for some health issues, including travel sickness, to injurious or seasonal illness.
For any travel, and particularly long distance journeys, the single most important layer of coverage, beyond taking your usual medication, is your health insurance policy. It is important to be aware of how your health cover will perform for you while you are on holidays to shield you from the financial consequences of medical emergencies while away from home.
Understanding Your Coverage: Pan-India vs. Geographic Limits
The first step is verifying the geographical scope of your existing health plan.
A. Pan-India Coverage
Most standard individual and family floater policies will cover medical expenses you incur anywhere in India. This means that when you travel from Mumbai to Kolkata, or from Delhi to Bengaluru, typically, your policy will cover you in the same way while at your destination as it does while you are at home.
The rationales are clear: if you became ill abroad, or if you were injured while on holiday, your policy would cover reimbursement for hospital admission and important care - surgery, and pre and post-hospitalisation under terms and limits stated in your policy (for exemplifying purposes).B. Network vs. Non-Network Hospitals
The ability to access cashless treatment is paramount during a travel emergency.
- Network Hospitals: Your insurer has a partnership with these hospitals. If you are hospitalized in a network hotel at your travel destination, you can simply show your insurance card, and the insurer pays the bill (cashless). This is the easiest way, especially when you are far from home and may not always have access to cash.
- Non-Network Hospitals: If you end up in a non-network hospital, you will need to pay the bills up front - then submit documents to the insurer for reimbursement. The coverage still applies, but you will be responsible for immediate liquidity, which can be an issue during travel.
- Travel Tip: Always check the list of network hospitals at or near your final destination or route before you go.
Key Medical Situations Covered During Travel
Health insurance is not just for major surgeries; it protects against common travel-related illnesses and accidents.
A. Emergency Hospitalisation
This represents core protection. In the event of either a serious accident or serious illness (e.g. serious viral fever, dehydration from food poisoning, or dengue), and you will require an admission for more than 24 hours, your policy will cover the costs related to your admission, including hospital room costs, nursing fees, doctor fees, and necessary medications.
B. Day Care Procedures
If you need a medical procedure that is completed within 24 hours (for example, some eye surgeries, and minor fractures) and is included in your policy, the cost would be covered, regardless of whether it happens in your home city or when you travel.
C. Road Traffic Accidents (RTAs) and Injuries
Unfortunately, RTAs occur frequently during holiday travel. Your health insurance will pay for the hospitalization if you sustain injuries in a road traffic accident. In some cases, your health insurance may pay for emergency ambulance services costs (to a limit) to transport you to the nearest hospital, easing a considerable burden for you in the moment.
D. COVID-19 and Seasonal Illnesses
Given the seasonal uptick in viral illness and the risk of new variants, the travel increases your exposure. Having a strong health plan can help ensure that if single hospitalization is required because of an infectious disease, it will be covered and that you will also receive treatment if warranted in order to limit the costs of getting sick out of your community.
The Role of Critical Rider Benefits
Beyond the standard base policy, certain add-ons or riders become especially valuable for frequent or long-distance travelers.
A. Critical Illness Rider
Travelling can sometimes reveal or worsen a serious underlying condition. A Critical Illness rider provides a lump sum payment upon the diagnosis of any relevant major illness (such as heart attack or stroke), irrespective of the actual daily hospitalization costs. This lump sum can be invaluable in that it allows you to protect against loss of income, cover care post discharge, and even permit you to seek treatment out of your town/city where your health policy limitations may not apply (e.g., out of country) .
B. Emergency Evacuation/Assistance Services
Some premium or specialized health plans include an Emergency Evacuation or Medical Assistance rider, offering peace of mind when traveling to remote areas.
- Medical Repatriation: This includes the expenses for medical transportation that is medically necessary for you to get from a less capable facility back to a city with more advanced hospital services. The goal is to provide you with appropriate, on-going, and quality medical treatment.
- Air Ambulance: During emergencies that are critical, life-threatening, and where road transportation would be too late, this rider would cover the exorbitant cost of an air ambulance to potentially save lives.
Exclusions and Fine Print to Check Before Traveling
To avoid unwelcome surprises, travelers must be aware of what their policy does not cover.
A. OPD and Non-Emergency Consultations
Most standard health insurance plans do not pay for outpatient department (OPD) visits. If you simply need to go for a consultation for a minor condition (such as a common cold or mild stomach bug) and are not going to be admitted, you will essentially have to pay for this on an out-of-pocket basis.
B. International Travel
A typical domestic health insurance policy does not cover medical emergencies that occur outside of India. Therefore, if your plans for the holidays include international travel, you'll need a separate International Travel Insurance policy to fill in this coverage gap.
C. Policy Waiting Periods
For anyone with a new policy, keep in mind that most insurance policies have some type of waiting period in their coverage (30 days for new illnesses, 2-4 years for preexisting policies). You will not be able to get your claim approved in the event you need to make a claim during that waiting period. Make sure to always check your waiting periods before and during any big trip.
Steps to Take Before and During Your Festive Trip
To ensure you are getting the most out of your health insurance, please use this essential checklist:
- Review Policy Documents: Make sure you know the specified geographic limits and the total Sum Insured.
- Keep TPA/Insurer Hotline Handy: Write down the customer care number as well as the Third-Party Administrator (TPA) number. This will be your first call in a medical emergency, especially to get cashless processing.
- Always Carry Your Health Card: Keep a hard copy and a digital copy of your health card, plus a valid photo ID.
- Notify Insurer on Time: If you are hospitalised in emergency circumstances, notify the insurer or TPA (generally 24 to 48 hours) so when the time comes, the cashless claim process can be smooth and efficient.
By taking the time ahead of time and understanding the scope and the limits of your health insurance, the only memories you bring back are happy ones and knowing you had complete confidence with a whole lot of financial support.
(The author is Co-founder, Staywell.Health)
[Disclaimer: The opinions, beliefs, and views expressed by the various authors and forum participants on this website are personal and do not reflect the opinions, beliefs, and views of ABP News Network Pvt Ltd.]
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