Does Health Insurance cover diagnostic charges?

Introduction

A health insurance plan is mandatory for everyone irrespective of age, as it helps to cover the medical and surgical expenses of the insured individual or family.

Health insurance plans protect one from pre as well as post-hospitalisation expenses. In treating any critical illness, there is always a demand for a high-cost diagnosis process, including X-rays, MRIs, Ultrasound or invasive tests, etc. These expensive tests take a heavy toll on our finances.

Various types of health insurance plans are available in the market; it is challenging to understand the inclusions and exclusions in health insurance. We often get confused while deciding which type of plan serves our needs and purpose.

So, before purchasing any plan, we must go through the entire prospect to better understand what the insurance covers and what does not.

What are diagnostic charges?

Diagnostic tests are simple or advanced examinations done by medical practitioners to identify, screen, detect or monitor a person’s health and body to determine any illness, disease or condition. It is used to gather the necessary clinical information to start a diagnosis.

The diagnostic charges may vary for each test based on diagnosis equipment, process, method and type.

Some of the standard diagnostic procedures are

• CT Scan (Computed Tomography)
• MRI (Magnetic Resonance Imaging)
• X-Rays
• Ultrasounds
• EMG (Electromyography)
• ECG (Electrocardiogram)
• Biopsy
• Mammography
• Blood tests
• Colonoscopies
• PET (Positron Emission Tomography)
• Eye tests

These diagnostic tests may cost you from several hundred rupees to thousands; the cost depends on the nature of the tests you undergo. The diagnostic charges of pre and post hospitalisation which are in association with the in-patient hospitalisation will be covered under a Health Insurance Policy.

Does health insurance cover diagnostic charges?

The answer is YES; most diagnostic tests like X-Rays, MRI, and blood tests are covered under health insurance plans, but it varies from plan to plan. The diagnostic charges will be considered subject to it is relevant to the treatment done for the current hospitalisation.

The patient’s stay must be as per the health policy’s minimum stay duration. Diagnostic tests prescribed to OPD patients are generally not covered under health policy plans. Wherever there is a Government capping for the Diagnostic tests, the same shall be applied by the Insurer.

However, many health insurance plans have features where pre and post-hospitalisation charges are included. So, the insurer may cover diagnostic costs 30, 60 days before hospitalisation and 90/ 180 days after the discharge date, but it varies from plan to plan.

So, choosing the right comprehensive health policy for you and your family is needed to protect you from financial burnout.

How to choose a health insurance policy that covers diagnostic test charges?

As you know, there are various insurance policies available in the market. It is necessary to understand the terms and conditions of each plan before purchasing any particular Health Insurance plan.

Conclusion

Before buying a health policy, it is essential to understand the inclusion and exclusions of the policy. Diagnostic tests like CT-Scan, MRI, and X-ray costs are high today; it is crucial to choose a comprehensive plan that covers the pre and post-hospitalisation expenses.

As discussed earlier, diagnostic tests are the first step of treatment used to identify the disease, illness or condition, and it can’t be avoided at any instance. A good health insurance plan will protect you from these unexpected expenses and help you save money from these medical emergencies.