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How to cut out-of-pocket medical costs in India

About 62% of the total healthcare costs are made up of out-of-pocket expenditure (OoPE) in the country, as per the Insurance Regulatory and Development Authority of India (IRDAI).

Generally, various health insurance policies extend several benefits to policyholders to cover the cost of medical treatment. However, there are a few categories of expenses that a health insurance scheme may not cover. An individual may be required to shell out from their own pocket despite having a health plan.

Buy adequate health insurance: When opting for a health insurance cover, look for features being offered such as out-patient department (OPD) cover and options of consumables cover that include the cost of items like syringes, bandages, medical gloves, etc. Ideally, go for plans without sub-limit and deductibles. Also, it is a prudent move to go online and compare various policies, features and premiums before opting for a health insurance plan. Finally, before opting for any health insurance scheme, always read the fine print carefully.

Prefer non-diagnostic hospital centres: This will help save on costs instead of preferring a private hospital for undertaking blood tests and radio imaging such as MRI, CT scan and ultrasound facilities, etc.

Opt for generic medicines wherever possible: Medicines tend to form the biggest component of personal spending on healthcare in the country. In this regard, generic medicines can be as effective as the prescribed brand of medicines. Generally, opt for such generic medicines from a local chemist instead of a hospital pharmacy.

Always go for network hospitals: In case an individual has health insurance, the insurer tends to negotiate treatment and stay costs with a network of doctors, hospitals, or healthcare facilities. When an individual goes for care from healthcare facilities within that particular network, they pay less. However, when an individual receives care from a non-network hospital, they will end up paying more in the bargain. Reach out to the insurance company to understand more about the network of healthcare facilities. ClearTax

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