Separate Health Insurance for people covered by DGEHS
My wife is Delhi government teacher and hence we both are covered by DGEHS(Delhi Government Employees Health Scheme).
We have no child yet and parents are also covered by the organization dad retired from.
My question is:
Do we need to get extra health insurance other than what DGEHS provides? Specially if we met with an accident and/or have a huge bill, as DGEHS has specific rates for its hospitals and not sure how much it will pay if we are not in the list of hospitals.(see below points)
Below are what I have found till now:
- DGEHS hospital list is only of Delhi and few NCR hospitals.
- For emergency, Treatment in private hospitals not recognized/not empanelled under the scheme in medically emergent conditions will also be admissible when treatment is necessitated in such hospitals being situated near the place of illness / trauma and when no other recognized facility is available nearby or due to circumstances beyond the control of the beneficiary. However, reimbursement in such cases shall be made by the concerned department within the ceiling of DGEHS rates.
- I am thinking of 5 lakh base + 5 lakh super top up floater, with option to get plan which refills the amount even if one person has already used in a year. We are both fit so cover should get to 20 lakh if not used for couple of years.
- But would we need it? I can think of only scenario where we have for say 20 lakh bill from private and DGEHS based on their rates would only approve 5 lakh. Or if we want a private room but based on my wife's grade, we can only get general ward.
- Family wise we can afford it as I am also an Engineer. Don't want to rely on employee's basic group health insurance plan as well.
DGEHS site: http://health.delhigovt.nic.in/wps/wcm/connect/doit_health/Health/Home/Directorate+General+of+Health+Services/DGEHS/