Health Insurance

What is Health Insurance?

A health insurance, also known as medical insurance, is a sort of general insurance that protects you against financial losses by covering you in the event of a health condition or medical emergency caused by a disease, illness, or even an accident.
This includes pre- and post-hospitalization expenditures, annual health check-ups, psychiatric support, severe illnesses, and maternity-related charges, among other things, depending on your specific health insurance plan.
They can be taken by a single person or by a group. It is necessary to have adequate coverage to protect against escalating medical expenditures and to be able to access high-quality healthcare services.

Why do you need a Health Insurance?

1. A health insurance coverage can cover hospitalisation charges, prescription and lab test charges, ambulance and doctor fees, and so on. Some health insurance plans additionally cover OPD costs up to a specified amount.

2. It aids in reducing your out-of-pocket payments by providing a cashless medical treatment facility in network facilities.

3. Nowadays, with the coronavirus outbreak, it is even more vital to have or purchase medical insurance that covers the expense of treatment, including PPE kits, masks, ventilators, ICU expenses, and so on.

4. If you do not have coronavirus health insurance, you can purchase Corona Kavach and Corona Rakshak health policies to alleviate your concerns.

5. Even people who are thinking about starting a family can purchase a health insurance policy that includes maternity and newborn infant coverage.

6. If you have a medical insurance coverage, the insurer will cover the costs of major surgeries such as liver transplantation, open-heart surgery, and day-care procedures such as cataract surgery, varicose veins, and the like.

7. A health insurance policy allows you and your family to have peace of mind without having to worry about future hospitalizations or medical emergencies, which can otherwise deplete a significant chunk of your savings.

Benefits of having a health insurance policy

A comprehensive health insurance plan will cover the cost of hospitalisation, including pre and post-hospitalization fees, medical care at home (also known as Domiciliary Hospitalization), childcare treatments, and ambulance charges, among other things.

Covers Pre & Post Hospitalization Costs

According to the terms and conditions of the insurance company, a health insurance policy covers all expenses incurred before the patient is admitted to a hospital and after discharge from the hospital for a set period if such expenses are related to the sickness.

Cashless Treatment

Cash is something that not everyone has access to all of the time, which is why cashless health insurance has gained popularity. If you are covered under a health insurance plan that offers cashless treatment, you will no longer have to worry about paying your medical bills because your insurance company will handle the payment through a cashless programme on your behalf, allowing you to focus solely on your medical treatment.

No Claim Bonus (NCB)

For health insurance, a No Claim Bonus (NCB) is a set amount of money you'll save if you don't file a claim throughout the policy's term. This discount will be applied to your premium when you renew your health insurance.

Ambulance Fee

Once admitted to the hospital, the person is relieved of the burden of transportation costs, which are covered by the insurer.

Co-payment

When purchasing a medical insurance policy, you will come across the word "co-pay." When you make a claim, a co-pay is a pre-determined amount that you must pay before your health insurance company will cover the balance of your medical expenditures. The amount of your overall Sum Insured is unaffected by co-payment.

Medical Check-Up Facility

A medical plan entitles the covered to routine medical examinations. Some insurers offer a free check-up service, or you can purchase it as an add-on benefit.

Tax Benefits

Under Section 80D of the Income Tax Act of 1961, you may be eligible for tax benefits for premiums paid on a health insurance policy. Tax benefits are available up to a particular level depending on the policyholder's age and the age of his or her parents (if any).

Family Discounts

Various health insurance companies in India give this discount for registering any family member or individual in a health insurance policy. This is a type of incentive offered by health insurance to existing policyholders who refer others to them.

Individual Health Insurance Plans

This is one of the top health insurance plans in India, and it is something that almost everyone is familiar with. Individual Health Insurance Plans, as the name implies, are specifically designed to safeguard a single person's health against a variety of severe illnesses for a single sum insured. Although family members might be covered under the finest Individual Health Insurance Plan, you will need to select a different Sum Insured for each family member. The Sum Insured is usually exactly proportional to the premium you pay for this health insurance online policy.

Family Floater Health Insurance Plans

Family Floater Health Insurance policies provide comprehensive medical coverage for all members of your family against a variety of illnesses and ailments for a single Sum Insured. This medical plan can cover your parents, spouse, and children under the age of 18. Individual mediclaim plans taken by each family member have a higher premium than a family floater health insurance plan. The importance of a family floater health insurance plan is that it covers all members of the family and also offers a fixed Sum Covered for all insured members for single or multiple claims filed throughout the policy term.

Group Health Insurance Plans

A Group Health Insurance policy is created for a group of co-workers. If you own a small business or a large corporation, you should purchase such plans for your employees. It is a type of benefit that is provided to employees. You can purchase the cover as an employer to increase employee retention. The Group Health Insurance Plan has a reasonable premium. If the sum covered is depleted, certain insurance companies allow you to refill it an unlimited number of times. Hospitalization due to an accident, illness, severe illness, psychiatric illness, or maternity is covered under a group health insurance plan.

Senior Citizen Health Insurance Plans

Senior Citizen Health Insurance Plan is a health insurance policy that is specifically tailored for persons over the age of 60. This is a wonderful option if your parents or grandparents are over the age of 60. A Senior Citizen Policy will cover the cost of drugs, hospitalisation due to an accident or disease, and therapy both before and after the hospitalisation. Before selling a Senior Citizen Health Insurance Policy, certain insurers may require a comprehensive physical examination. The maximum admission age has been raised to 70 years old, with the opportunity to renew for the rest of one's life.

Maternity Health Insurance Plans

Nowadays, almost all of India's finest health insurance firms offer maternity health insurance policies. This health insurance policy covers the costs of childbirth, prenatal and postnatal care, and even vaccinations for new born babies in some cases. To put it another way, a maternity health insurance policy covers all of your maternity expenses. However, the features and advantages of this specific health insurance plan may differ from one insurer to the other.

Critical Illness Insurance Plans

The critical illness plan, which is one of the best health insurance policies, is meant to give medical coverage to insured persons against a variety of critical illnesses that are defined in the policy. Getting treatment for critical diseases & surgeries is an expensive affair. The Critical Illness Plan will pay you a predetermined sum as soon as you are diagnosed with the sickness, regardless of the actual cost of treatment. Purchasing a Critical Illness Policy is the smartest decision you can make because it protects your savings. The policy can be renewed indefinitely. It includes diseases such as cancer, heart attack, kidney failure, paralysis, aorta graft surgery, stroke etc.

Top-Up Healthcare Insurance Plans

If you need more coverage, you can purchase a top-up policy. However, such plans include a "Deductible Clause." In the event of a claim, payment will be provided over and above the policy's stipulated limit.

What is covered under a health insurance policy?

A health insurance policy's coverage is determined by the type of policy and the insurance provider. An excellent policy is adaptable to your needs and meets them to the greatest extent possible.

Some of the common inclusions of a health insurance policy are:

Expenses for inpatient hospitalisation
In case organ transplant, the donor's expenditures
Overnight stay in a hospital due to an injury
Pre-existing illness or disease
Pre & Post Hospitalization expenses
Ambulance Charges
Regular health check-ups
Maternity cost & childcare
Day care procedures
Treatment availed at home

Few things to keep in mind while buying a health insurance policy

When there are so many health insurance companies to choose from, it can be difficult to find one that meets your needs. However, before you select your insurance plan, here is a simple checklist to consider.

Make certain that the Sum Insured is correct. Consider whether or not it will suffice for you or your family.
Set the proper Sum Insured limit for your parents who are financially dependent on you.
Choose the plan with the shortest wait time.
Examine the maximum age-renewal rate.
Purchase health insurance from firms with a high claim settlement ratio.
Choose the insurance plan with the largest hospital network on their list.
Check the coverage a plan is offering, don’t just compare the premium.
Choose a health insurance company that offers health insurance portability

Frequently Asked Questions

If you choose the cashless option, your health insurance will either pay your hospital bills immediately or refund any payments you make toward medical expenditures incurred as a result of an illness or injury.

While the age of eligibility for health insurance policies varies, adults generally have to be between the ages of 18 and 65. Children must be between the ages of 90 days and 18 years to be eligible.

You must clarify with your insurer whether your policy covers you across the country or only within certain limitations before purchasing the insurance. In most cases, a health insurance policy will cover you throughout India. Unless otherwise stated, the policy may not cover claims that occur beyond of India's geographical boundaries.

For a set period at the start of the insurance term, your insurer will not cover pre-existing illnesses. The waiting period is what it's called. Various pre-existing conditions have different waiting periods, so contact your insurer to learn more about your illness's waiting time. Certain pre-existing conditions are not covered by health insurance.

In a given year, you may file an unlimited number of claims. However, the claim amount should not exceed the policy's assured sum. For example, if you have a health plan of INR 2 lakh, you can only collect INR 2 lakh from your insurance.

At the time of emergency, you can get yourself treated at any non-network hospital and pay for the expenses. Later on, you can file a reimbursement claim from your insurance company. The insurer will ask for certain documents that you need to provide to get your claim.

Yes! Purchasing health insurance entitles you to tax benefits under Section 80D of the Income Tax Act of 1961.

Yes, you can do so at the time of policy renewal.