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Health Insurance

What is a health insurance policy?

Health Insurance is a kind of insurance that provides coverage for your medical expenses.

In other words, health insurance, also known as Mediclaim, pays for advance medical treatments that usually required overnight stay at the hospital. This form of insurance also covers other medical costs like daycare which do not need you to be hospitalised. Overall a health insurance policy gives you relief from financial stress while protecting your savings.

What is a health insurance policy?

Why should you opt or buy a health insurance policy?

Health insurance policy is a form of insurance that covers medical expenses incurred for medical treatments/ surgeries or during medical emergencies. In simple words, these plans save our hard-earned money or savings from draining out in the cost of the medical treatments. A health insurance plan reduces the financial burden related to medical eventualities.

Illnesses or diseases do not come knocking your door; they are unexpected. Hence, in such crisis times, health insurance comes as a rescuer by providing financial assistance while ensuring all the required treatments, which usually are quite expensive and hard to spend from our pockets.

What is a health insurance policy

Moreover, health insurance plans offer medical coverage and tax benefits on the premiums paid under Section 80D of the Income Tax Act 1961. Therefore, a health insurance plan is a necessity for every individual who wants to save his or her money from spending on medical expenses while saving more.

Different types of health insurance policies

There are different types of health insurance plans offered by various insurers. Let know them in detail:

  • Individual health insurance plans: 

    As the name suggests individual health insurance plans provides medical coverage for a single individual. It offers various benefits like hospitalisation expenses, cashless claims, reimbursement, pre-and post-hospitalisation cost, domiciliary treatment cover and more.

  • Family floater health insurance plans: 

    Family floater, health insurance plans, covers the entire family comprising of the policyholder, spouse, children and parents under a single plan. The overall sum insured is shared by all the family members and the whole family gets coverage on a floater basis. Any member is eligible to make a claim up to the sum insured.

  • Critical illness health insurance plans:

    If the policyholder is diagnosed with any critical illness, these health insurance plans cover such diseases. The sum insured is paid to the insured, which they can use to handle medical treatment expenses or pay any other financial liabilities.

  • Senior citizen health insurance plans: 

    Senior Citizen health insurance policies are meant for people in their old ages. Those who are 61 years and above are covered under this policy. This form of health insurance plan includes hospitalisation expenses, OPD, Daycare, pre-and post-hospitalisation expenses, and tax benefit under section 80D of the Income Tax Act.

  • Top-up health insurance plans: 

    Top-up health insurance plans offer additional coverage at a considerable minimum premium amount. If the insured person thinks that the policy coverage is low, they can purchase the top-up plan to enhance the coverage. These health insurance plans come with a deductible limit, and a claim more than a deductible limit is paid.

  • Super top-up health insurance plans: 

    Also known as aggregate health plans, these health insurance plans are like top-up plans and enhance the policy coverage at affordable premium rates. These plans also come with a deductible limit and claims surpassing the limit gets paid. But in case of top-up plans consider each claim separately, and super top-up health plans sum up the total claims made in a year and then apply them against the deductible limit. If the total claim amount is more than the deductible limit, then the claim is paid out.

  • Maternity Health Insurance plans: 

    The maternity health insurance policy covers maternity expenses, including pre-and post-natal care and child delivery cost (normal and caesarean). Some insurers also provide coverage for vaccination expenses of new-born babies.

  • Group Health Insurance plans: 

    Majority of employers nowadays offer health insurance to their employees. The employers’ health coverage includes hospitalisation expenses of the employees and their family members – spouse, children, parents. Opting for a group health insurance policy is a wise decision as you do not require to pay any premium as the employer pays it.

Benefits of Health Insurance Policies

Health insurance plans offer a host of advantages and exclusive features beneficial for you. Here are those:

  1. Health insurance policies cover all medical expenses incurred for medical treatment during hospitalisation and post hospitalisation. Thus, the health plans save your hard-earned money from draining out into medical costs.
  2. Health insurance plans offer cashless claims for the medical expenses incurred in any insurer network hospital. In cashless claims, the policyholder does not require to pay for the hospital expenses as the bills get directly settled between the insurance company and the hospital.
  3. Besides providing coverage for medical expenses, health insurance plans also offer add-on coverage benefits such as free health check-ups, second medical opinion and more.
  4. Health plan offers tax benefits against the premium paid towards the insurance policy. Premiums paid against medical coverage for your self and family members are eligible for tax deduction under section 80D. The deduction limit for covering self and family is Rs 25,000 and another Rs 25,000 for covering dependent parents. And suppose the policyholder or dependent parents are senior citizens; in that case, the maximum limit is each case goes up to Rs 50,000 which means that a maximum of Rs 1 lakh can be claimed as tax benefit through health insurance plans.
  5. Health insurance policies come with No-Claim Bonus facility. If no claim is made in a year, a bonus is given, which includes either a rise in the sum assured or add-on benefits like annual health check-ups and gift vouchers.
  6. Health insurance offers lifelong renewals without any maximum cover ceasing age.
  7. The tenure of the health insurance policy can vary – it can be one, two or three. However, if policies with a longer-term are chosen, then a premium discount is offered.

Is Covid-19 treatment expense included in my Health Insurance policy?

This is the most common and generic question that crosses everyone’s mind at least once in today’s time. So, the answer is Yes! The existing health insurance plans in India covers Covid-19 treatment cost, in case you get hospitalised for the same, excluding the fee of consumables. But as the consumable price is high, you can opt for Covid- specific medical insurance plans. These kinds of health insurance policies are launched in India for providing wholesome protection against Covid-19. Here are the details of the plans:

  • Corona Kavach: 

    This health insurance plan offers coverage for all medical expenses incurred for Covid treatments. It includes hospitalisation costs along with home quarantine expenses without any sub-limits or deductibles.

  • Corona Rakshak: 

    Under this policy, if you suffer from Covid-19 and get hospitalised for three days or more, you get the entire sum insured in lump-sum. Corona Rakshak policy gives you financial assistance required for Covid treatments.

Health Insurance policy Inclusions and exclusions

Although health insurance policy inclusions and exclusion vary from one insurer to another, below are some generic ones.

Inclusions Exclusions
Inpatient hospitalisation – treatment cost, room rent, ICU room rent, doctor’s or surgeon’s fees, nurses’ fees, etc. Illnesses that occur within the first 30 or 60 day of policy buying
Pre and post hospitalisation expenses. Pre-existing disease during the waiting period.
Ambulance cost Cosmetic treatments
Day care treatments- which does not require hospitalisation for a minimum 24 hours. Genetic or inborn disease and ailments.
Organ donor expenses Pregnancy-related treatment, unless covered specifically.
Expenses for treatments taken at home or Domiciliary treatments. HIV/ AIDs infection
Ayush treatments – expenses incurred for non-allopathic treatments like Ayurveda, Unani, Siddha and Homeopathy Injuries or illnesses happened due to war or related perils, self-inflected injuries, alcohol or drug abuse etc.

To know the exact inclusion and exclusion in respective policies, always go through the insurer website, policy brochure or wordings. It is advised to understand the policy details and choose the one that best suits your requirement. It is also better to truthfully disclose all your health-related information to the insurer a discuss with the experts to make a sound buying decision.

Essential Factors to consider while buying health insurance plan

Medical coverage is essential for every individual for financial security. But there are ample health insurance plans available in the market, and it becomes quite challenging to understand and choose among all the options. Therefore, you need to consider certain factors while opting for a health insurance policy.

  • Coverage type: Individuals should thoroughly assess their needs and then select a health plan accordingly. If you don’t have any health insurance plans, then an individual or family floater plan could suffice your requirements. If you already have a health plan, you can probably go for a top-up health plan to enhance your policy coverage.
  • Coverage for all your family members: Ensure that the health plan that your opting covers all your family members as health problems can strike anybody and each one in the family should have medical coverage.
  • Adequate sum insured: You should opt for an adequate medical coverage sufficient to manage the high medical cost.
  • A health plan with comprehensive coverage: Look for a health plan that offers most inclusive coverage benefits, relevant to their requirements.
  • Affordable cost of premium: Apart from all the insurance coverage benefits, choose a health plan with a reasonable premium such that you can afford to pay in the long run.
  • Compare the plans: The ideal way to pick the right health insurance plan is to compare different policies and then buy one. Through comparing other plans, you will be able to analyse and choose the best health plan.

Eligibility for purchasing Health Insurance policy

Some of the essential eligibility criteria for buying health insurance policy are:

  1. A health insurance policy can be purchased by a person aged 18 years or above. Under several plans, the maximum entry age is 65 years or 70 while some permits lifelong entry. Children are eligible for getting health insurance coverage on an individual basis from 5 years onwards. However, under a floating health plan, children are covered from 91 days till the maximum of 23 or 25 years until they are considered dependent.
  2. Under floating health plans, you can cover yourself, spouse, children, parents, along with extended coverage for parents-in-law, siblings, grandparents, and other close relatives.
  3. Health insurance policies are lifelong renewable, and there is no coverage closing age.
  4. The maximum sum insured limit depends on the chosen policy and can start from Rs 50,000.
  5. Usually, the tenure of health insurance plans is one year. Still, several policies allow buying multi-pear policy wherein you can purchase policy for a continuous period of 2 or 3 years.

Bottomline

Needless to mention that health insurance plan is an inevitable choice as it offers financial security from the growing medical expenses. Suppose you are looking for or want to know more about medical coverage. In that case, you may visit BimaKaro which offers various health insurance plans from the top insurers in India. In case you want to understand and gather more knowledge about the health plan, you can speak to their insurance experts who will comprehend your requirements and suggest the ideal medical coverage for yourself and your family.

Related Post:

Review Overview
Essential Factors to consider while buying health insurance plan
SUMMARY

Medical coverage is essential for every individual for financial security. But there are ample health insurance plans available in the market, and it becomes quite challenging to understand and choose among all the options. Therefore, you need to consider certain factors while opting for a health insurance policy.

  • Coverage type
  • Coverage for all your family members
  • Adequate sum insured
  • A health plan with comprehensive coverage
  • Affordable cost of premium
  • Compare the plans
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