Health Insurance : Stay prepared for medical emergencies

What is Health Insurance

A health insurance policy provides coverage for any future medical expenses of the insured and his/her family, based on the type of cover opted for.

Health insurance companies either provide reimbursement to the insured for their medical expenses, including treatments, surgeries, hospitalisation expenses and the like which arise from injuries/illnesses, or directly pay to the hospital/medical institution the total hospital bill, ensuring a cashless treatment to the insured. Typically, a health insurance plan in India will provide you multiple benefits such as

  • Coverage for pre and post hospitalization
  • Cashless hospitalization
  • Room rent coverage

Types of Health Insurance Plans

Individual Health Insurance Plans

These policies cover yourself, your spouse, your children and your parents. These policies typically cover all kinds of medical expenses, including hospitalisation, day care procedures, hospital room rent and more. Under an individual health insurance plan, each member has their own insured amount.

Senior Citizens Health Insurance

These health plans have been designed specifically keeping the medical needs and requirements of senior citizens in mind. Since older citizens are more likely to have health issues, these policies may require a full medical check-up beforehand and are more expensive than regular insurance policies.

Family Floater Insurance Plans

A family floater plan allows you to cover your family members under a single policy and everybody shares the insured amount. These plans are typically more affordable than individual plans since the sum insured is shared.

Critical Illness Plans

Life style related Health issues such as cancer, stroke, kidney failure and cardiac diseases are on the rise these days and can be very expensive to treat and manage in long-term. That is why critical illness insurance policies have been created. They can either be purchased as a rider or add-on with your regular health insurance plan or separately as a unique plan. These policies offer cover for very specific issues and often provide claim pay out as a single lump sum payment after the diagnosis of a critical illness.

Personal Accident Insurance Plans

The number of road and other accident cases have increased over the years, and people end up losing their life or getting disabled, and bearing the treatment expenses. That is why today, there are dedicated types of health insurance in India to protect the citizens. Thus, availing of the personal accident insurance policy is a wise idea. This policy provides a lump sum amount to the victim or his/her family as support. Some of the plans also offer education benefits for kids, add-on coverage like temporary total disablement, assistance service, worldwide emergency, and accident in-patient hospitalisation with personal accident plans.

Top up Health Insurance

An individual can buy the Top Up Health Insurance plan if he seeks coverage for higher amounts. But there is a “Deductible Clause” added to this policy. Therefore, when the claim is made, the payment done is over and above the pre-defined limit that is mentioned in the policy. Moreover, there is also a Super Top-Up plan available for the individual. It provides additional coverage over the regular policy to increase the amount of sum insured. The Super Top-up plan can only be used once the insured sum of the regular policy gets exhausted.

Group Health Insurance

Group Health is a very upcoming and trending form of health insurance plan these days. Many medium and large-scale enterprises are offering this kind of insurance policy to their employees to cover for the hospitalisation and medical expenses of the employees and their families, as an attractive and tax efficient tool to retain employees. The premium of this policy is comparatively lower than the Individual Health Insurance Policy.

Access quality healthcare without worrying about the costs. Get health insurance today.

Things to Consider While Buying Health Insurance

  • Deductibles It is essential to look into the deductibles involved in that policy before buying any type of health insurance policy. A deductible is an amount that is to be paid by the insured as a part of a claim whenever it arises, and the rest of the amount is paid by the insurance company
  • Age The buyer needs to understand the importance of the age factor while buying the Health Insurance plans for oneself or for family members. There are various plans that depend upon the age of a buyer, and their premium, waiting period and renewability also play a role
  • Medical History of Family Members At the time of buying a Health Insurance Policy, one must consider and discuss the medical history of the family members as it can impact the premium of the policy. If any of the family members is already suffering from a health problem, then the possibility of claiming the insurance rises
  • Exclusions An exclusion in terms of policy is a provision that eliminates coverage for some type of risk. A few common exclusions in most of the Health Insurance Policies include pre-existing diseases, pregnancy, cosmetic treatment, medical expenses to treat injuries, alternative treatments, lifestyle-related diseases, limitations on hospital costs, and diagnostic tests. Therefore, the buyer has to discuss these exclusions with the insurance provider while buying any Health insurance
  • Sum Assured-An insurance company extends insurance coverage in the form of a sum assured, which a policyholder gets in exchange for the premium you pay. Choose the best health insurance cover, which offers sufficient coverage at affordable premium rates.
  • Waiting Period In the case of Health Insurance Policy, the waiting period refers to the amount of time you have to wait to avail the benefits under your insurance policy. The waiting period varies from plan to plan.
  • Lifetime Renewability The different Health Insurance Plans offer different renewability options. So, you must be watchful before buying one for yourself or your family member.
  • Network Hospitals While buying any Insurance Policy, a buyer must choose the insurance company that covers the widest network of hospitals in their list.
  • Claim Settlement Ratio The individual should pick up the insurance company that provides a fast claim settlement ratio.

Benefits of Health Insurance

Financial Assistance

The Health Insurance Policies ensures financial assistance to the insured family during any sort of medical emergencies in the form of reimbursement of medical expenses. This way, the family is saved of trying the meet the exorbitant costs of hospital bills apart from the trauma of the medical emergency itself.

Annual health check ups

Health Insurance policies provides you with the coverage benefits of annual health check-ups on high sum insured. Hence, the company looks after the expenses that are incurred in the insured person’s annual health check-ups

Tax Benefits

Buying a Health Insurance Policy will help you in tax deductions under Section 80D of the Income-tax Act.

Covers complex procedures

Health Insurance Policy provides coverage benefits for complex procedures such as organ transplants.

Deal with Medical Inflation

Investing in Health Insurance Policies will help you to deal with medical inflation in a much easier and a better way without putting any extra burden on your pockets.

Benefits for organ donors

Buying a health insurance policy will provide coverage benefits in case you are donating any organ. It offers coverage up to the sum that is insured.

Frequently Asked Questions

Medical expenses can be a financial burden for individuals who fall ill or get injured. Health insurance is a policy that offers financial aid to such individuals. The insurer pays a fee to the policy provider who, in turn, covers some or all of the medical charges incurred.

Identifying the top health insurance company in India is a challenging issue that requires a comprehensive and multifarious approach. Given the diverse needs and expectations of individuals, it is challenging to select one company as the best. However, several factors could be considered while making such an assessment. These factors include the scope of coverage, cost, claim settlement process, customer service, network of hospitals, and overall reputation of the company.

The best health insurance plan is subjective and depends on an individual's unique needs and budget. A plan that provides comprehensive coverage with a broad network of healthcare providers may be preferable for individuals with chronic illnesses or those who require frequent medical care.

Yes, Certainly, it is possible to take a health insurance plan from the Life Insurance Corporation (LIC) of India. As a leading life insurance provider in the country, LIC offers a range of health insurance products to meet the diverse needs of its customers.

The criteria for obtaining health insurance coverage in India differs based on the particular health insurance plan. However, in general, individuals who are aged between 18 and 65 years are eligible to purchase a health insurance policy. Health insurance policies can be purchased either on an individual basis or as a family floater policy, which provides coverage to the entire family under a single policy.

The purchase of health insurance at the best possible age in India is a difficult task that necessitates the meticulous evaluation of numerous variables. Ideally, a person should obtain health insurance coverage at a young age (18-30), when the risk of developing chronic illnesses and other health problems is relatively low. This can help to ensure that they are covered in the event that they do become ill or require medical attention.

As an individual, you may feel that since you are already covered under the employee group insurance plan provided by your company, there may be no need for you to pay a separate premium for another health insurance policy. However, it is important to note that the coverage provided by employee group insurance plans may not always be sufficient to meet all your healthcare needs.

Buying an additional policy can give you an added layer of protection in case you lose your job or change jobs. It also gives you the flexibility to choose from a range of insurers and their policies that best suits your needs and budget.

To alleviate dissatisfaction with your current plan, take a moment to assess the advantages and drawbacks of potential alternative options. Consider speaking with a healthcare advisor or insurance broker who can provide insight into the various plans available to you. Additionally, do your research by evaluating the quality of care offered by different providers and examining their service ratings and customer reviews. If you find that switching plans is not an option, consider reaching out to your insurance provider to address any concerns you may have.

If a policyholder is not satisfied with the services or coverage provided by their current insurer and wishes to switch to a new one, they can do so without any disadvantage or loss of benefits.

The Insurance Regulatory and Development Authority of India (IRDAI) mandate that the portability of policies must be allowed for all health insurance policies issued by all insurers.

It is not uncommon for individuals to seek a health insurance plan that will cover their entire family. Thankfully, achieving this objective can be accomplished through a myriad of choices available in the market. Among these alternatives is the much sought-after family health insurance plan. This type of plan is designed to provide coverage for all members of a family, including spouses, children, and sometimes even parents or other dependents.

It is possible to have more than one health insurance policy; however, it is not common practice. The majority of individuals typically have a single health insurance policy that covers all their medical expenses. In some cases, individuals may have multiple policies due to specific circumstances such as being covered by a group policy through their employer and also having an individual policy.

It is highly recommended that individuals purchase a health insurance plan regardless of whether they have a network hospital close to their house or not. Health insurance provides a safety net for unpredictable medical emergencies and expenses. It is important to note that health insurance plans cover a wide range of medical services beyond hospitalization, such as doctor's visits, diagnostic tests, telehealth services, and prescription medications.

A cashless claim refers to a type of insurance claim process where the policyholder need not pay for the medical expenses out of their own pockets. The insurance firm manages payments by directly settling bills with hospitals or healthcare providers. The insurance company collaborates with a network of hospitals where policyholders can obtain medical care. The facility enables easy and hassle-free access to medical treatment for the policyholder without worrying about arranging funds for paying off bills.

As a medical professional, it is important to maintain honesty and integrity in all aspects of life, including the completion of insurance application forms. While it may be tempting to declare oneself a non-smoker in order to receive a lower premium, this decision ultimately undermines the insurance system and can have significant consequences in the event of a claim.

Smoking is a well-known risk factor for many serious health conditions, such as cancer and heart disease, which can increase the likelihood of an insurance claim. By declaring oneself a non-smoker when in fact one is a regular smoker, the insured is misrepresenting their true level of risk, leading to an unfair advantage and potentially leading to claims being denied

It is advisable to disclose all pre-existing medical conditions in the insurance application form. This is because non-disclosure may result in claims being denied and policies being cancelled or made void.

Moreover, it is important to note that insurance policies are designed to cover unexpected events. By disclosing existing medical conditions, insurers can provide appropriate coverage and premiums can be adjusted accordingly. By failing to disclose such conditions, insurers may find grounds to reject future claims based on non-disclosure.

Deal Plexus is a professional advisor that can assist you in obtaining a good health insurance plan. Deal Plexus provides