Health Insurance

Health insurance is a cover that protects you from the medical expenses caused by illness, accidents or injuries. It is a type of indemnity bond in which the insurer commits to bear all costs incurred due to hospitalization, OPD charges, medical examination, doctor’s fees, medicines and any other bills concerning the insured. A growing number of people are considering health insurance. According to the National Family Health Survey conducted for the fiscal year 2021, around 41 per cent of people are covered under health insurance or at least one person from each family has bought a health plan.

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Health insurance policy, by law, is a guarantee that the insurance company provides to the policy holder, to provide financial support to the insured needed during medical exigencies, in return of the fixed consideration called premium.

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Let us go through the significance of health insurance:

  • Fight the diseases of everyday life: With a hectic lifestyle and pollution surrounding us, diseases like diabetes, blood pressure, and respiratory disorders, every person has some or other health issue. The negligence starts with following a sedentary lifestyle, taking too much stress, to pollution, unhealthy eating habits, gadget addiction and undisciplined lives. While you can take precautionary steps and keep a check on your health status, you can opt for buying a health insurance policy wherein all the health checkups, necessary tests can be covered, helping you to worry a little less about your finances.
  • To safeguard your family: You can consider buying a healthcare plan which includes all of your family members. From your aged parents to young children, everyone can be included in one single plan. You can make sure all of them get first-class treatment by buying the correct insurance plan.
  • No effect on savings: Any health issue can crop up at any moment and if you have a health insurance plan that covers it, half of your stress and tension goes away as you don't have to think about draining your financial resources. With some of the insurance providers giving cashless transactions facilities, there is no need to spend even a penny.
  • The earlier it is, the more beneficial it is: If you buy an insurance plan at an early age, you can reap benefits for a longer period of time. When you are young and have better health, the premium amount is low as compared to when you take it in your late 30s. Also, extensive coverage will be offered while you are still young.

There are different types of health insurance policies available. Before choosing which is suitable for you, one should know about all the key features about them:

  • Individual health insurance: As the name suggests, this type of plan is for a single person. It covers almost everything from pre-hospitalisation to post-care, medical examinations, medicines, etc till the time the insured limit has reached. This plan is generally taken by earning youngsters who are unmarried. The premium is decided according to the age and medical history of the person getting insured. Also, if you get married you can include your family and even children by just paying some extra amount of premium. But for existing illnesses, you can get a claim only after 2-3 years.
  • Family Health insurance: It is also popularly called the Family floater plan. Under this policy, each and every member of your family is covered with only one member paying. From spouses to elders, to children each one of them is being taken care of through a single plan. If a situation arises where two members are getting treatment, then you can reap the benefits for both of them till the limit is reached. Just try to avoid adding members who are above the age of 60 as they are more prone to getting ill and the premium will also be impacted accordingly.
  • Critical Illness Insurance: This is a very elaborated plan which offers a sizable amount for life-threatening diseases. There is no need of getting hospitalized for getting the claim. The diagnosis done through the proper procedure is enough to get the claim. The underlying factor is that an amount is decided beforehand irrespective of the charges incurred due to admission to the hospital or the medical tests. A list of diseases is included in this plan:
  • Kidney failure
  • Heart attack
  • Cancer (upto a level)
  • Angioplasty
  • Cancer
  • Organ transplant
  • Covid
  • Paralysis
  • Senior Citizen Health Insurance: This type is outlined for people above the age of 65 years. This plan is specifically for all those who are insuring their parents or grandparents. Just like every other health plan, it covers hospitalization expenses and post-treatment bills also. The cherry on the top is that it offers expenses incurred due to Domiciliary Hospitalization and Psychiatric issues. The upper age limit to get covered under this policy is 70 years. The only disadvantage is that the premium is on the higher side due to the age factor.
  • Senior Citizen Health Insurance: This type is outlined for people above the age of 65 years. This plan is specifically for all those who are insuring their parents or grandparents. Just like every other health plan, it covers hospitalization expenses and post-treatment bills also. The cherry on the top is that it offers expenses incurred due to Domiciliary Hospitalization and Psychiatric issues. The upper age limit to get covered under this policy is 70 years. The only disadvantage is that the premium is on the higher side due to the age factor.
  • Top-up Health insurance: An individual can buy such a plan if wants a higher sum assured than the one offered in the regular policy. There is a particular clause associated with this policy known as Deductible Clause. You have to pay a fixed amount no matter what the amount of the claim is. Also, there is a Super Top-up plan but only kicks in when the regular policy is exhausted.
  • Hospital Daily Cash: This is an innovative type of health insurance plan. Once a person is admitted to a hospital, the expenses that incur on a daily basis are not fixed. In that case, Hospital Daily cash is beneficial. The individual gets a daily cash benefit of Rs500 to Rs10,000 depending upon the situation and as per the coverage amount selected at the time of insurance. Other add-ons include Parental accommodation and a wellness coach.
  • Personal Accident Insurance: The cases of road accidents are increasing day by day so this plan is specifically dedicated to covering injuries caused due to road accidents. It is very stressful to bear the treatment costs induced due to an accident. Sometimes people also lose their lives. It is better to cover yourself under this policy. As it provides a lump sum amount to the family of the victim.
  • Mediclaim: Nobody gets notified before an accident or a diagnosed disease. Sometimes you have to be admitted to a hospital to get treated. If you have bought a Mediclaim policy, it ensures compensation for all your hospitalization expenses caused due to an accident or an illness. The cover includes surgery costs, room rent, doctor’s charges, etc. Different categories are available such as group mediclaim, individual mediclaim and even overseas medical insurance.
  • Group Health Insurance: This type of health insurance is gaining momentum these days. Many medium and large-scale organizations are offering this insurance policy to their employees. The policy is bought by the employer for the benefit of its employees. The premium is comparatively lower as it takes a large number of people to save them from draining their financial resources.
  • Disease-Specific: People are prone to viral infections. One such disease is Covid-19. The treatment is an expensive one causing a hole in your pocket. To make it easier for people, few insurance providers are giving disease-specific coverage. A few of the diseases covered in these policies are Dengue, chikungunya, Zika virus, Covid, etc.

As you can see there are so many different types of plans when you want to buy a health insurance plan. There are so many companies offering such plans. The rising costs of medical services have made it mandatory for each one of us to buy health insurance for ourselves and our family members. Planning for the unforeseen future will keep your life going leaving you stress-free and tension free.

FAQ

Do I need a separate health insurance policy if I'm covered by my employer's group coverage?

Yes. You will need a personal health insurance plan because your employee health insurance only covers medical expenses while you are employed with the company; after you leave, your policy term ends. In light of medical inflation, it is critical to have a personal health insurance plan that you customise to your own medical needs, as opposed to a corporate health plan that is tailored for all employees.

What exactly do you mean about "pre-existing disease"?

A pre-existing disease (PED) is a condition, illness, or injury that occurs at the time you purchase health insurance, and these PEDs are usually excluded from coverage for a period of time. Diabetes, hypertension, thyroid disease, asthma, and other conditions may be involved.

What does cashless hospitalisation mean in a health insurance policy?

Cashless hospitalisation is a method in which an insured person does not have to pay any medical expenses out of pocket in the event of a hospitalisation or operation, and the entire bill is covered by us. However, certain deductibles or non-medical charges may be due at the time of release.

What are pre- and post-hospitalisation expenses?

When you plan to have surgery, there are certain pre-hospitalization expenses such as diagnosis costs, consultations, and so on. Similarly, there may be similar expenses after discharge to monitor the health of the insured patient; these expenses are referred to as pre and post hospitalisation expenses.

Is it necessary for me to have a medical examination before purchasing health insurance?

Yes, medical testing may be required before purchasing health insurance. Furthermore, some health insurance policies only need it if you have a pre-existing condition or are above the age of 40.

How do I include my family members in my current policy?

You can add family members to your insurance when you buy it or when you renew it.

When can my children be included in the plan?

You can include your child after 90 days of birth, up to the age of 21.

What are the advantages of purchasing health insurance when you're young?

You'll pay a smaller premium and receive more benefits. Because the likelihood of having a pre-existing ailment is low, waiting periods may not affect you. Also, common illnesses like the flu and accidents can strike at any age, so it's crucial to be protected even when you're young.

Is it possible to have multiple health insurance policies?

Yes. Because each plan operates differently and offers different benefits, you can always have more than one health insurance plan based on your needs and coverage requirements.

What do you mean by a health insurance waiting period?

The waiting period is the time period during which you are unable to file a claim with us to get some or all health insurance coverage for a specific condition. This implies you have to wait a certain amount of time before filing a claim.

What is a 'Free Look Period'?

If you feel your policy is not advantageous during this free look period, you have the opportunity to cancel it without penalty. The free look period might range from 10-15 days to considerably longer depending on the plan supplied.

What is the difference between network and non-network hospitalisation?

Network hospitals, also known as cashless hospitals, are affiliated with us and provide cashless hospitalisation benefits; however, if you are admitted to a non-network hospital, you must pay the bills first and then file a claim for reimbursement.