A Detailed Guide about Health Insurance in India

Rahul bought a health insurance policy when he was 28 years old and completed 2 years in his job in an MNC. He got married at the age of 29 and immediately got his policy endorsed by adding his wife in the same policy. By the time, he had completed his 3 years of the policy, each year was claim-free. But destiny was cruel to him and Rahul met with a car accident.

Luckily, he and his wife were saved while his car was crushed. It was Rahul’s mistake that he sped his car. They were hospitalized for 7 days. The cost of treatment and hospitalization expenses were reimbursed by the insurance company. It may just be an example but a reality for many. So, let us understand

What is a Health Insurance Policy?

A Health Insurance Policy is an arrangement between the policyholder and the insurance company. This is a plan in which you pay a premium to ensure that the insurance company takes care of the medical expenses that are triggered by any health issue or accident.

The amount in this bill may be huge sometimes, hence one should buy health insurance to avoid such an eventuality.

Read: 7 Health Insurance Questions You Need to Ask Potential Providers

Major Benefits of Taking a Health Insurance Policy:

  • Avail Cashless treatment at the Network hospitals
  • Reimburse your medical expenses and bill if you get a treatment in a non-network hospital
  • All the expenses are covered if you are hospitalized due to any illness or an accident.
  • Critical illness benefit
  • Day-care procedures are covered so no need to pay and get the treatment done within a day
  • Maternity benefits covered up to 2 kids. There is a waiting period of 2 years to avail this benefit
  • Medical expenses incurred in having an organ transplant is covered
  • Pre & Post Hospitalization costs are covered
  • No room rent or ICU rent capping
  • Complimentary annual health check-up of insured individuals
  • No need to pay for the Ambulance you availed in emergency
  • AYUSH benefit for Senior Citizens
  • Didn’t claim your insurance entire policy year? Not a problem, enjoy no claim bonus discount
  • Income tax benefits under section 80D

Also See: Don’t Do It Alone: The Importance of Health Insurance

Benefits of Taking a Health Insurance Policy

Types of Health Insurance Plans in India

Understanding your health insurance plans can be a challenging task. The different insurance plans can be confusing and leave you with a headache.

  • Individual Health insurance plan provides coverage to Individuals. If you opt for this plan and cover 3 people from your family, then every individual in the policy is going to have an Individual sum insured.
  • Family Floater Plan is for the entire family and a single sum insured is shared among the members. This Family Health Insurance plan comes with a cheaper premium as compared to the individual policy.
  • Senior Citizen Health Insurance Plan: This is appropriate for senior citizens. As people above 60 are prone to diseases, this plan has a higher premium.
  • Group Health Insurance: This plan covers the medical expenses of a group of employees till they are part of the company. Generally, this is opted by corporate houses or start-ups.
  • Critical Illness Cover: This is dedicatedly designed to cover some declared diseases such as Cancer, Stone, Kidney Failure, Paralysis, Coronary Artery Bypass Surgery, First heart attack, Pulmonary Arterial Hypertension, Multiple Sclerosis, Aorta Graft Surgery.
  • Maternity Health Insurance: A maternity cover is an add-on along with the health insurance policy that covers expenses incurred in the prenatal stage, delivery and post-natal stage.
  • Top-Up Health Plans: Insurance policy you may buy for higher cover limits are called Top-Up Health plans. Such policies come with a “Deductible Clause”. It implies that it will pay the amount over and above the deductible amount. Up till this amount of deductible, you will have to bear the expenses.

Must Read: 5 Things You Need To Know When Choosing Health Insurance

How to choose a Health Insurance Plan?

When there are many health insurance products available in the market, it gets difficult to choose from them. You should always Compare health insurance plans provided by different insurers and make an informed decision.

Here is a list of things you should check when buying/comparing health insurance plans:

  • Decide what Sum Insured you need: Choose the plan which you think offers maximum health coverage under the Sum Insured you choose.
  • Choose the Correct Plan: Compare all the plans available and choose the best one that is suitable for you. In an individual plan, every member gets an independent Sum insured, so the coverage is high. But in a family floater plan, a single sum insured floats to all the members. So, the coverage is reduced as the sum insured will be shared. At the same time, Family Floater comes with a cheaper premium then Individual Plan. So, the choice is yours.
  • Get your Parents a “Senior Citizen Plan”: It is not a good idea to include your parents in the Family Floater plan as the premium will rise considering the age of the elders. And they might be prone to diseases, as a result, you and the other members will be left with no coverage as they might end up consuming most of the sum insured.
  • Get Quotes from Different Insures: Try getting quotes of the health plans you want from different insurance companies and compare, this way you can get a better insight of Insurance premiums, coverages, exclusions and many other important factors.
  • Don’t buy a policy with a high waiting period: You should have a health insurance policy with a minimum waiting period.
  • Check for conditions: Read all the terms and conditions thoroughly before you buy any health insurance policy. Knowing everything about the pre-existing diseases, clauses, cappings, waiting periods will enable you to make an informed decision.
  • Check for the age of renewal: You should have a policy that has a higher age of renewal. The insurers now offers lifetime renewability. So, check this before finalizing a product as it will reduce the financial strains in case of emergency.
  • Be assured of network hospital: Choose the plan with an insurer who has a large network of hospitals.
  • Policy from an insurer who is fast with claim settlement: The insurance policy you choose should be from an insurance company whose claim settlement is high and flawless.

If you are confident enough that you will not attract any disease then you might be thinking, “Why should I pay the premium if I am unlikely to claim!”, Right? You are wrong! Here is “Why all of us need health insurance?”.

Check Out: Stay Alive and Healthy: 10 Tips to Prevent an Untimely Death

Why Health Insurance is Really Important these Days?

  • More Pollution, More Sickness: Air pollution across the country, across the world is on the rise. This results in higher chances of respiratory diseases. This is a threat to humanity and can’t be avoided with a mask. So, it is better to be prepared for such probable diseases.
  • You Have a Desk Job: A desk job and no physical activity makes the human body sick. Will you believe that the sedentary lifestyle is responsible for 61% hospitalization? So, if you are a corporate guy, health insurance is a must!
  • Lifestyle Diseases are on the Rise: In today’s world, nobody needs to be old to attract diseases. People are prone to dangerous diseases like cancer, diabetes, etc from a very young age.
  • You Commute a Lot: Pick any newspaper, you can read about several fatal accidents. In the year 2018, 1.5 lakh people lost their lives and 4.69 lakh people got injured in road accidents in India.
  • Healthcare Inflation is Touching Skies: The healthcare inflation is increasing at a rate that is double the overall retail inflation. So, for common people, sometimes it becomes impossible to get treatment for certain diseases.
  • Mental Illness on the Surge: Out of 137 crores Indian, approximately 26 crores are the youngsters. A report from WHO states that India has the largest population of people suffering from mental illness. Our country tops in the number of suicides among youngsters. If you are young then it is natural that you are prone to attract such disease considering today’s lifestyle, competition, job pressure and many other factors.
  • Save money: Health insurance will save your medical expenses and some of your income tax. You can use that money to invest better and achieve your financial goal.
  • Avail the Best Treatment: With a health insurance policy, you don’t need to think about the expenses when you are availing for a treatment, you can afford the best hospitals and best doctors.
  • Heart Diseases are Being Common: In this changing world, everyone can have heart disease. You can avoid this with good habits and lifestyle but where is the harm in preparing yourself to fight possible heart disease with an insurance policy.
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