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Health Insurance

Health insurance is an important issue in everyday life. All of us need health insurance or some type of medical care because even if you have good genes, accidents can hit you. Unhealthy living and working conditions, accidents and sickness are some serious risks of our time. The financial benefits provided by a health insurance plan make it one of the most powerful and influential investments in your life.
Here is a detailed breakdown of health insurance policies in India.

What exactly is Health Insurance?

Health insurance or medical insurance is a type of insurance policy that pays for a policyholder’s medical and surgical costs. It either pays the institution that treats the insured directly or reimburses the costs incurred as a result of illness or injury.

Looking to buy health insurance? Browse frequently visited Topics for better understanding

What are the types of Health Insurance?

Every individual has a different set of requirements from an insurance policy. To cover all those requirements, a wide range of health insurance is available.

Individual Medical Insurance
Individual Medical Insurance

Individual medical insurance allows you to get health insurance coverage for yourself and other members of your family, including your children, spouse, parents etc. The good thing about these insurance policies is that each policyholder gets their own insured sum amount.

Family FLoater Medical Insurance
Family FLoater Medical Insurance

As the name implies, Family Floater medical insurance plans offer coverage to all members of a family under a single policy. These policies are usually more affordable than their individual counterpart since the total insured sum amount is shared by all the insured individuals.

Senior Citizen Health Insurance
Senior Citizen Health Insurance

Senior Citizen health insurance plans are specifically tailored according to the needs of old people. Necessary coverage, such as hospitalisation costs and psychiatric check-ups, are included in the base coverage. However, it is important to note that these plans are typically more expensive than individual or family floater insurance plans as older people have an increased risk of health issues.

Critical illness health insurance
Critical illness health insurance

With the rise of lifestyle-related diseases, critical illness health insurance coverage is becoming very popular in the country. Kidney failure, cancer, cardiac problems, stroke and treatment for such other illnesses can get very expensive with the time. Critical illness health insurance offers coverage for these specific health issues so that you can recover without any financial hassle.

Group Health Insurance
Group Health Insurance

Group health insurance plans are often offered to employees from the company as an employee benefits package. It covers a large number of people under a single policy. These plans are very affordable, but they only offer coverage for basic health problems.

Mediclaim Insurance
Mediclaim Insurance

A Mediclaim insurance policy is a type of medical insurance in which the insurance provider compensates the policyholder back for any healthcare expenses incurred in the course of treating their illness. You can file your medical bills to your insurance provider for reimbursement if you have mediclaim insurance.

What is Arogya Sanjeevani Plan?

Arogya Sanjeevani Plan is a fundamental health insurance plan that covers hospital and medical costs up to a limit of Rs. 5 lakhs. All health insurers are required by the IRDAI to develop basic and conventional health insurance plans for both individuals and families.
It covers pre-and post-hospitalization costs, including those for beds, nursing, ICU, doctor visits, and other services. You and your family are protected from the financial burden of medical crises with the Arogya Sanjeevani Health Insurance Policy.

Why Should I buy Health Insurance?

The following is a summary of all the advantages that health insurance plans provide, making them a must for every family:

  • Cover Against Rising Healthcare Cost:  inflation for food and clothes. Finding money at the last minute might be difficult for someone who hasn’t saved much cash. Given that the majority of illnesses develop in older people, this presents a special challenge for seniors. Getting health insurance is one strategy to cover unexpected medical or health needs. 
  • Peace of Mind : Regarding coverage for diseases and ailments, health insurance allows a great deal of freedom. The insurance plan even pays for certain surgery or critical illness depending on the exact medical costs. Various health insurance policies cover up to 30 serious diseases and more than 80 surgical procedures. Even after benefits for certain conditions have been paid out, the policy remains in effect. With medical insurance, you may be guaranteed a more stable future in terms of your health and finances. This makes having health insurance coverage important for people, particularly if they are in charge of the family’s finances. 
  • COVID-19 Protection : Health insurance plans are an excellent way to safeguard your household from the growing coronavirus pandemic. Specially designed coronavirus health insurance plans such as Corona Kavach policy or Corona Rakshak policy ensure you receive the highest quality of treatment without any financial hassle. 
  • Tax Advantages : Income Tax Act Section 80D allows the policyholder to deduct a part of the premium amount paid towards a health insurance plan from their annual taxable income. The deduction limit of policyholders under the age limit of 60 years is Rs. 25000 every year and for senior citizens, you are eligible for an additional deduction of Rs. 50000. 

What are the health insurance add-ons?

Riders and add-ons are crucial parts of any insurance protection. In return for a higher premium, it improves a plan’s essential coverage. The ten most popular add-ons to health insurance plans in India are shown below.

1. Critical Illness :

This add-on enables critical illness coverage to the policyholder in case it was not offered by the basic plan.

2. Personal Accidental Coverage:

This add-on provides a lump sum payout if you face disability or death due to an accident.

3. Room Rent Waiver:

This add-on offers the policyholder an extended hospital room rent limit.

4. Maternity Coverage:

This add-on provides reimbursement for expenses related to childbirth and pregnancy to the insured.

5. Global Coverage:

This add-on enables cashless as well as reimbursement claims for treatment received outside the country.

6. Air Ambulance :

The emergency need for an air ambulance is covered by the add-on air ambulance protection.

7. Unlimited Recharge:

This add-on enables critical illness coverage to the policyholder in case it was not offered by the basic plan.

8. International Second Opinion:

This add-on enables critical illness coverage to the policyholder in case it was not offered by the basic plan.

9. AYUSH Treatment:

This add-on enables critical illness coverage to the policyholder in case it was not offered by the basic plan.

10. PED Waiting Period Reduction:

This add-on enables critical illness coverage to the policyholder in case it was not offered by the basic plan.

How to file a health insurance claim?

The following is a step-by-step explanation of how to file a health insurance claim:

Cashless Claims

1. Get in touch with your insurance provider and let them know about your hospitalisation.

2. Get admitted to a network hospital.

3. Inform the hospital insurance desk about your insurance plan.

4. Fill in the pre-authorisation form.

5. The insurance company will take care of all your medical expenses. You need to pay the balance only at the time of discharge, which is not covered under insurance, such as consumables.

Reimbursement Claims

1. Get in touch with your insurance provider and let them know about your hospitalisation.

2. Get admitted to your hospital of choice and pay the entire bill on your own.

3. Once discharged, submit your claim form along with all ORIGINAL medical bills, discharge summary, and the policyholder’s KYC and bank account details.

4. The insurance company will reimburse your expenses if the company approves your claim.

Health Insurance Exclusions

Health insurance policies in India, like all other insurance products, include a predetermined list of conditions that are not covered by the policy. The most typical medical insurance plan exclusions are shown below.

  • Pre-existing Illnesses that are not covered
  • Illness during the waiting period
  • Pregnancy
  • AYUSH Treatment
  • Hospital costs exceed the policy limit

The Bottom Line

The greatest factor in choosing the best plan is your health. With this in mind, you should research and compare many different plans to find the one most aligned with your needs. Incorporate what you have learned from previous medical care, family history, age etc. Make sure that you take these into consideration before making a final decision.

Frequently Asked Questions

Yes. Almost every health insurance product includes COVID-19 treatment in its base coverage.

Mediclaim is a type of medical insurance plan in India which reimburses all the medical expenses made by the policyholder during the policy term. It is the simplest form of health insurance without any additional benefits.

The base coverage of Mediclaim does not cover Ayurveda or any AYUSH treatment. However, if you buy an AYUSH treatment add-on, the insurance company will add it to your coverage in exchange for a small premium amount.

Leading Health Insurance Companies

Manipal cigna health insurance
Aditya birla capital
STAR health insurance
care health insurance

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