3 lakh health insurance
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3 lakh health insurance
In this era of rising healthcare costs, health insurance is the only way to access quality medical treatment. Health insurance is like a shield that protects against unexpected and exorbitant medical expenses. There are a variety of health insurance plans available in the market today, offering different types of coverage. Among these varied options, a 3 lakh health insurance plan offers comprehensive coverage and affordability.
This blog explores everything about a 3 lakh health insurance plan including its features, benefits, eligibility criteria, working and much more. Keep reading to find out why it is a perfect choice for all your healthcare needs.
What is a Health Insurance Plan of ₹3 Lakh?
A 3 lakh health insurance is a type of health insurance policy that covers medical expenses due to illness or injury, up to the sum insured value of ₹ 3 lakhs. Under this plan, the insurer agrees to cover hospitalisation expenses and other covered medical expenses up to ₹ 3 lakhs in exchange for a premium paid by the insured. Sometimes also known as a mediclaim policy, it covers basic medical expenses due to hospitalisation, pre and post-hospitalisation care, room and ICU charges, etc. By taking care of healthcare expenses such a plan reduces the financial burden of the policyholder. Such plans are available both on individual and family floater basis.
A 3 lakh health insurance plan is an affordable plan offering comprehensive health coverage and access to timely medical care during an emergency.
How does a ₹3 Lakh sum insured Health Plan work?
A ₹ 3 lakh mediclaim policy provides coverage on an indemnity basis. It covers all or some part of the medical expenses in case the policyholder files a claim for hospitalisation or medical expenses. The maximum amount covered by the insurer is the sum insured which is ₹ 3 lakhs. The policyholder pays a premium to the insurance company for the coverage provided. Let us see how it works.
1. When a policyholder avails treatment at a network hospital, he can file for a cashless claim settlement. The insured has to inform the insurance company before the specified time in case of planned hospitalisation. In case of emergency hospitalisation, the insurer should be notified within 24 hours. If the claim is approved, the insurer directly settles the hospital bill.
2. A third-party administrator provides assistance for documentation and the entire cashless claim process.
3. If the treatment is taken at a non-network hospital, the claim is reimbursed after the insured submits all the required medical documents relating to the treatment.
4. For reimbursement claims, the insurer first verifies all the submitted documents and then approves or rejects the claim request. Once approved, the insured gets the claim amount reimbursed in his account.
5. To avoid claim rejection, the insured should read the policy terms and conditions and understand the inclusions and exclusions.
Who Should Opt For a ₹3 Lakhs Health Insurance Plan?
A health insurance plan with ₹ 3 lakhs sum insured is suitable for specific categories of individuals including;
1. Young Professionals
Young individuals in their 20s who are just starting their careers should buy a 3 lakh health insurance plan because it is an essential investment. Such individuals are young and healthy so they do not need a big sum insured amount. As they are not risky, they can get a health insurance plan at a very low premium. They can avail of tax benefits and can upgrade their coverage when they need it.
2. Low-Income Families
Families with low income should buy a 3 lakh health insurance plan because it is affordable and provides basic coverage, which can provide financial security during a medical emergency. It will also give them access to quality and timely medical care.
3. Individuals with Employer’s Health Insurance
Individuals having health insurance coverage from employers can buy a 3 lakh health insurance family to supplement the existing coverage. It can prove useful in covering the gaps in the employer’s coverage.
4. Individuals Without Pre-Existing Conditions
Individuals who are healthy and do not have any pre-existing condition may not require a high sum insured coverage. Having basic medical coverage may be sufficient for them. So they can opt for a 3 lakh health insurance plan.
Premiums for ₹3 Lakh Health Insurance Plan
A premium is the most important factor one considers while buying a health insurance policy because it is the cost of maintaining the coverage. A premium is the amount a policyholder pays to the insurance company for the health insurance coverage provided. There are a number of factors that determine the amount of premium a policyholder pays for health insurance coverage.
Factors Influencing the 3 Lakh Health Insurance Premium
Let us look at the factors that play a crucial role in determining the premium value for a 3 lakh health insurance policy.
1. Age of the Policyholder
The age of the policyholder is an important deciding factor. As a person gets older, he becomes more prone to health problems, which can lead to hospitalisation and costly medical bills. Insurance companies typically charge higher premiums for older policyholders since they are more likely to file a claim than younger policyholders.
2. Health Profile
A policyholder’s medical history, pre-existing conditions, lifestyle and habits also influence the premium, he will pay for health insurance coverage. Individuals with a family history of critical illnesses or pre-existing conditions have to pay higher premiums. Smokers and tobacco users are also charged high premiums. Your health conditions, family medical history and habits determine how risky you are to the insurance company.
3. Budget and Financial Situation
If you cannot afford high premiums for high coverage, you opt for coverage that is affordable and within your budget.
4. Type of Plan
The premium value also depends upon the type of plan you choose. The premiums are different for individual plans and family floater plans. Individual plans are a little more expensive than the family floater plans. However, the premium for the family floater plan depends on the age of the oldest member of the family.
5. Additional Features
The add-on covers that we include in our policy, are used for additional features in the policy. These add-on covers enhance your coverage at an additional cost and hence translate to higher premium value. These add-on covers provide additional benefits such as maternity cover, AYUSH cover or a critical illness cover.
6. Location
The cost of hospitalisation and medical care is different in different cities. Based on medical costs, cities in India are divided into different zones. So if the medical costs are higher, the zone is also higher and so is the premium you pay for coverage. Hence, the city you reside in also influences your health insurance premium.
How to Calculate Premium for a ₹ 3 Lakh Health Insurance Plan?
The premium of a 3 lakh health insurance policy can be easily calculated using an online premium calculator. You just have to provide the required information to the online premium calculator. These calculators are easily available on the websites of all insurance companies. You can use these calculators for free as given below.
1. Open the online health insurance premium calculator.
2. Enter your age, area pin code, sum insured amount, and any other information required.
3. Click on Calculate premium
4. An estimate of the premium amount will be generated.
What are the exclusive features of a Health Insurance Plan of ₹3 Lakhs?
There are a variety of health insurance policies available in the market all with different features. Here are some features you should check and understand before buying a 3 lakh health insurance policy.
1. Cashless Benefit
It is an important feature of a health insurance policy. With the help of cashless settlement, you can avail treatment in a network hospital without worrying about finances. This is very helpful during a medical emergency. So while buying a health insurance policy, always check your insurer’s network of hospitals. Look for network hospitals near your location, where you can get cashless treatment.
2. Room Rent Limits
It is always best to have health insurance coverage with no limit on room rent or room type. However, such plans are expensive and come with a higher sum insured value. So while buying a health insurance plan understand the room rent limits and the amount you will have to pay out-of-pocket. Ensure that the maximum room rent amount is covered by the insurer.
3. Pre and Post-Hospitalisation Expenses
Pre and post-hospitalisation expenses form a major part of any medical treatment. Hence it is advisable to have coverage for pre and post-hospitalisation expenses to reduce your financial burden. It covers expenses for check-ups, medicines, and medical visits for the number of days specified in the policy.
4. Sub-limits
Sub-limits are the limits applied to coverage for medical expenses included in the policy. These are generally fixed amounts or percentages of the sum insured provided as a claim for a particular medical expense. Policies with higher or no sub-limits are always recommended.
5. Co-payment
Co-payment is the percentage of the total claim amount, the insured has to pay from his own pocket. A high co-payment percentage may reduce your premium amount but it will increase your out-of-pocket expenses. Hence, choose a policy with minimum or zero co-payment.
Comparison Between Higher Sum Insured Plans And Low Sum Insured with Top-up Plans
If a 3 lakh health insurance plan is not enough to cover you and your family’s healthcare needs, you can buy a high-sum insured plan but it will cost more with a high premium. Alternatively, you can buy a top-up plan with a 3 lakh health insurance plan at a relatively low premium.
Let us see the key differences between a higher-sum insured plan and a low-sum insured plan with a top-up plan.
| Basis of Comparison | Higher Sum Insured Plans | Low Sum Insured with Top-up Plans |
| Coverage | Provides a high sum insured with comprehensive coverage | Supplements a low sum insured with a top-up plan and offer extended coverage beyond the coverage of the base plan |
| Premium | High premium | Low premium compared to a high sum insured plan |
| Deductible | These plans do not have a deductible or have a low deductible | A top-up plan comes with a deductible and the plan can be used only after the deductible is paid. |
| Claim Process | Simple as there is a single policy | Needs to coordinate between base plan and top-up plan |
| Portability | Easy to port | Porting two policies at the same time is a complex process. |
Both these types of plans have their pros and cons, it is better to choose one according to your financial capacity, coverage requirement and healthcare needs.
What are the benefits of opting for a ₹3 Lakh sum insured Health Insurance Plan?
There are many benefits of buying a 3 lakh health insurance policy.
1. Affordable
Affordability is the biggest benefit of a 3 lakh health insurance policy. The premiums of these plans are much more budget-friendly compared to a high-sum insured plan. Because of low premiums, such a plan makes health insurance accessible to a broad range of people.
2. Access to Quality Healthcare
With a health insurance policy, it becomes easier to avail treatment at top-notch network hospitals without worrying about the costs of the treatment.
3. Covers Essential Medical Expenses
A 3 lakh sum insured is a good amount to cover hospitalisation expenses, surgeries, doctor’s fees and other medical expenses. It provides coverage for all the essential basic medical care an individual may require.
4. No-Claim Bonus
A no-claim bonus is a very useful benefit that can increase your sum insured value for every claim-free year.
5. Tax Benefits
Premiums paid for a 3 lakh health insurance plan are eligible for tax deduction under section 80D of the Income Tax Act.
What is the eligibility condition and the documents needed to purchase a ₹3 Lakh Health Insurance plan?
The eligibility for a 3 lakh health insurance plan is a minimum of 18 years for adults and 90 days for children. The maximum entry age for adults is 65 years but some insurers have no upper limit. For dependent children, the maximum age is 25 years. The documents required at the time of purchasing a health insurance plan include
1. Photo identity proof
2. Address proof
3. Age proof
4. Medical reports
5. Passport photographs
What's Covered Under a ₹3 Lakh Health Insurance?
The basic coverage offered under a 3 lakh health insurance policy is as follows:
1. Hospitalisation Expenses
The policy covers medical expenses in case of a minimum of 24 hours of hospitalisation due to sickness or injury. The expenses covered are room charges, nursing charges, doctors’ fees, surgery costs and other related medical expenses during hospitalisation.
2. Pre and Post-Hospitalisation Expenses
The policy also provides coverage for medical expenses incurred before and after hospitalisation that may include diagnostic tests, nursing charges, doctor’s visits, medicine charges and more. The coverage is provided for 30 days of pre-hospitalisation expenses and 60 days of post-hospitalisation expenses
3. Daycare Procedures
Procedures that require hospitalisation for less than a day are also covered under the policy. Check your policy for the list of daycare procedures covered.
4. Ambulance Charges
It is an important inclusion that covers transportation charges during a medical emergency and helps the insured in getting timely medical treatment. The expenses incurred in availing of ambulance service are covered up to the limit specified in the policy.
It is important for a policyholder to carefully review the terms and conditions, inclusions and exclusions of a policy before selecting a plan.
What's Not Covered Under a ₹3 Lakh Health Insurance?
There are certain cases when a health insurance policy does not provide coverage.
1. A pre-existing disease during the waiting period.
2. Any medical expense during the initial waiting period except for hospitalisation due to an accident.
3. Any treatment required for substance abuse or rehabilitation
4. Injuries caused by participation in adventure sports.
5. Cosmetic procedures
How to Buy a ₹3 Lakh Health Insurance Policy Online?
Nowadays it is very easy to compare and buy a health insurance policy online. Here are simple steps to buy a 3 lakh insurance plan online.
1. Visit the official website of the insurer
2. Go to health insurance products
3. Explore plans and select one you find suitable
4. Provide your personal details to generate a quote
5. Select the type of the plan: individual or family floater
6. Upload the required documents
7. Pay the premium online
8. Your policy details will be mailed to you immediately
Reasons to Go for 3 Lakh Health Insurance in India
There are many reasons you should consider buying a 3 lakh health insurance plan.
1. Suitable For Young Individuals
A 3 lakh health insurance plan is a suitable plan if you are planning to buy at a young age at the beginning of your career. As you are young and healthy and not likely to file a claim, you pay less premiums.
2. Medical Inflation
Rising medical costs are another reason why you should buy a 3 lakh health insurance plan. Such a plan will cover essential medical expenses. It will help reduce your financial burden during a medical emergency.
3. Provides Coverage for Your Family
A single plan provides coverage for the healthcare needs of the entire family. It ensures that your family gets the best medical treatment without draining your finances.
4. Protects Your Finances
Every individual irrespective of age is prone to infections and injuries. Having health insurance coverage from a young age keeps your finances protected in case you require any medical treatment.
How to Select a 3 Lakh Health Insurance Plan?
To select the most suitable 3 lakh health insurance plan, consider the following points.
1. Select the Right Type Of Plan
If you are seeking coverage for yourself only, an individual plan is suitable but if you are looking for coverage for the entire family, a family floater plan is the best choice.
2. Check the Waiting Period
Look for a plan with the least waiting period for pre-existing diseases and other covered diseases. So that you don’t have to wait for long to file a claim.
3. Select a Plan With Lifelong Renewability
Always choose a plan that has lifelong renewability, so that you have coverage for your lifetime and you don’t have to look for another health insurance coverage.
4. Review the Inclusions and Exclusions of a Plan
Before buying a plan review its inclusions and exclusions and make sure that the coverage provided aligns with your healthcare needs.
5. Check Reviews
Check the reviews of insurance companies from their existing customers. The reviews will give honest feedback about all the good and bad aspects of an insurer and the plans and will help you make an informed decision.
Conclusion
Consider a 3 lakh health insurance plan for its affordability and comprehensive coverage. A health insurance plan will help you get access to quality medical care when required and will also help you maintain a healthy lifestyle.
Frequently Asked Questions
Every individual has different coverage requirements according to their financial background, age and lifestyle. A 3 lakh health insurance policy is suitable for individuals with low income or young professionals.
Yes, you can purchase a 3 lakh health insurance policy on a family floater basis covering your entire family in a single policy.
Yes, you can either increase the sum insured of your 3 lakh health insurance policy but you will have to pay a much higher premium. On the other hand, you can enhance coverage by adding a top-up health plan to your base plan.
Yes, you can add a rider for a critical illness, maternity benefit, etc. for additional benefits.
It depends on the insurance company but most insurers provide free annual health check-ups at the time of policy renewal.
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