Health insurance benefits
Health Insurance Benefits
Health insurance benefits are becoming increasingly important as we witness significant inflation in the medical industry. A health insurance plan acts as a protective shield to safeguard your hard-earned savings despite any hospitalisation. This implies that if the insured individual(s) is hospitalised for any medical ailment or injury, the insurance provider will cover all the relevant expenses, maintaining the terms and conditions of the chosen policy undertaken.
To avail of these significant facilities, you need to pay a fixed amount of premium at regular intervals, to keep the policy plan running.
The benefits offered by a standard health plan are enormous. We will delve deeper to discuss how, maintaining a health insurance plan will efficiently manage your financial portfolio, especially in the case of medical emergencies.
Importance of health insurance
Health emergencies may trouble you or any of your family members at any time without any prior warning. If it is serious enough leading to hospitalisation, a significant amount of your hard-earned money will be wiped off. Medical treatment costs are always reaching new heights. Under such circumstances, health insurance acts like a saviour. Some of the major importance of maintaining a befitting health policy include:
- Combatting lifestyle diseases
Lifestyle diseases are gradually becoming more prevalent, especially for people within 45 years of age. Hypertension, diabetes, obesity, heart issues, respiratory ailments, etc. can be seen almost in every household. Unhealthy, sedentary lifestyles, work-related stress, anxiety, and pollution, all of these are contributing factors to the rise of these ailments. Despite taking preventive measures, any major unfortunate health event might prove to be significantly challenging for the entire household. Keeping this in mind, it is best to remain covered under a suitable health plan, covering regular health check-ups to ensure better health monitoring. - Safeguarding the family
While securing your health, you can opt for a single umbrella plan that will cover the health of your entire family. However, you must consider the health of your ageing parents while including them in the plan. It is best to buy a separate plan for them, as they are more vulnerable to several health issues. This might exhaust the sum insured amount and the plan might prove to be in vain if any other family member needs hospitalisation in the same year.Ensure that the insurance amount is adequate to meet the contingencies, without compromising the quality of treatment. Before making the final choice, you must carefully research and compare different plans to understand what suits you and your family the best.
- Countering inadequate coverage
If you are already maintaining a health plan, like a group insurance coverage from your employer, discover the extent of its coverage. Generally, such plans offer primary coverage. However, if it doesn’t cover any hereditary potential threats, it might fail during emergencies. It is best to opt for a comprehensive coverage plan. You can start low, depending on your current financial status, and then gradually enhance the cover. - Dealing with medical inflation
The rise and advancement of medical technology are significantly inflating treatment costs. You must note that the extent of medical treatments is simply not limited to hospitals alone. The consultation fees, diagnostic investigation costs, room rent, medicine costs, etc. all are on the rise. Without proper financial planning and backing, it can affect your hard-earned finances. Maintaining a health plan can act as a safeguard in this respect. - Protecting your savings
Any health issue not only causes mental stress, but it can also prove to be quite stressful on your finances. A befitting health plan ensures better finance and health management by protecting your savings. Some insurance providers offer cashless facilities, while others reimburse the cost. You can utilise your income in some other category, like children’s education, family marriage, home purchase/renovation, post-retirement planning, etc. Moreover, you can even enjoy tax benefits on premiums paid for health plans. This further enhances your savings. - Ensure early for better security
Buying a health plan at a young age proves to be highly beneficial. Early purchase guarantees lower premiums, with enhanced coverage scope. Your responsibilities remain low while you are young, and your health is also comparatively stronger. This negates the issue of serving any waiting period for PEDs. Even if there is, it will exhaust, while you are still young and healthy, offering extensive comprehensive coverage, especially useful in the long run.
List of Health Insurance Benefits
Considering the contemporary medical scenario of the country, the importance of health insurance cannot be denied. Here, we mention the complete list of the most significant benefits of having a health insurance plan:
- Comprehensive medical coverage
Health policies are specially crafted to offer comprehensive medical coverage, ensuring your peace of mind during difficult treatment times. With a health plan, you need not have to worry neither about finances or about the quality of treatment and medical care. It works well both for planned and unplanned hospitalisation. - In-patient hospitalisation
It is the technical term used to denote the hospitalisation of a patient for a minimum of 24 hours. All health insurance policies offer in-patient hospitalisation cost coverage. Depending on the policy terms, it can be either cashless or reimbursement. - Pre- and post-hospitalisation coverage
Apart from hospital treatment charges, most health plans offer pre- and post-hospitalisation coverage up to a certain span. It includes medical consultation charges, diagnostic investigation costs, etc. Post-hospitalisation costs imply the treatment costs incurred after the concerned patient is discharged from the hospital.However, you have to ensure that the pre- and post-hospitalisation expenses are only covered when the patient is treated for the same health issue both before and after hospitalisation. Normally, health plans offer a 30-day pre-hospitalisation cover and 45-60 days post-hospitalisation cover, depending on the terms of the chosen plan.
- Daycare charges
Daycare procedures imply surgical procedures that require hospitalisation for less than 24 hours. It is also alternatively called short-term hospitalisation. Cataract surgery is one of the best examples of the process. It is best to opt for health insurance plans that offer daycare coverage because it can prove to be burdensome on your finances. - Critical illness cover
Any health issue that seems to be prolonged and fatal in nature is called critical illness. Ailments like heart issues, renal failure, cancers of several levels of intensity, etc. fall under the category of critical illnesses, which are covered by special health plans.During claim settlement or compensation, the critical illness cover functions differently than standard covers. Here, the total amount of the sum assured is paid as a lump sum on the detection of any of the listed critical ailments of the insured individual. Organ donation coverage is also offered under this scheme.
- Room rent and ICU costs
A comprehensive health plan covers room rent and ICU costs in case of hospitalisation. Room rent implies the room charges incurred for accommodating the insured individual during hospitalisation. As per medical requirements and demands, he/she may be kept in a general ward, special cabin, ICU, or ICCU. The charges will vary accordingly under each case. Most insurance providers maintain a capping of room rent charges, any expenditure beyond that must be covered by the policyholder. - Cashless treatment facilities at network hospitals
Hospitalisation is a serious matter and thinking about finances at such a crucial juncture might be pretty exhilarating. It is best to opt for a cashless treatment facility at any network hospital under the health plan you have chosen. Here, the treatment expenses are directly settled by the insurance provider with the hospital authorities. You might need to clear the co-payment share as per the policy terms if applicable. - Domiciliary treatment coverage
Most standard health policies offer domiciliary treatment coverage. This means that the insurance provider will cover the treatment expenses incurred while treating the insured individual at home rather than in any hospital. This coverage is especially beneficial for older individuals with limited mobility. The principal target of this coverage is to let the insured individual receive proper medical care and attention even at home without worrying about finances. - Ambulance charges
The health insurance policies offer additional benefits by offering ambulance charges incurred while moving the ailing insured individual up to a certain extent. If you are a metro city dweller, these charges might prove to be significantly high. Therefore, it is best to acquire a health plan with an ambulance cover facility. - Pre-existing disease cover
One of the most highlighting benefits of maintaining health insurance coverage is that it covers pre-existing health issues after a specific waiting period has elapsed. During policy purchase, you or any of your family members might suffer from certain chronic health conditions like heart issues, asthma, cancer, hypertension, diabetes, thyroid, etc. It is especially more applicable for elderly policy buyers.As you are buying a health plan, its coverage must ideally include pre-existing ailments along with the provision for treating those issues in the future. Therefore, you do not need to spend anything from your pocket to treat those listed diseases.
However, you must look out for the waiting period tenure before purchasing the plan, during which you cannot raise any claim for treating any issues arising due to PED conditions. The lower the waiting period the better, ensuring faster coverage.
- Cumulative bonus on renewal
Depending on the terms of the plan, not every plan tenure allows claim settlement as raised by the concerned policyholder. Under certain circumstances, the concerned health plan passes on the special benefit of raising no claim by enhancing the overall sum assured of the plan during its renewal.
The enhancement of the sum assured is technically termed a cumulative bonus and its limit ranges between 10% and 100% of the total sum assured. However, you must consider the particular plan you have chosen to know the specific details. This is one of the comparatively lesser-known advantages of maintaining health insurance. - Lifetime renewability
This special benefit allows the insured individual to renew their health insurance policy without maintaining any particular age restriction. This particular feature comes in handy if you are maintaining a family floater plan, and the eldest member included in the plan reaches the optimum age limit.Under normal circumstances, the plan will discontinue the coverage. However, with a lifetime renewability facility, you can effortlessly enjoy coverage benefits for yourself and your family members as long as you wish. This facility alleviates the financial burden of any medical contingency, especially for older policyholders with the assurance of uninterrupted coverage on renewal, irrespective of age.
- Convalescence benefit
Certain health issues require a comparatively longer recovery period than the hospitalisation period. Several factors might be responsible for such situations like the severity of the ailment or the complicated treatment procedure, etc. This is where the convalescence benefit of a health plan comes into the picture.Under such circumstances, the concerned insurance provider pays out a lump sum amount to continue with the relevant treatment procedures. The duration span generally ranges between 7 and 10 days, depending on the terms of the concerned health plan. This payout also comes in handy to compensate for the loss of income for undergoing treatment procedures.
- AYUSH cover
You must look out for health covers that offer coverage for alternative medical treatment practices. Such alternative therapies include Ayurveda, Yoga, Unani, Siddha, and homoeopathy. These treatment procedures are not included in mainstream medical practices. However, the health insurance provider keeps these avenues open for the policyholder to ensure optimum coverage and allows them to enjoy maximum benefits out of the chosen plan. - Daily hospital cash allowance
A hospital stay will invariably prohibit you from working leading to significant income loss. Moreover, you have to face medical treatment costs and rising hospital bills. However, you can manage such pressing situations with the help of the daily hospital cash allowance offered by the health insurance provider.The insurance company will provide a specific daily allowance during your hospital stay, allowing you to cope with your income loss during the course. The limit of this allowance varies from one plan to another. You must consider your chosen plan to know the specific details.
- Medical health check-up facility
Health issues often arise out of the blue. Therefore, it is better to monitor it regularly and watch out for any early signs detected and then proceed accordingly. So, it is good if your health plan offers a free medical health check-up option to ensure proper evaluation.Depending on the terms of the health plan you are maintaining, your medical health check-up charges will be borne by your insurer. It can be either cashless or reimbursed later on submission of all the relevant original documents, bills, and reports.
This is generally an annual event. However, certain companies offer it as a special bonus for not raising any claim for a specified tenure.
Bariatric treatment facility
Only a handful of selected insurance providers offer coverage of bariatric treatment. This is a special weight loss and management procedure for treating acute obesity when all the popular standard measures like dieting, rigorous exercises, etc. have failed to achieve the desired target results.- Sum insured restoration coverage
This is a special feature in health insurance where the sum assured is compensated back to its original value despite usage. This feature can be generally observed in the case of family floater plans. It aids in the efficient management of recurring medical expenditures for one or variable beneficiaries.The exhaustion of the sum assured implies that you have to bear the medical costs incurred after this exhaustion by yourself. This may prove to be quite burdensome on your income and savings.
However, with the restoration feature, the sum assured gets automatically reinstated to its original initial value.
Depending on the nature of policy exhaustion, the restoration benefits can be classified into two different types: partial exhaustion of the sum assured or complete exhaustion of the sum assured. In the case of complete exhaustion, the entire sum assured needs to be exhausted to receive the restoration benefit. However, only partial exhaustion is enough to restore the sum assured in the case of partial exhaustion.
Before purchasing, you must clarify these details to avoid any future misunderstandings.
- Maternity and neonatal coverage
Welcoming a baby in the family is very auspicious and joyful, but it becomes smoother with proper financial backing. You must choose health plans with maternity and neonatal coverage facilities. Although motherhood is very enjoyable, it may include certain physical complications requiring expert medical care. A health plan with maternity coverage significantly aids you under such circumstances.Maternity coverage facility in health plans provides newborn care for babies aged 90 days.
You must remember to buy a maternity cover health plan beforehand as a detected positive pregnancy while buying the plan is considered to be a PED.
- Add-on rider facility
Depending on your requirements and considering health factors, you can customise your health plan by adding befitting riders to the basic policy. These riders are optional and are utilised for enhancing the overage span of any particular health plan.The market is overloaded with various kinds of riders offered by different insurance companies. You must be careful and wise enough to select only the most suitable ones. This is because, for every rider you choose, you have to pay an additional premium. Unnecessary selection might lead to unnecessary financial drainage.
- Covid-19 coverage
Apart from the diseases listed in the chosen policy document, all health insurance plans compulsorily offer coverage for COVID-19. Since the outbreak of the coronavirus pandemic, back in 2020, IRDAI has made it mandatory for every health cover to extend their coverage for Covid-19. Therefore, if you are seeking coverage for this particular disease, any standard health plan will cover it expeditiously. - Wellness benefits
Apart from the financial protection and support that health insurance offers, wellness benefit is an additional facility, emphasising “prevention is better than cure”. These benefits can be in the form of special discounts on plan renewal, special discount vouchers for varying supplements and boosters, membership benefits of different health clubs, and gyms, etc., free diagnostic investigation facilities, redeemable medical vouchers, etc.
Such protective coverage benefits will protect your health and closely monitor it, aiding you to beat health issues keep it in good shape, and keep you in the pink of your health. - Tax benefits
Health plans offer tax benefits too u/s 80D of the IT Act. The complete scenario can be summarised as follows:
| Scenario | Optimum deduction of the return of income for the policyholder, the spouse, and dependent children | Optimum deduction in return for income for parents (dependent or not) | Total deduction u/s 80D | ||||
| None of the beneficiaries is a senior citizen | Up to ₹ 25000 | Up to ₹ 25000 | ₹ 50000 | ||||
| The concerned policyholder and other family members are below 60 years and parents are senior citizens | Up to ₹ 25000 | Up to 50000 | ₹ 75000 | Either the policyholder or any other family member has reached 60 years and the parents are also senior citizens | Up to ₹ 50000 | Up to ₹ 50000 | 100000 |
Apart from the tax deductions for premiums paid towards health insurance, these plans even offer preventive health diagnosis deductions up to ₹ 5000, a specific sub-limit maintained under the above-mentioned amounts. However, these limits are liable to change depending on the changing tax laws.
Conclusion
From the above analysis, you can well comprehend the importance of maintaining health insurance. It is a protective shield that protects your finances by paying off the medical dues, without compromising the quality of treatment. Moreover, it even offers tax benefits, allowing you to further save your hard-earned savings.
Frequently Asked Questions
Yes, since medical emergencies may happen anywhere, health insurance is generally valid throughout the country. However, you must be aware of the geographical scope of your chosen plan.
There are no restrictions to the number of claims you make in a policy tenure. You can keep claiming as long as your sum insured lasts.
Yes, there is no restriction on the number of health plans you maintain. Experts opine that maintaining more than one plan proves to be more beneficial.
It is the initial 15 days after policy initiation. If you do not like the plan, you can cancel it within this period without any additional charges.
You must research to know and compare the yearly premium of several plans; wisely analyse your yearly medical requirements. You can review other available plans, apart from the current one to enhance the scope.
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