Health insurance is an insurance policy that assures the financial coverage for medical expenses in the event the policyholder is hospitalized. The policy provides medical coverage towards the expenses arising out of a medical emergency. Health Insurance Companies cover the insured with the facility of cashless hospitalization at a network hospital or provide a reimbursement for the expenses incurred.
Health Insurance provides financial assistance to cover hospitalization expenses, daycare expenses, ICU charges, and other medical expenses. To avail the benefits of medical insurance coverage, the policyholder is required to pay a specific amount periodically, known as the premium.
Premium paid for a health insurance policy is deductible from the taxable income under section 80D of the Income Tax Act, 1961.
As the name suggests, an individual health insurance plan covers for a single person (an individual). The plan covers medical expenses for hospitalization, injury, room rent, and more. This policy offers sum insured which can be used by only one person that is the individual covered under the plan.
In a family floater plan, one can cover entire family under a single policy. The sum insured under this type of policy is generally higher as compared to regular individual health insurance plan that covers a single individual. The best part about this plan is that one can cover the entire family by paying single premium amount.
The group health insurance plans are highly popular in the corporate sector. Most of the medium and large-sized enterprises avail this insurance policy to cover medical expenses of their employees. It is a benefit that most employees expect while joining a company and this also helps the employer retain their employees.
Critical illness health insurance policy is a special plan that covers critical illnesses such as stroke, kidney failure, organ transplant, cancer, and more. Treating critical illnesses can get expensive and having such policy eases the financial burden and that enables an individual to save a lot of money. If the insured person is ever diagnosed with a critical illness, the insurance pays a predetermined amount towards the treatment expenses.
It provides cashless hospitalization facility at any of the network hospitals of the insurance provider and facilitates cashless claim.
Medical treatments cost rise by 15% every year due to Inflation.
Gives the insured a financial security & quality healthcare access by helping to meet expenses like hospitalization, day care treatments and even OPD expenses.
No Claim Bonus is a bonus provided to the insured if no claim has been filed for any treatment in the previous policy year. The reward can be offered ... View more
This allows an individual to obtain medical treatment without any hassle with peace of mind as the policyholder do not need to worry about the hospitalization expense.
The insured person can avail tax benefits under section 80D of the Income Tax Act, 1961. The premium paid towards insurance plans for an ... View more
While it is very important to compare the premium of Health Insurance policy, premium should not be the sole criteria for the selection of the policy. The features of the policy or the coverage provided by the policy should also be considered while deciding to buy a health insurance policy. Most important thing is to first identify the coverage which one wants to take. Based on the coverage, the premium should be compared and health insurance plan should be selected accordingly.
Pre-Existing Diseases are those which suffer from before opting to buy a health insurance plan, and therefore insurance companies do not cover them from day 1 of the policy. There is a waiting period ranging between 2-4 years during which the insured cannot submit claim for expenses arising on account of pre-existing diseases. Therefore one should look for health plans that cover existing diseases and have the least number of years of waiting period.
This feature of a health insurance policy takes care of both pre and post-hospitalization expenses. It takes into account the costs incurred during a certain number of days both prior to and post hospitalization for a specified period from the date of discharge, provided the expenditures are related to the disease/sickness.
There are several plans that provides ambulance expense waiver. Insured is free from burden of ambulance expenses as it is borne by the insurer. This is an add-on benefit and one can opt for it while buying medical insurance.
It is a type of insurance that helps an insured individual or a group meet health care expenses. It is a way to lessen the financial burden in the event of medical emergencies like illness, injuries, etc.
"Health is Wealth" – This maxim itself describes the importance of health. Medical care is becoming progressively expensive with each passing day. It can hamper our financial planning.
Buying Health Insurance protects us from sudden, unforeseen costs of hospitalization which would otherwise make a dent into our savings or lead to indebtedness. While the health care is becoming expensive, buying Health Insurance is much more affordable.
Insured is a person who buys insurance policy whose interests are protected by an insurance policy. Insured can be an individual or a group (consists of family members).
It is the maximum amount for a year that an insurance company can pay to the policyholder (insured) in the event of his/her hospitalization.
Depending on the need & choice of the insured a wide variety of insurance products are available nowadays with a range of health cover benefits. Some of them are –
Hospitalization cover is the most common form of health insurance. Such plans primarily cover payments for hospital stays, surgery, and related expenses incurred on the insured’s health. Policy can be taken either for an Individual or for Family. For instance, consider a family of 4 members, each member having health cover of Rs.1 lakh. Here a member can claim reimbursement for a maximum of Rs.1 lakh. Now if the same family opts for a family health plan cover of Rs.4 lakh, then any member of the family covered under the policy can claim reimbursement for more than Rs.1 lakh, subject to maximum of Rs.4 lakh across all insured members. Such plans are known as Family Floater Policy.
Such plan pays a certain prefixed amount to the policyholder for each day of hospitalization. It is not in any way related to the actual expenses incurred in the hospital. Such plans are very helpful to cover adjunct costs and to some extent, provide for income loss due to hospitalization. Depending on the plan the number of days of cash benefit is capped. For instance, daily cash benefit of Rs.5,000 for maximum of 50 days during the policy period.
Any major sickness or illness can burn a bigger hole in the patient’s pocket. Such exorbitant cost derails the finances of the family. Here, Critical Illness Insurance comes a real survivor. Here, the insurance company offers a lump sum amount in case the insured gets diagnosed with any of the critical illness mentioned in the policy document. Depending on the plan Life threatening critical illnesses such as heart attack, cancer, kidney failures, strokes, etc. are covered under critical illness insurance.
The Premium is the amount paid by the Insured (buyer) to the Insurer (Insurance Company) to get the benefits as mentioned in the insurance policy.
You would need to pay higher premiums to avail a higher sum assured. Age is the primary factor that determines the premium- the older you are, the higher becomes the premium because you are prone to illness. Subsisting diseases, smoking habits, medical history, among others, also weighing in determining premiums.
The health insurer usually provides either direct payment to the hospital (known as cashless facility) or reimburses to the insured the expenses associated with illness and injuries or disburses a fixed benefit on occurrence of an illness.
It is the reward offered by the insurer for not making claim during the tenure of the policy. The NCB amount gets accumulated to the sum assured of the insured. With drastic rise in medical costs every year, the NCB offered by a health insurance company can be very helpful in covering increased medical expenses.
Although it is aimed at providing health cover, several pre-existing diseases (as mentioned in the policy document) are excluded under a Health Insurance policy. There would also be several standard exclusions like cost of hearing aids, visual aids (spectacles, lenses), cosmetic surgery, abuse of alcohol & drugs, hospitalization due to self-inflicted injury (suicide) among others.
Yes. IRDAI had issued the Circular on 10th February 2011 in the interest of the policy holder. As directed in the circular you can change Health Insurance policy from one insurance company to another without losing the benefits you have accumulated. This applies not only to switching from one insurance company to another, but also from one plan to another with the same insurer.
Unless specifically prescribed in the policy, an insured is allowed any number of claims during the policy period, subject to maximum limit of the sum assured under the policy.
Health insurance comes with attractive tax benefits as an added incentive. There is an exclusive section of the Income Tax Act - Section 80D - which provides tax benefits for health insurance. It is unlike the section 80C applicable to Life Insurance wherein other form of investments/ expenditure also qualify for the deduction.
Insurance companies have tie-up arrangements with several hospitals all over the country as part of their network. Under a health insurance policy offering cashless facility, a policyholder can take treatment in any of the network hospitals without having to pay the hospital bills as the payment is made to the hospital directly by the Third-Party Administrator, on behalf of the insurance company. Cashless facility, however, is not available if you take treatment in a hospital that is not in the network.
Some health insurance policies pay for specified expenses towards general health check-up once in a few years.
It is a one premium and one policy for all members of the family. Family floater is a policy that takes care of medical expenses of your entire family. Any or all insured persons under the policy can avail hospitalization cover subject to maximum limit of sum assured.
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