Health Insurance also called Medical Insurance is a contract between the Insurer ( The Insurance Company) and the Policyholder (The Insured) where the Insurance company offers medical coverage to the Insured up to the Sum Insured Limit. The policy protects the Insured and his/her family against the medical expenses that may arise due to a serious illness or accident or any diagnosis of major diseases.
The health insurance plans offer cashless treatment with its network hospitals or repayment facilities for the medical cost of the treatment like coverage for pre/ post hospitalisation. Medical check-ups, room rent coverage etc.
Why To Buy A Health Insurance Plan
In India, Health insurance is offered in two types: An indemnity plan and Fixed Benefit Plan. The indemnity plan has further subtypes like group insurance, family floater Insurance, etc, and the Fixed Benefit Plan a fixed amount is already decided for some listed illnesses like cancer, heart diseases, etc. which also has subtypes like Preventive insurance, personal accident, etc. Let’s now look into the benefits in detail.
The advantages that an Insured can get from the Health Insurance plans are listed below.
- Hospitalisation Expense & Cashless treatment
This benefit includes Pre and Post hospitalisation expenses which cover the medical costs that you may have sustained on an illness before getting hospitalised as well as the follow-up treatment expenses spent after getting discharged. This is covered up to only a fixed number of days as per each policy document rules. On the other hand, the cashless benefit plan also allows the insured to get the required treatment in-network hospitals without paying any money during hospitalisation up to the limit of the sum assured in the policy.
- Ambulance expenses
This facility covers the cost of ambulance services incurred to reach the nearest medical centre during an emergency.
- NCB or No Claim Bonus
This is a discount that the Insurance company provides the Insurer for every claimless year. When you renew the policy you can check if you are eligible for an NCB discount.
- Free Health Check-Ups
Insurance companies do offer free medical checkups occasionally to their policyholders for reminding them about how important it is to lead a healthy life. Some companies offer a master health check-up too. This largely depends on the conditions mentioned in the policy
- Day Care procedures and Daily Hospital cash
Some insurance companies offer daily cash to a certain limit to cover the additional expenses in the hospital like food, travel etc. during hospitalisation. Usually, the amount is up to Rs. 2000 per day but it varies in the case of ICU procedures and such. Daycare procedures cover the cost of assisting daycare treatments that require hospitalisation for less than 24 hours.
- Pre- Existing diseases
The best insurance policies provide coverage for a pre-existing disease after you have completed the waiting period which is usually a period of 2 to 4 years.
- Tax advantages
On getting the health insurance policy you will be eligible to enjoy some tax advantages for the premiums paid under Section 80D of the IT Act,1961. However, this is only up to a certain limit depending upon the age of the policyholder or his/her parents.
- Restoration benefit
Some insurance companies provide plans with some extra expense in premium in which once the insured uses the sum assured amount completely, the company will restore the amount automatically and no additional cost needs to be paid by the insured. This is applicable as per the clauses mentioned in those policies.
- Organ transplant and Surgery expenses
This is the coverage for the expense incurred for the transplantation of an organ and the surgery related to the organ donation. Some companies provide the plans for the same. But the costs for any complications after the surgery and medical tests are not covered under this plan.
Top Indian Brands Offering The Best Health Insurance Plans
Some of the top or Best health insurance plans available in India are mentioned below :
- Apollo Munich Optima Restore/ HDFC ERGO Health Optima Restore
- Religare Care
- Star Family Health Optima
- My Health Suraksha Silver SmarT
- Aditya Birla Activ Assure Diamond
Secure & Wise Plans To Opt For A Better Health Insurance
- Individual Health Insurance Plan – This plan covers the health expenses of a single person. However, he/she can opt for a bigger sum assured if the person can pay a higher premium.
- Family Floater Health Insurance plan – This plan allows insurance for not only a person but also his/her family members like spouse/children/parents are eligible to enjoy the benefit of the entire sum assured. The premium is also less compared to a single individual plan.
- Senior Citizens Health Insurance – This plan is particularly meant for people above the age of 60yrs. The plan usually covers the cost of medicines, hospitalisation arising out of illness or accidents and treatments in the hospital. Psychiatric benefits are also covered in some. Some policies also cover AYUSH. According to IRDAI rules, all senior citizens up to the age of 65 must be insured. However, the maximum age limit can be pushed to 70 with lifetime renewability. The plans are usually expensive as senior citizens are exposed to more illnesses.
- Maternity Health Insurance – This plan covers child delivery including terminations of pregnancy if it must as advised by the medical specialist, expenses for newborn baby up to its first 3 months and also infertility expenses. However, the maternity cover comes into effect after a minimum waiting period of 2 years.
- Critical Illness Insurance plan – Lifestyle diseases are on the higher side for the majority of people as per the reports. For this, the insurance companies offer a Critical illness cover which is dedicated for diseases like cancer, stroke, kidney failure, paralysis, first heart attack, etc. The health plans for these kinds of diseases have a pre-defined sum assured which will be paid by the insurance companies. This cover is considered the smartest plan as it protects your savings a long way.
Can’t Figure Which Plan Is Right For You? Tips To Get You Sorted!
Buying a health insurance plan at an early age is more beneficial as it saves you the waiting period and you can avail of the benefits at a later stage in life. You will be eligible to earn a good amount of bonus and the sum insured can be increased over the later years of life. However, there are a few things to be kept in mind and you have to choose the right insurance company which provides you with the best plan which shall meet your needs and help you save your hard-earned money. This can be a bit challenging but here are some important points to look out for which will certainly help in deciding what is right for you.
- Ensure the extent of Coverage provided – The sum insured and the type of coverage provided by an insurance company will decide the type of illnesses and other expenses you can claim in your plan. You might want to take a close look at the benefits offered by the insurer like daily cash benefits during hospitalisation, critical illness cover, maternity cover, etc.
- Proper sum assured /Sum insured plans – This factor is crucial in selecting the right medical insurance policy. The higher the sum insured the better the benefits you are eligible for. You might also want to make sure of the sum assured by the particular insurance company.
- Waiting Period – Most of the health insurance plans get activated only when the initial waiting period is over as mentioned in their terms. Some illnesses like thyroid, blood pressure, diabetes etc are the common ones. So it’s always wise to choose a policy that has a minimal waiting period.
- Network of Cashless medical care centres – Always check the list of network hospitals mentioned in the list of your insurance company where you can file a cashless claim during hospitalisations.
- Check for riders offered – Each insurance company has various riders offered to the customers which is an additional benefit apart from the normal cover mentioned in the policy terms. Choose the best rider according to your personal needs.
Apart from the points to be kept in mind it’s crucial to opt for the right insurance company. You need to do extensive research yourself to ensure which one suits you the best. Factors like a Company brand, Financial stability of the company, a company that has a high-quality customer support department, Quick and flawless claim settlement process, companies that got the best feedback or reviews, etc are some of the major factors to be kept in mind while finding out the right Insurance company for your healthcare needs.
Common Faqs
- Is it important to buy Health Insurance in India?
Although it’s not mandatory in India it falls under the category of absolute necessity to cover illnesses that are common in all human beings. The earlier you get the better benefits you can avail yourself. - What is the average cost of health insurance in India?
The cost is different for Individual plans and family plans. Normally it is Rs 10,000- Rs 17,000 annual payment for a Rs. 5 Lakh family floater policy whereas the same plan costs Rs 7,000 per year for a single person. - What happens if I miss paying the premium for my health insurance?
In such cases normally the company gives you a grace period for up to 1-3 months. If you miss paying within that period the policy will automatically lapse.