*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
Medical emergencies can arise at anytime, anywhere and to anyone. It is always better to be prepared and organised for such incidents. The rising number of health concerns, diseases, disabilities, and illnesses across the world makes health insurance a must for all individuals. Health insurance reimburses or takes care of all expenses related to medical treatment, medical equipment, accidents, accidental death, etc. of the insured. In most countries, governments also offer health insurance for the poor and destitute by offering plans where the government pays for the premiums. This is to ensure that all citizens of a given country have access to proper health care as a basic human need.
A health insurance policy is a contract or agreement between an insurance company and an individual where the insurance company agrees to provide coverage or reimbursement for medical expenses incurred by the insured, provided, the insured pays the required premium to the health insurance company as per the contract and for the duration of time agreed upon. The goal of health insurance is to protect an individual and his family from any economic burden that can arise due to mounting medical expenses during an emergency. It can be considered as an investment or proper financial planning where an individual keeps aside a certain amount every month or year to be paid as premiums to the health insurance company. In the case of a medical emergency, the health insurance policy takes care of most of the medical expenses that occur.
There are two types of health insurance plans, which include a Basic Plan and a Supplementary or Super Top-up plan. The basic plan usually covers any medical expenses related to accidents, day-care procedures, surgeries, hospitalisation, and critical illnesses. The features and facilities offered by the health insurance vary from policy to policy and company to company. The super top-up health plan or supplementary plan is a plan that can be added as an extra to the basic health plan. The insured will be required to pay an additional premium but can increase his/her average sum insured and perhaps even receive additional coverage and facilities.
There are several types of health insurance plans offered by private or government organisations. An individual is expected to choose a plan depending on his/her requirements based on economic viability, health status, and any other requirements.
Individual health insurance plan is designed for an individual. It takes into account, the age, previous medical conditions, location, etc. when determining the premium to be paid and the coverage offered.
The family floater health insurance plan is a policy that covers all members of a family in one plan. This is typically for a family of four, but some policies even allow up to 15 family members. The premiums are higher, but if calculated, it will be much cheaper than paying individual premiums for each member. The sum insured is shared by all members covered under the plan.
Senior Citizens Plans are designed for individuals over the age of 60 years. Such plans may be quite expensive as senior citizens are more prone to diseases and illness.
This insurance is specially designed for women who are planning to have a baby and those who are expecting one. It covers expenses from prenatal to the postnatal stage. Both mother and baby are covered under the plan. Such plans can usually be bought as add-ons to existing health insurance plans.
Such plans are generally bought and offered by large companies to their employees for covering any medical expenses and critical illness. These plans are usually economical and more lenient.
This can be bought as a separate plan or a rider to an existing plan and covers unforeseen accidents.
There are several factors to consider before an individual decides on what is the best health insurance plan for him or her and their family. Certain parameters such as financial stability, product portfolio, claim settlement process, the sum insured, network hospitals, etc. must be compared and analysed before deciding the most suitable health insurance plan. The factors that must be considered and compared are as follows:
Always look for a health insurance company that has a good brand image, is well known in the country, and is easily accessible through its helpline or offices across the country. One must also consider the credit rating score of a company to gauge its financial stability. This is an essential factor because you have to make sure that the company can pay your medical expenses when the time arises after having collected your premiums.
As times keep changing, the product portfolio and policies offered by various insurance companies also keep getting updated. Look for a company that offers a diverse range of products to ensure you can find one that suits your specific requirements.
When looking at various companies, always compare if the premiums paid vs. the coverage received is viable. It does not prove beneficial to pay a premium of Rs. 1,00,000 per year if the policy only offers a maximum sum insured of Rs. 30,000.
The most important thing to consider when choosing the best plan and company is to compare the claim settlement ratio. When an insurer asks to settle claims, it must be done in a smooth, efficient, and timely manner. Some insurance companies offer paperless claim settlements directly from their network hospitals
Always read the fine print and consider what treatments, illnesses, coverage, etc. are excluded from the basic policy. If required, purchase an additional add-on policy.
The various health insurance plans offered by public and private companies encompass a range of products that cover hospitalisation, medical insurance, life insurance, etc. These plans can be tailored and customized to suit an individual’s requirements. However, most health insurance plans have some key features and benefits in common:
This refers to medical expenses incurred because of home hospitalisation for three days or more.
Some health insurance plans cover costs related to organ donation. With this feature, the donor is financially and medically covered during and after the process.
Specific high-end medical insurance plans cover all kinds of day-care treatments such as colonoscopy, chemotherapy, radiation, and dialysis to name a few.
This refers to alternative treatments such as Ayurveda, Naturopathy, Homeopathy, etc. Some health insurance policies cover such alternative medical expenses as well
When an individual is hospitalised, their caretaker will also incur costs such as daily food, health centre expenses, etc. during their time at the hospital. Such expenses may also be covered by specific health insurance plans as well as the loss of revenue due to illness or hospitalisation.
In case of emergencies and critical illnesses, health insurance plans can also cover any expenses related to ambulances and transfer to hospitals.
General check-ups and fitness tests may also be covered.
Certain medical plans cover vaccinations and expenses incurred due to bee sting, dog bite, etc.
If a policyholder needs to be transferred to another hospital during an emergency, expenses arising from such a transfer can also be reimbursed.
Individuals paying health insurance can claim a tax deduction up to Rs. 1,50,000 on their income tax returns in a financial year.
Since there are a huge number of health insurance plans available in the market, one must do their research thoroughly before deciding on which plan to buy finally. There are a few factors to consider before choosing the best health insurance for you:
Buying individual health insurance for each family member may turn out to be more expensive. But the disadvantage of family plan is that the sum assured is divided amongst all the members in the plan. Consider these factors before choosing a plan.
Several health insurance plans offer coverage internationally as well as throughout the country. The premiums for such plans will be more but will give you the option of getting yourself or a family member treated at a specialty hospital anywhere in the world.
Choose a plan that offers your paperless claim settlement and cashless transactions at the hospital to avoid the headache of filing a claim with unnecessary paperwork later.
Consider wisely before choosing additional riders. For example, you may want to add on accidental riders or maternity policy as a rider to your existing plan.
Claim Settlement Ratio is a significant factor to consider because you want the claims to be settled quickly and efficiently without any delays.
Most good high-end health insurance companies offer the option of customizing a plan and tailoring it to your needs. Look for such health insurance plans when choosing the best plan.
It is very easy to choose and buy a health insurance plan online. It will save you a lot of time and money. Go through all the information properly, compare different health insurance plans and calculate the premium owed as well. You may visit the website of any health insurance company and check out for more information.
There are some common documents required to apply for health insurance policies. These include:
Many health insurance plans require that the minimum age be 18 years and the maximum age be anywhere between 60 to 80 years. However, some plans are flexible and do not have any minimum age entry. Dependents of the policyholder can also be covered under a health insurance plan. It can be parents, siblings, or children. The minimum entry for children may vary from 90 days to 25 years, depending on the insurer. Health insurance plans can be renewed every year for lifetime, however, some insurance companies may require a health check-up after a certain age and may increase their premiums based on the data.