With medical costs spiraling out of control and the increase in shift to lifestyle diseases, healthcare today is at its all-time high in terms of treatment costs. In the event of an unforeseen illness, you may have no option other than to utilize your hard-earned savings, built over your lifetime. Finally, what's more important than your health and what better way to protect it than with the right Health Insurance Plan.
What is Health Insurance Policy?
Health insurance, also called Mediclaim, is a way to pay for medical treatments that typically require you to be in hospital overnight. It also covers certain other day care procedures like cataract surgery, etc. that don't require you to be hospitalized but are expensive nevertheless. A health insurance policy, therefore, covers your medical expenses and gives you financial relief.
Health insurance: Importance & why to buy it?
Medical insurance is a form of insurance which covers the medical costs incurred in case of medical emergencies. These plans, thus, take care of the financial burden associated with medical contingencies. In today's age, when illnesses and diseases are on the rise, a health insurance plan becomes necessary. Though medical developments have provided a cure for most of the illnesses, such cures and treatments come at very expensive costs. These costs become unbearable for the common middle-class man. A health plan, by covering these costs, takes off the financial strain caused by frequently occurring illnesses. It, therefore, proves to be an essential requirement for every individual looking to secure his finances against medical contingencies. A Health Insurance plan ensures complete peace of mind and makes sure that you use your hard-earned savings for the real reasons – Be it your child's higher education or his dream wedding or just about anything you dreamt of all your life.
Types of Health Insurance Plans:
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Individual health insurance plans: Covers a single individual under the cover.
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Family floater health insurance plans: Covers the entire family under the plan, including policyholder, spouse, dependent children, and parents.
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Critical illness health insurance plans: Covers major critical illnesses. If diagnosed with any covered illness, the sum insured is paid.
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Top-up health insurance plans: Provides supplemental coverage at minimal rates of premiums. There is a deductible limit under these plans.
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Senior citizen health insurance plans: Designed for individuals aged 61 and above. The sum insured is limited and premiums are affordable.
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Disease-specific health plans: Covers specified illnesses like diabetes, cancer, and heart-related ailments.
Things to Keep in Mind While Buying Health Insurance Plan:
Since medical insurance plans are important in providing financial security, they are quite popular. Almost all general insurance companies in India offer a wide variety of health insurance plans for individuals. Here’s a guide to choose the best health insurance in India.
- Understand the type of coverage required.
- Ensure that all family members are covered.
- The sum insured should be optimal.
- Look for comprehensive coverage features.
- The premium rate should be reasonable.
- Compare before buying.
Factors that Affect Health Insurance Premiums:
- Age: Higher age usually results in higher premiums.
- Past Medical History: This significantly impacts premium rates.
- Occupation: Your occupation influences premium rates.
- Body Mass Index (BMI): Higher BMI results in higher premiums.
- Smoking Habits: Smokers generally pay more premiums.
- Geographical Location: Location affects premium costs.
- Policy Duration: Longer-term plans usually have lower premiums.
- Co-insurance Feature: Choosing this can reduce premiums.
Key Features of Health Insurance:
- Coverage: Comprehensive coverage during health emergencies.
- Renewal Benefits: Benefits for no-claim requests in the previous year.
- Co-payment: Helps reduce yearly premium costs.
- Cashless Treatment: Direct payment to network hospitals.
- Tax Benefits: Exemptions under section 80D.
- Flexibility: Options to change premiums or policy terms.
Inclusions: What is Covered in Health Insurance Plan
- In-patient Treatment: Cost of hospitalization.
- Daycare Procedures: Minor surgeries without overnight stay.
- Pre-hospitalisation: Costs before hospitalization.
- Post-hospitalisation: Follow-up treatment costs.
- Domiciliary Treatment: Treatment at home under certain conditions.
- Organ Donation: Costs related to organ donation.
- Ambulance: Transportation costs to the hospital.
- AYUSH Benefits: Coverage for alternative treatments.
- Maternity and Newborn Coverage: Childbirth and newborn costs.
- Daily Cash Benefit: Additional cover for daily expenses.
Exclusions: What is Not Covered in Health Insurance Plan
- Intentional Injuries: Costs from intentional injuries or suicide attempts.
- Adventure Sports: Injuries from adventure sports are not covered.
- Criminal Activities: Medical costs from criminal activities.
- Cosmetic Surgeries: Unless due to an accident.
- Infertility Treatment: Not usually covered.
- Not Mentioned in Policy: Any unlisted treatments or surgeries.
Health Insurance Claim Settlement Procedures:
To make a successful claim in a health insurance policy, policyholders are required to follow the process below:
In case of cashless claim settlement:
- The policyholder should inform the insurance company of the claim.
- Submit a pre-authorisation form at least 4-5 days before planned hospitalization or within 24 hours for emergencies.
- Provide the health card and identity proof to the hospital.
- Submit all medical documents, reports, and bills to the insurance company.
In case of reimbursement claims:
- The insured should get admitted to the hospital.
- All the relevant documents should be collected after discharge.
- Submit all necessary documents to the insurer for processing.
Conclusion
It’s essential to keep health insurance updated with your changing lifestyle. The claim process should be straightforward. Compare different plans to find the best fit.
Having health insurance is a proactive step toward financial stability and well-being. Always consider consulting a professional for personalized advice.