What is Health Insurance?

What is health insurance?

Health insurance policy acts as a financial protective shield to manage our finances well against high healthcare costs. It is a unique insurance product offering coverage for medical expenses under specific terms & conditions and maintaining the rules and regulations of the specific plan concerned.

Different Types of Health Insurance Plans

India is loaded with several types of health insurance policies:

• Individual health plans: These are standard health covers catering to the medical coverage for one specific individual. Depending on the terms of the chosen plan, it covers all sorts of medical expenses, hospitalisation costs, pre- and post-hospitalisation costs up to a specific limit, doctors’ consultation costs, surgery costs, organ donation charges, etc.


• Family health plan: This sort of policy is also termed a family floater plan. It covers like a group policy and involves the entire family under one umbrella plan. It is a comparatively more cost-effective approach than maintaining individual health policies for each member.


• Senior citizens' health plan: As the name suggests, this sort of plan is specifically designed for people above 60 years of age. Depending on the chosen plan terms, it allows PED coverage and cashless hospitalisation benefits.


• Maternity health insurance: It is evident from the name that this sort of plan covers pregnancy-related and childbirth cost coverage protection. Delivery costs, pre-and post-natal cost coverage, and neonatal expenses are all covered, offering cashless treatment facilities and other unprecedented medical contingencies.


• Critical illness insurance: This sort of plan allows coverage for life-threatening ailments like cancer, kidney failure, heart attack, etc. However, the list of critical ailments varies from insurer to insurer. You must be aware of this list beforehand to ensure optimum coverage benefits.


• Group health plans: It allows medical insurance coverage for a specific group of people like employees of a particular organisation or members of a specific society. It is one of the biggest employee benefits. It allows consultation cost coverage, surgery costs, cashless hospitalisation, etc.


• Top-up plans: These plans offer additional benefits and are taken over an existing health plan. They usually cover medical expenses that exceed the specified sum insured by the existing plan.

Benefits of a Health Insurance Policy

Health insurance policies offer a host of benefits. Some of the most striking benefits of having a befitting health plan include the following:

• Health plans allow in-patient hospitalisation costs, and pre- and post-hospitalisation expenses up to pre-defined limits.


• Domiciliary treatment costs and daycare procedure charges are also covered under health plans.


• The premiums paid towards health insurance premiums are eligible for tax benefits u/s 80D of the IT Act.


• You can enhance the coverage span with additional riders like COPD cover, critical illness cover, etc. depending on your requirements.


• You can even restore the sum insured limit on exhaustion with a sum reinstatement benefit. It works if you have exhausted the specified sum insured in one year.


• Depending on the plan terms, certain policies even offer compensation benefits in the case of income loss due to certain medical reasons.

How to choose a health insurance policy?

Amidst the host of medical insurance products currently available in the market, choosing the right plan might often prove to be quite overwhelming. However, these small but practical tips will surely ease your journey:

• Visit the official websites of all the potential health insurance companies and cross-check the different plans they are offering.


• You must compare the coverage, premiums, facilities, etc. that are offered by all the competent plans of different companies, considering your requirements.


• In the case of family floater plans, you must check the specific age limit. Considering this, you may further add additional family members to the existing plan. However, for senior members, it is best to maintain a separate plan.


• Senior citizen health plans cater to the unique health requirements of people of and above 60 years.

You must be well acquainted with the terms and conditions of your chosen plan. Please clarify any ambiguity before the final purchase.

Factors to consider before purchasing a health policy

You must consider certain typical factors before purchasing any health plan to ensure optimum coverage:

• Always consider the premium amount payable and whether it justifies the coverage span.


• Consider checking the claim settlement ratio. It offers a picture of the claims raised and settled in the past years. It is better to opt for one with a high ratio.


• Always check the coverage span and the list of inclusions and exclusions of your chosen plan. Try to choose one with benefits like cashless hospitalisation, accidental coverage, hospitalisation costs, pre- and post-hospitalisation costs, etc.


• Try to opt for an insurer who maintains a wide list of network hospitals. It encourages the possibility of accessing cashless treatment facilities more easily. The insurer will directly settle the dues with the hospital authorities.


• Consider checking the terms observed by your opted plan regarding PED coverage. Opt for one which offers the minimum waiting period for any specific PED, considering all the other relevant factors are favourable.


• Ensure to know and understand all the terms and conditions of your chosen health policy for a smooth claim settlement.

Conclusion

Now you have a basic understanding of what health insurance is how it works its benefits. Considering all these above factors you can make your choice to open the doors towards accessing quality medical treatment and care with the help of a befitting health plan.

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