What is Health Insurance?
Health insurance, also known as a health policy plan, is insurance coverage which pays for medical and surgical expenses incurred by the insured. It’s a contractual agreement between the insurance company and the policyholder, where the insurer agrees to pay for the insured’s medical expenses in exchange for a monthly/yearly premium for medical insurance.
Individuals, families, or organisations can avail of it, it helps cover the costs of routine check-ups, doctor visits, diagnostic tests, hospitalisation, and other medical expenses. It provides essential financial protection against unexpected medical expenses, which can often be very high. Health insurance plans best cater to the policyholder’s needs and budget, and various types of plans are available, including individual health insurance, family floater health insurance, critical illness insurance, and group health insurance.
Choosing the right plan in India or online medical insurance can help reduce the financial burden on the policyholder and their family, allowing them to focus on their recovery instead of worrying about the cost of treatment. It is crucial to select the best policy for medical insurance or medical procedure for the family to ensure comprehensive coverage and peace of mind.
Benefits of Buying Health Insurance
- Financial Protection: Health policy plans or Medical Insurance provide financial protection against the high cost of medical expenses, helping policyholders and their families manage unexpected medical bills.
- Peace of Mind: Health insurance policies assure policyholders and their families of financial protection in case of any medical emergency, providing peace of mind.
- Tax Benefits: The premium paid towards a Health Policy Plan or Medical Insurance is eligible for tax benefits under section 80D of the Income Tax Act, making it a wise financial decision.
- Cashless Treatment: Many plans offer the convenience of cashless treatment, allowing policyholders to avail of medical services without upfront payments.
- Access to Quality Healthcare: Ensure access to quality healthcare without worrying about the cost, promoting good health and well-being.
- Coverage for Pre-existing Conditions: Some insurance policies cover pre-existing medical conditions after a waiting period, making it an attractive option for families with existing health conditions.
- Best Plans: Choose from the best health insurance plans for families in India, including online medical insurance and policies tailored to meet specific medical needs.
- Family Plans: Secure your family’s health with comprehensive plans designed for families, providing holistic coverage for all family members.
- Medical Insurance Policy for Family: Find the best medical insurance policy for your family’s needs, ensuring their health and financial security.
- Insurance Health Policy: Insurance health policies offer comprehensive coverage for medical expenses, protecting policyholders from unforeseen healthcare costs.
Top Reasons to Buy Health Insurance Plan
- Protection against Rising Medical Costs: Health Policy Plans or Medical Insurance provide protection against the constantly rising costs of healthcare, ensuring financial security.
- Access to Quality Healthcare: Policyholders get access quality healthcare without worrying about the cost, promoting good health and well-being.
- Secure Financial Future: Protection against unexpected medical expenses that can impact one’s financial situation, providing a safety net.
- Tax Benefits: Premiums paid towards Medical Insurance are eligible for tax benefits under section 80D of the Income Tax Act, making it a smart financial decision.
- Coverage for Pre-existing Conditions: Some Plans cover pre-existing medical conditions after a waiting period, ensuring comprehensive coverage for existing health conditions.
- Family Health Insurance: Plans offer coverage for the entire family, ensuring the health and financial protection of loved ones.
What is Covered in a Health Insurance Plan?
A Health Policy Plan or Medical Insurance typically covers the following expenses:
- Hospitalisation Expenses: This includes room rent, nursing expenses, doctor’s fees, and other miscellaneous charges incurred during hospitalisation, providing comprehensive coverage for medical treatment.
- Pre and Post-hospitalisation Expenses: This covers expenses incurred before and after hospitalisation, such as doctor’s consultations, diagnostic tests, and medication, ensuring holistic coverage for medical care.
- Day Care Procedures: This includes expenses incurred for treatments that do not require 24-hour hospitalisation, such as dialysis, chemotherapy, and radiotherapy, providing coverage for advanced medical procedures.
- Ambulance Charges: Some Plans cover ambulance charges incurred during hospitalisation, ensuring financial protection during medical emergencies.
- Maternity Expenses: This includes expenses incurred for prenatal and postnatal care, delivery, and newborn care, providing coverage for maternity-related healthcare costs.
- Critical Illness Cover: Some Medical Insurance Plans provide a lump sum benefit in case of the diagnosis of specified acute illnesses, offering additional coverage for critical health conditions.
- Domiciliary Hospitalisation: This covers expenses incurred for medical treatment taken at home, in case hospitalisation is not possible, ensuring coverage for healthcare received at home.
Health Insurance Limitations: Expenses Which Is Not Covered Under Medical Policy
While Health Policy Plans or Medical Insurance provide comprehensive coverage for various healthcare expenses, there are specific exclusions that are typically not covered, including:
- Pre-existing Medical Conditions: Most plans in India have a waiting period for pre-existing medical conditions, during which they are not covered, ensuring coverage for future health needs.
- Cosmetic Procedures: Procedures such as plastic surgery, liposuction, and other cosmetic procedures are usually not covered in the plans, as they are considered elective or cosmetic in nature.
- Treatment for Substance Abuse: Treatment for substance abuse, including alcoholism and drug addiction, is generally not covered in the plans, as it is considered a specialised treatment.
- Experimental Treatments: Treatments that still need to be widely accepted or considered experimental, such as clinical trials, may not be covered by health insurance plans, as their effectiveness may not be established.
- Waiting Periods: Some insurance plans may have periods for specific treatments or conditions during which they are not covered, ensuring that policyholders have coverage for future medical needs.
- Preventive Health Check-ups: Some insurance plans may not cover routine preventive health check-ups, as they are considered part of routine healthcare and not specific treatments.
Documents Required for Health Insurance:
The following documents are typically required to buy a health insurance plan:
- Identity Proof: driving license, passport, voter ID card, or PAN card.
- Age Proof: Passport, Birth Certificate Or Aadhar Card.
- Income Proof: Salary slip, IT returns, or bank statement.
- Medical Reports: In some cases, insurance companies may require medical reports from policyholders to assess their health status.
As a leading insurance broker at Assurance Hub, we understand the importance of having a comprehensive health insurance plan that meets your needs. When buying a plan, it’s essential to provide accurate and complete documents, including identity proof, age proof, income proof, and medical reports, to avoid future claims delays or rejection.
Here are the key factors to consider before choosing a health insurance plan:
- Coverage: Ensure that the plan provides coverage for medical expenses relevant to you and your family’s needs, including hospitalisation, outpatient treatments, diagnostic tests, and pre-existing medical conditions.
- Network Hospitals: Check if your preferred hospital is included in the insurance company’s network and if they have tie-ups with convenient hospitals.
- Premium: Choose a plan that offers adequate coverage at a premium that fits your budget.
- Waiting Period: Consider the waiting period of the chosen plan and if it’s acceptable for you.
- Claim Settlement Process: Understand the claim settlement process of the insurance company, including its reputation for settling claims promptly.
- Renewability: Check if the insurance plan is renewable for life or has any renewal age limit.
- No-Claim Bonus: Consider a plan that offers a no-claim bonus, which increases the sum insured for every claim-free year.
- Pre-existing Medical Conditions: Ensure that the plan covers pre-existing medical conditions, if applicable, and check for any waiting period.
- Add-on Covers: Consider if you need any additional covers, such as critical illness or personal accident cover, and check their availability with the chosen plan.
- Online Availability: Consider if the plan is available online, as buying online can save time and money.
In conclusion, choosing the right health insurance plan is crucial, and Assurance Hub is committed to providing you with the best options. Contact us today to learn more about our plans and how we can help you find the best coverage for you and your family.
Frequently Asked Questions
To choose the right health insurance plan, consider your health needs, budget, network, benefits, costs, reputation, and service. Compare different types of plans and check their features and limitations. Look for a plan that covers your preferred providers and offers adequate coverage at an affordable price.
A health insurance premium is the amount of money you pay, usually monthly, to your health insurance company to keep your coverage active. It is different from other costs like deductibles, coinsurance, and co-payments, which are amounts you pay when you need medical care. Your premium may vary depending on your age, location, network, plan type, and income level.
A pre-existing condition is a medical condition that you had before buying a health insurance policy like cancer, asthma, diabetes etc. According to IRDAI, if you were diagnosed with a disease or medical condition up to 48 months before buying the policy, it is called a pre-existing disease. Health insurance companies may have different rules and waiting periods for covering pre-existing conditions.
A waiting period is the time you have to wait before you can use certain benefits of your health insurance policy. For example, if your policy has a waiting period of 90 days for maternity cover, you cannot claim for any maternity-related expenses within 90 days of buying the policy.