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Health Insurance

Health insurance is basically an insurance policy that provide required financial help in case you fall ill or diagnosed with any serious disease. It assists with the cashless treatment or expense reimbursement so that you can completely focus on speedy recovery instead of the cost of the treatment. In case of an illness which leads to hospitalization, a health insurance policy will reimburse for expenses associated with the same.

Highlights

  • It provides financial assistance to deal with the expenses of treatment at any hospital and lighten the financial burden.

  • Allows you to avail cashless treatment in a network hospital. Reimburses insured in case of non-network hospitals.

  • Tax benefits in the form of tax exemption under section 80D of the Income Tax Act 1961.

PolicyX.com is here to help you with all health insurance needs. If you want to avail deep knowledge, if you want to compare health insurance plans from top insurance companies, if you want to buy the best health insurance, all your requirements associated with health insurance will be fulfilled by the team of PolicyX.com

Importance of Health Insurance in India

Investing in a health insurance policy is highly important for yourself and your family because of the growing inflation rate in the healthcare industry, especially in the private sector. A sudden medical emergency that leads hospitalization can create a hole in your pocket and can easily derail your finance. It will become highly tough, if the breadwinner of the family is now in a hospital bed. You can easily avoid all this by buying a health insurance plan. By paying a small annual premium, you will get the required financial assistance which will lessen your stress in case of any medical emergency.

Buy buying an effective health insurance policy, you will get the required cover against expenses made towards doctor consultation fees, costs towards medical tests, ambulance charges, hospitalization costs and even post-hospitalization recovery costs and much more.

Example - Ramesh is a full time employee of an organization. He is working at a good position and carries several responsibilities on his shoulder. He was living a healthy lifestyle. But suddenly one day he met an accident that leads him towards hospitalization and a few surgeries as well. He was not insured with any health insurance policy and nor his family's financial condition was good enough to deal with all expenses associated with the treatment.

So his wife borrow money from their relatives and that was quite embarrassing for them. He got the treatment and recovering fast. But this incident strike him hard. After this, Ramesh understand the importance of having savings and insurance as well. Since then he makes sure to insure each and every member of the family with an effective health insurance plan and carries a decent amount of savings in the bank account for emergencies.

Ramesh was lucky enough that he got the required assistance on time but this doesn't happen with all. So to deal with such emergencies of life, it is important to have an investment in a health insurance plan. And people should invest in the same at the earliest.

At PolicyX.com, which is an IRDA approved website, you can buy the best health insurance plan according to your needs. You can freely compare on the basis of premium, features, health insurance benefits and can select the best plan according to your needs in just a few minutes.

Top 6 Health Insurance Plans in India 2019

  1. Religare Care with Smart Select

  2. HDFC Ergo Health Suraksha

  3. Diamond with Unlimited Reload by Aditya Birla

  1. ManipalCigna ProHealth Protect

  2. Royal Sundaram Lifeline Supreme

  3. Apollo Munich Health Wallet

Insurance Companies Plan Cover Features Renewa-bility Premium / Year
Religare Health Insurance Care with Smart Select 2 Adult +2 children Co-Pay - You pay 0% of claim.
Maternity - Not Covered.
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.5L per year upto Rs 2.5L
Restoration - Upto Rs 5L
Lifelong renewability 12535
HDFC ERGO Health Suraksha 2 Adults & 2 Children Co-Pay -You pay 0% of claim.
Maternity - Not Covered
Hospital Room - All categories.
No Claim Bonus - Rs 0.25L Per Year Upto 2.5L.
Restoration - NA.
Lifetime renewability 14290
Aditya Birla Capital Diamond with Unlimited Reload 2 Adults & 2 Children Co-Pay - You pay 0% of claim.
Maternity - Not Covered
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.5L per year upto Rs 2.5L.
Restoration - Upto Rs 5L Unlimited times.
Lifelong renewability 15896
ManipalCigna ManipalCigna ProHealth Protect Policy 2 Adults & 2 Children Co-Pay - You pay 0% of claim.
Maternity - Not Covered
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.275L per year upto Rs 11L.
Restoration - Unlimited.
Lifelong renewal 14965
Royal Sundaram Lifeline Supreme 2 Adults +2 Children Co-Pay - You pay 0% of claim.
Maternity - Not Covered.
Hospital Room - No capping on room rent.
No Claim Bonus - Rs 1L per year upto Rs 5L.
Restoration - Up to Rs 5L.
12443
Apollo Munich Health Wallet 2 Adults & 2 Children Co-Pay - You pay 0% of claim
Maternity - Not Covered
Hospital Room - Actual - No capping on room rent
No Claim Bonus - 50% Multiplier Benefit is Applicable.
Restoration - Upto Rs 5L
Lifelong renewal 25042

(5 lac -sum assured, Age of Head person-32)

Types of Health Insurance Plans

In India, there are many types of health insurance to cater different needs of customers. So for choosing the right one which can go well with your needs, you should first learn how many forms are there that you can explore.

Following are the major types of health insurance policies available in India.

Individual Health Insurance

The basic and most common form of health insurance is an Individual health insurance. It covers a single person but there's always flexibility of availing the bigger sum assured. The premium that we pay annually depends on the amount of sum assured. Individual health insurance is the need of every individual.

Family Floater Health Insurance

Family Floater Health Insurance is the best health insurance policy that allows to insure all family members under a single policy. All the family members can enjoy the benefit of the entire sum assured. It's a rare situation when any 2 members of the family fall ill simultaneously. As a result, the entire sum assured can be utilized by a single member. The amount of premium paid for such kind of policies is quite less as compared to other plans. Members who can get covered under Family floater health insurance policy includes your spouse, children who are dependent and the parents.

Critical Illness Plan

Critical Illness plan offers a fixed benefit payout in case of any critical illnesses specified under the policy. With the lump sum benefit you will be able to pay the huge hospitalization costs and can get the treatment on time.

Senior Citizen Health Plan

The plan is designed especially for the old age people, particularly the age above 60 years. This plan is a great to fight against all medical contingencies during old age. As per the IRDAI regulations, every insurance company must insure people up to the age of 65 years.

Maternity Health Insurance

Nowadays, almost every health insurance company cover pre and postnatal care, child deliveries and sometimes vaccination expenses of new born babies as well. In short, it provides cover to all your maternity expenses. However, features and exclusions can vary from insurer to insurer.

Unit Linked Health Plan (ULHP)

Health insurance companies have recently introduced ULHPs. It is basically a combination of health insurance and investment. Along with the health protection, ULHPs will help you in building a corpus which can be used by the investor to meet expenditures that do not get covered under health insurance plans. The return, of course, depends upon the market conditions at that time. But these plans are still in the development stage and are recommended for those who can handle products like unit linked insurance plans (ULIPs) and unit linked pension plans (ULPPs).

Benefits of Health Insurance Policy

To buy any insurance plan, the most important thing is to focus on the features of the same. Below are a few features that you will get with a basic health insurance plan. With the understanding of the following features, buying an effective health insurance plan will become easier for you.

Cashless Treatment

Cashless treatment is a feature that allows the insured to get required treatment at the network hospital without paying a single penny. In a cashless treatment option, the insurance company will pay on your behalf and allows you to have complete focus on your treatment. It will be a big help in case of hospitalization as you do not have to arrange funds during medical emergencies and can pay more attention towards the treatment.

No Claim Bonus (NCB)

No claim bonus is a discount that you will receive from insurer for every claimless year. It is a bonus that motivates a lot of policyholders to not file any petty medical claims. You should keep in mind that NCB comes as a discount on the payable premium at the time of renewing policy or whenever you want to increase the sum assured amount. At the time of renewal you must check that you are getting your no claim bonus or not.

Family/Loyalty Discounts

It is a discount that you will receive on enrolling family member or any person in the health insurance policy. It is a form of reward that insurance company pay to existing policyholder on referring people to them.

Round-The-Clock Customer Support

With almost all health insurance plans, you will get the benefit of 2487 customer service. To provide more ease to customers and to solve their queries, all health insurance companies provide 24/7 customer service.

Sum Assured Restoration

The benefit of sum assured restoration is that once the sum assured amount is completely used, the insurance company will restored the amount automatically any you don't have to pay any additional cost for it. Usually, health insurance plans with restoration benefit are expensive as compared to normal health insurance policies.

Online Application and Renewal Facilities

Insurance companies offers you the benefit of buying a new plan and renew the existing one from the comfort of your home. Almost all insurance companies own websites and updated the same regularly to stay in touch with their existing customers, to make new ones, to sell and to introduce new insurance products. With such great services, it becomes easier for a customer to buy a new plan within few seconds from the comfort of your home and can also renew the existing one.

Free Health Check-Ups

To motivate all policyholders towards a healthy life, insurance companies offers free medical check-up facility once in a while. Depending on the company and the type of policy that you hold, you may be eligible for a master health check-up.

Lifelong Renewability

Lifelong Renewability is the benefit that keeps you insured for a long term. While buying a health insurance plan, pay attention to the benefit of Lifelong Renewability.

Tax Benefits

No doubt, it is a plus point of investing in a health insurance plan. On buying any insurance policy you will be liable to receive tax benefits and the same thing is here with the health insurance plan. With a health insurance policy, you will get tax advantages for the premiums under Section 80D of the Income Tax Act, 1961.

Portability

Portability offers the advantage to switch from one insurer to another. The plus point is that you don't have to compromise with the waiting period or any other features and benefits that you are receiving with the existing insurer.

Health Insurance Plans Eligibility Criteria

Before buying anything, it is important to check the eligibility criteria so that you can have an understanding about the plans and your needs.You can easily invest in the best health insurance plan just by comparing several plans online. You can go for an individual plan or can also choose a family floater. Here are the eligibility criteria:-

  • Entry age(Adults)- 18 to 65 years(Exclusive plans are there for 70 age and above)

  • Entry age (Children)- 90 days to 18 years.

  • Renew-ability- Lifelong renew-ability(varies from plan to plan).

What Should Be The Ideal Health Insurance Cover?

To define the cost of mediclaim, the cost of the same depends upon the sum assured, health history, current health conditions, age of the customer and many other things. If you are looking for a higher sum assured then you must have to pay a higher premium as well. What should be the ideal health cover is like a question for many but the answer is their within your needs. An ideal health plan will be the one which can provide the needful health cover to you on-time.

If You Own Health Insurance by Employer

In India, offering health insurance plans to its employees has already become a trend and almost every company is doing the same to motivate its employees and to make them feel secure.It also often covers hospitalization expenses of the spouse, dependent children, and parents. It's advisable to take the mediclaim irrespective of the amount covered because you don't have to pay any premium for that. Now, whether you need to take another health insurance policy will depend on a few factors. Is the cover provided by your employer is sufficient? Is the insurance company good enough? What will happen when you change jobs?

Mediclaim is provided as an incentive to employees. So it's important that you understand the insurance policy details and also check the coverage. Ask your human resource (HR) department for the details; what's covered and what's not. In many cases, employees are satisfied over the fact that their company is providing health insurance, but later found that several things are not included at all or were covered only in parts.

Example 1.- If we talk about a middle class family, a 5 lakh cover as minimum sum assured is necessary. A person can opt for family health cover and if he/she is going for a family floater then the minimum sum assured should be Rs7.5 lakh. Moreover, for extra cover, a top up plan can be bought which can be used when your basic health insurance plan's limit is crossed. A decent cover that a family should have in the urban areas is of Rs 10 lakh as sum assured.They can go up to Rs15 lakh to Rs20 lakh as required.

Example 2.- If we talk about buying health insurance with pre-existing disease then there is important to understand the seriousness of the diseases. Like how much the treatment will cost. And think about the future as well.

Like, if a heart surgery cost Rs 5 lakh today, then in the next 20 years the price will raise to Rs 80 lakh 20 years later. To deal with such scenarios, a minimum cover of 20 lacs is a need. You must go with the policy which keeps on increasing the cover on every claim free year. You must go for a top up cover to enhance your existing health insurance cover. Top-ups plans are basically cheaper as compared to others. Buy a health insurance cover at a young age and don't rely on the health insurance plan provided by the employer.

Health Insurance For Senior Citizens

Even about a decade back, mediclaim companies were unwilling to extend cover to the aged and senior citizens. But of late, several insurance companies are providing health insurance plans for parents. Insurance cover paid to an individual aged 65 years or above can lead to an additional tax relief of up to Rs 20,000. But remember that premium payable for senior citizens are much higher. If you are employed and have a mediclaim cover from your employers, approach your HR manager and negotiate with the insurance company to provide an additional cover for your parents. The insurer may provide the cover at an attractive premium because the volume will be high.

Top 5 Senior Citizen Health Insurance Plans

Insurance Company Plan Benefits Premium/Years
Religare Care Senior Co-Pay - You pay 20% of claim
Hospital Room - Single Private Room
No Claim Bonus -Rs 0.5L per year upto Rs 2.5L.
Restoration - Upto Rs 5L.
27762
HDFC ERGO Health Suraksha Gold Regain Co-Pay -You pay 0% of claim
Hospital Room - All categories.
No Claim Bonus - Rs 0.5L Per Year Upto 5L
Restoration - Yes
36470
Aditya Birla Diamond with Unlimited Reload Co-Pay - You pay 20% of claim
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.5L per year upto Rs 2.5L
Restoration - Upto Rs 5L Unlimited times
37676
Star Health Insurance Senior Citizen Plan Co-Pay - Fresh Illness : 30% For any Claims and in case of cover against PED : 50% For any Claims
Hospital Room - Upto Rs 6000
No Claim Bonus - Not Applicable
Restoration - Not Applicable
42480
ManipalCigna ManipalCigna ProHealth Plus Policy Co-Pay - You pay 0% of claim
Hospital Room - Covered up to any Room except Suites
No Claim Bonus - Rs 0.55L per year upto Rs 11L.
Restoration - Unlimited
48343

Tax Exemptions in Health Insurance

Did you know that apart from the basic medical cover, a health insurance plan do provide several additional benefits and tax benefits is one of them. PolicyX.com is here to make you understand the important benefit of buying a health insurance Policy. Below are a few circumstances to understand how you can get tax benefits with health insurance.

No one over 60 years

In case where no one in the family is over 60, the deduction is up to Rs 25,000. For health insurance paid for parents below 60, deduction is up to Rs 25,000. Hence total deduction a person can avail is up to Rs 50,000.

Either parent over 60 years

In case where one of the parents is over 60, tax benefit of up to Rs 50,000 is allowed. Also, if a person pays premium for family-self, spouse and children, enjoys Rs 25,000 as a tax deduction. This means on a total, a person can avail tax benefits up to Rs 75,000 in a year.

Eldest member in the family over 60 years

Where a family member- self, spouse or children- is over 60, one can claim up to Rs 50,000 in tax benefit on medical insurance. Additionally for parents over 60, a person can get up to Rs 50,000 as tax benefit. So, total deduction in this case would be around Rs 1 lakh a year.

For Example - Rohit is young marketing officer who is working at a reputable company and get Rs 45000 monthly as salary. He bought health insurance plan for himself and his parents who are not over 60 years. He invest very smartly in a health insurance plan and shows the same at the time of filing ITR. With the help of both health insurance plans, he managed to save Rs.50000 on tax which is a big relief for him.

How You Can Choose Best Health Insurance Policy?

To choose the best health insurance policy, you must take advantage of PolicyX.com's online comparison services. Some of the leading brands which offers health plans are MaxBupa, Bharti-AXA, Tata AIG, Apollo Munich, Star Health etc. PolicyX.com helps you compare and choose the best health insurance plan for you.

You just have to compare health insurance plans provided by top insurance companies on our website. With the basic information that you fill on our website, we will search for the most suitable health plans for you and offers the relevant quotes which make the whole process of buying health plan easier for you.

With the available free quotes, it will be easier for you to compare plans on the basis of features, cost, riders, exclusions, benefits and much more.

The level of coverage mostly depends upon the type of the medical insurance policy. A lot of companies now offer health insurance in India and therefore as a consumer, you have multiple choices from leading brands.

Steps to choose the best Health Insurance Plan

  • Visit at the health insurance quotes section of PolicyX.com

  • Put basic details in the form like your name, contact number,email Id and age.

  • Click on the tab "CONTINUE"

  • After this, you will land at the quotes section.

  • Compare quotes on the basis of features, benefits, premium, pre-existing cover, no claim bonus, company and much more.

  • You can check the brochure as well

  • Select the desired plan, and click on "BUY THIS PLAN" Tab

  • Then you will get the Policy form to fill. Under the same, you have to share your medical history, identity proof, and necessary document.

  • Then you can make payments through the online payment methods

  • And you are done- You are insured now

  • The team of PolicyX.com will instantly share policy documents over email

(Note- Medical test would be done according to the plan features and insurance company's norms).

How to Choose The Right Health Insurance Company?

As discussed above, it is important to have a health insurance policy. But don't forget that choosing the appropriate policy which can go well with your needs is also very important. A wrong policy with inadequate sum assured would be of no use. So it is always advisable to choose the right health insurance policy for yourself. For the same there are a few things that you must keep in mind while choosing the best insurance plan according to your needs. Below mentioned are a few of them that will help you in the long run.

Reputation

The reputation of the company plans an important role. It is advisable to go for a company that carries a good brand image. Word of mouth recommendation and a sound research will help you choose the right health insurance provider.

Financial Stability

It is important for you to understand that research is important before finalizing things. You must check the financial solidity of the company and you can do the same by taking the help of the Credit Rating Information Services of India Limited (CRISIL) rating. Go for a company with AAA rating as it considered to have the highest financial strength to meet its obligations.

Product Portfolio

Don't forget that insurance is a vast industry and keeps on changing by the time. It does not remain same all the time and so your needs. That's why it is important to go for a company that offers a wide range of helpful insurance policies to cater different needs of customers.

Smooth And Quick Claim Settlement Process

You buy an insurance policy for your future emergencies and there is no doubt that you expect claim on time as well. Filing a claim can be a tedious job. It is true that no one wants to go through the long claim process that includes submitting papers along with supporting documents and a long wait for approval. It will get worse if company rejected your claim. Hence, it is advisable to search for an insurance company that follow the simple and easy claim settlement process.

Customer Service

Buying an insurance is like building a new relation and thus you always need someone who can help you in hard time and can support you to clear your queries. For the same, you will need to contact your insurer's customer service centre from time to time. So, it is also important to pay attention to the quality of customer service of your insurance company. Choose the company that offers online chat, email assistance, or phone assistance.

Insurance Advisor

Insurance is tough to understand by a common person. But now many insurance companies start appointing an insurance advisor to every consumer just to provide ease. Insurance advisors will help you in choosing an appropriate insurance plan according to your needs. When it comes to claim-related queries, they can provide prompt assistance. 24/7 customer support will be there with a toll-free helpline number to resolve customer queries.

Customer Feedback and Reviews

On of the most important and common aspect. Before buying anything, you must look for the customer ratings and feedback of an insurance company. For the same, you can take the help of IRDAI website to check the number of complaints and resolutions against the insurance company.

Things to Keep in Mind While Buying Health Insurance

The best health insurance for you is something that can go well with your needs. While buying a health insurance plan there are a few things that you should keep in mind such as

Understand Your Policy

Before taking any final decision, it is important for you to understand what it would cover and what would not. Check what it offers exactly. Look for all the coverage options against pre-existing illness, accident-related expenses, day care procedures, and maternity expenses. Then, go for a plan which is enough for you and your family.

Check Exclusions

Normally people look for features and benefits, they forget that exclusions plays a much more important role as it helps you in getting a clear image that where your insurance policy wouldn't support you. You can easily get the same on your policy's documents. But people normally avoid reading it, but you should read it thoroughly. Exclusions varies from insurer to insurer and plan to plan. Some of the popular exclusions are:

  • Dental services

  • Pregnancy

  • Cosmetic surgeries

  • Injuries caused by a war, terrorism, commotion, protest, or strike

  • Joint replacement surgery

  • Homeopathy

  • Ayurveda

  • Injuries caused when under the influence of any drug/alcohol

Think About Co-Pay

While you are searching for a health insurance plan you will often get the option of Co-pay. You have to take decision whether you need it or not. For this you have to first understand what is co pay? At the time of filing claims, if you have opted for a co pay then you have to pay a pre-agreed percentage of the claim and the insurer will take care of the remaining.

You should keep in mind that the sum assured amount under the plan will not be affected by co-payments. So, before taking final decision makes sure that you need it or not.

Premium Payment Frequency

You have to renew your policy regularly to keep it active. You will get the option of paying premium either monthly/quarterly/semi-annually/annually. However, before taking final decision, check that you will be able to pay the premiums and renew the policy on time.

Claim Settlement Ratio 2017-2018

It is one of the most important things that you should look for. If you check the report online, then you would come to know that the claim settlement ratio of many insurance companies have gone up in the last few years.

It is an important thing as it shows the number of claims that an insurer has settled versus rejected. With this ratio, you will be clear in choosing the right insurance company for your health plan. Ensure that you are going for high claim settlement ratio.

Insurance Companies Claim Settlement Ratio (2017-2018)
Apollo Munich Health Insurance Company 62.47
Bajaj Allianz General Insurance Co Ltd 77.61
Bharti AXA General Insurance Company 98.50
Cholamandalam Health Insurance Company 39.96
Cigna TTK Health Insurance Company 46.29
Future Generali Insurance Company 87.42
HDFC ERGO Health Insurance 52.58
Iffco Tokio General Insurance Company 90.69
Liberty Videocon General Insurance Company 74.58
Magma HDI General Insurance Company 34.93
Max Bupa Health Insurance 50.19
National Insurance Company 115.55
New India Assurance Company 103.19
Oriental General Insurance Company 113.86
Raheja QBE General Insurance Company 18.19
Reliance General Insurance Company 106.54
Religare Health Insurance Company 51.97
Royal Sundaram General Insurance Company 61.41
SBI General Insurance Company 52.93
Shriram General Insurance Company 50.83
Star Health Insurance Company 61.76
TATA AIG General Insurance Company 60.68
United India Insurance Company 110.95
Universal Sompo General Insurance Company 104.17

Portability Option

It is normal that sometimes we are not happy with the current insurer and want to switch to other insurance company. In such cases you can take advantage of portability option. The policyholder will be allowed to switch insurer and the best thing is that he/she does not have to compromise with the waiting period or any other features and benefits which were available with the existing insurer.

Lifelong Renewability

Check for this benefit while you are buying a new health insurance plan or changing the existing one.It is normal that people look for a plan that offers protection for a long term, especially when it comes to old age. That's why the health insurance companies starts offering lifelong renewability option.

No Claim Bonus (NCB)

NCB or no claim bonus is the percentage of discount that the policyholder receive on completion of every claimless year. It motivates people to not make petty claims. Insurance companies offer this as a discount on the premium or the policyholder may choose to increase sum assured amount at the time of renewal. At the time of buying policy, look for the no claim bonus option and percentage that the company offers.

Restoration Option

Look for this feature to get most of your health insurance plan. To offer optimum use of sum assured, insurance companies these days offer sum assured restoration benefit. Under a plan with restoration option, once the sum assured amount is completely used, it gets automatically restored without paying additional cost. Health insurance plans with restoration benefits are more expensive than the regular health insurance policies.

Health Insurance vs Mediclaim Policy

People with lack of knowledge about health insurance often get confused between health insurance and mediclaim. Basically a mediclaim offers coverage for hospitalization expenses for a definite pre specified illness till a certain time as per the sum assured. Under mediclaim policy, the maximum limit for all claims is fixed at a definite amount.

It works on the principle of indemnity in which hospitalization is a specific requirement to think about any claim. Even those people who are policyholder under a mediclaim policy need to pay hospitalization expenses from their pocket and the insurer will pay them later. Under a health insurance policy, policyholders will get the comprehensive coverage that will cover pre and post hospitalization as well.

The policyholder can also get coverage on ambulance charges, compensation for lost income, etc, but that all depends upon the riders associated with the health insurance policy. The upper limit of a health insurance policy can go as far as Rs 60 lakhs. Normally, health care policies also offer discounts on a regular basis over a definite period of time.

There is also a difference between health insurance policy and mediclaim on the basis of tax deduction. Health insurance premium paid towards a health insurance policy provides a tax exemption under section 80D of the Income Tax Act, the funds paid towards mediclaim premium paid for self or spouse or children are appropriate for tax exemption of Rs 15,000 under section 80D.

Health Insurance Portability

Usually, we have seen that many policyholders looks for better coverage or better insurance company for various reasons. Sometimes they are not happy with the current insurance company, sometimes, the plan doesn't looks sufficient enough, sometimes the needs are more, affordability can be an issue or else attractive towards any other health insurance plan can be one of the reasons behind the change. Almost all health insurance companies do allow you to change the insurer and plan at the time of renewal. Yes, at the time of renewal you can opt for any other insurance plan provided by any other insurance company and this is known as health insurance portability.

Health Insurance portability is a simple format under which the insured is free to change the insurance company and the plan. With the same he/she doesn't have to compromise with the existing benefits, waiting period and bonus. He/she can carry the same with the new insurance company as well. It seems to be an effective procedure which is helping millions of people on a daily basis in getting sufficient health insurance plan or you can say a wider cover at affordable premiums. There are many ways to porting your health insurance plan, but the online health insurance comparison seems to be the best when. The reason behind the same is that

  • You will get free insurance quotes from top insurance companies

  • Multiple options to choose from

  • Can compare easily from a single page

  • Comparison can be done on the basis of features, benefits, price, coverage and many more are there in the list

  • Can buy directly from the page in a few minutes

  • Less documentation & Hassle free process

Pros & Cons of Portability

Pros Cons
Portability allows a person to avail better health insurance plans in terms of coverage, benefits, and much more. He/she can modify the health insurance plans as per their health conditions/requirements. Person can take advantage of portability at the time of renewal only.
On switching to a new one you become entitled to Sum Assured and cumulative bonus which you are getting in the current one. There will be no compromise with the same Policies and features vary from insurer to insurer, so you need to opt for the new insurer very carefully
You can make sure about better claim settlement from all the companies while you plan to change your insurance company The new insurance company can reject the policy keeping in view your medical history and claim.

"Porting has never been so easy before"

Why Health Insurance Comparison Is Important?

With the growing awareness about health insurance, many insurance companies have come up with the several and irresistible options of health insurance. The needs of a health insurance plan may vary from person to person and that's why a single plan can go well with all of your requirements. To deal with such scenarios, insurance companies have come up with so many effective health insurance plans. But to choose the best out of all is again a daunting task. So that's why it is important to compare all available plans before buying the desired one.

We have seen that many people do make inappropriate health insurance investment that completely doesn't go well with your needs. What people usually do, they keep their focus at the premium of the plan rather than the features. To get a low premium plan, they end up with the inappropriate health insurance policy. And some people buy the costly one which is also a waste.

  • You should compare health insurance policies to get the best one out of all

  • You should do the comparison to keep yourself protected against unwanted deals

  • You should compare health insurance to understand how much you actually need

  • You should compare to save your time and money

Why Go For The Online Comparison?

Well, if you are thinking of comparing health insurance by visiting offices one by one, then let me tell you it will make things worse. By visiting offices physically and standing in the long queues just to attain information is not a smart choice. It will take so much of your time and energy as well. Moreover, in this era where you can have almost everything at your doorstep, moving out for the same will not be a wise decision. You must take the help of an online insurance web aggregator such as Policyx.com for the same.

The benefits of choosing an online comparison site are unlimited such as unbiased quotes, ease to compare, hassle-free buying process, comfort, saves time and money etc.

There is no doubt in saying that in today's world health insurance has become a necessity and everyone is looking for an effective yet affordable health insurance plan. There are multiple plans to select from but to get the best out of all is still a task. Thus to help you with the same, here we are.

PolicyX.com assists you entirely in getting free quotes and provides free comparison services. We at policy X.com do not charge any kind of money from users. We have tie-ups with the top insurers in India and hence we are able to provide free quotes easily to you on a single page.

You can get complete information about the plans and products on our portal. PolicyX.com is a one-stop shop for all your insurance related needs. So start the comparison of health insurance and get the best health insurance plan in India.

Why Compare Health Insurance With PolicyX.com?

It is true that there are many portals which can provide health insurance policy. But here at PolicyX.com, we are assisting you with free insurance quotes and comparison services. We are not charging for the same and do not ask for any type of commission as well.

Teams at PolicyX.com make sure that you are getting the best deal within your budget and you are away of fake promises and products. We try to provide the easiest buying process. We provide a hassle-free comparison process. Our systems and teams are well equipped to help you with the whole buying procedure from starting to the end.

Through our portal we just try to help you with the required information so that you can compare plans wisely

Here are a few points to make you understand why PolicyX.com is best for health insurance comparison:-

  • PolicyX.com is the leading and most trusted online insurance web aggregator.

  • It is an IRDA registered portal that follows the norms of IRDA for accurate reliable comparison service.

  • PolicyX.com offers free comparison service.

  • PolicyX.com provides plan comparison from leading brands such as Religare Health, Max Bupa, Bharti Axa, Tata AI, Apollo Munich, Star Health, etc.

  • Allows insured to buy the desired plan from the comforts of home in a few minutes by filling up the online proposal. Most of our health plans are online and you can get your policy instantly by making an online payment.

  • Allows insured to compare health insurance plans from over 10 companies within 30 seconds: You can buy the best health insurance policy according to your needs in 5 minutes .

Some Important Terms of Health Insurance

Here are some of the important terms that you will come across while subscribing to a health insurance policy.

Sum Assured

The sum assured, in simple terms, is the maximum coverage amount you get with your insurance policy. It forms the basis of all your claims. Consider the increasing costs of hospitalization, medicines, and treatment before you decide on your sum assured. It's advisable to select a higher cover. At the same time, the cover shouldn't be high enough for you to dig into your pockets for paying the premium.

Copay and Sub-Limits

Copay is a fixed amount paid by a patient to the provider of service before receiving the service. Some health insurance companies have introduced the co-pay and sub-limit system to prevent hospitals from billing unreasonable room rents to patients. In a co-pay policy, you need to pay a part of the expenses irrespective of the sum assured. For instance, if a policy has 10% co-pay, then the insurance company will pay 90% of the expenses and you have to bear the rest.

Besides, some insurers cap the expenses of treatments to reduce the claims of hospitals. This is known as sub-limit. While buying a mediclaim, choose a policy which has fewer sub-limits. Some mediclaim policies have no co-pay or sub-limits. Try to select such a plan.

Critical Illness

Critical illness refers to life threatening diseases. THere is a long list that comes under this section such as heart attack, kidney failure, cancer, and many more.

Restore Benefit

The restore benefit refers to a feature of the plan that reinstate your basic sum assured, if you have already exhausted the same as well as the multiplier benefit within your policy year. But in most cases, the benefit is not available on the same illness if the limit is already used up.

But a restoration benefit can be useful if you have subscribed to a family floater plan where the full sum assured is exhausted for treating only a single family member. The remaining members will have no cover to fall back upon in case of hospitalisation for the rest of the policy year.

No Claims Bonus (NCB)

No Claim Bonus, as the name suggests, is the insurance company's reward to the policyholder for not making a claim in the preceding years.

Insurers usually extend a NCB to a policyholder if there has been no claim in the preceding year. While buying a mediclaim, check the NCB amount before signing on the dotted lines. NCBs can range from 5% to even 100% of the sum assured. A high NCB gives cover against medical inflation and you don't need to worry about increasing your coverage year-on-year.

Pre-existing illness, Waiting Period

Pre-existing diseases refers to those diseases that you have before subscribing to the mediclaim policy. Most health insurance companies specify a waiting period for these illnesses. If you have a pre-existing illness, the insurance company is unlikely to give a cover against the same. In most cases, a pre-existing illness is covered after at least two years of buying the policy.

Exclusions

It simply means the diseases that are not covered under the mediclaim. For instance, if you suffer from diabetes while taking the policy, then kidney ailments are likely to be excluded from cover if the same happens because of the diabetes. Never hide any pre-existing ailments from your insurer while buying a mediclaim policy. It may reduce your hospitalization claims.

Top up Plans

A top-up health policy is an additional coverage for people who have an existing individual plan or a mediclaim from the employer.

Medical costs are increasing. It calls for large covers. But not all can afford a high premium. A top up plan can come useful in such a case. It reduces cost of deductibles i.e. the amount you pay before the insurance company pays up. The insurance company will only pay up to the sum assured. A top up plan, on the other hand, doesn't pay until the hospital bill breaches a specific limit.

Suppose, if the hospital bill is Rs. 8 lakhs with Rs 3 lakhs as deductible, you need to pay the latter, while the insurer pays the balance Rs 5 lakhs. But you can use your individual/group policy to pay the deductible amount. This is usually helpful because combination of a basic mediclaim plan along with a top up plan is much cheaper than a single cover. For instance, premium for a Rs 5 lakhs regular cover for a 26-year old male, will be around Rs 6,500. A top up with Rs 15 lakh cover will entail an additional premium of Rs 5,000, which is far cheaper than a standalone policy of identical amount.

Mistakes to Avoid While Buying Health Insurance Plan Online

There is no doubt in saying that choosing the right insurance company for your health insurance needs is a daunting task. Today, all internet facilities and several options of health insurance plans have made it easy for a person to buy the same in a few seconds, but this doesn't mean that you should become an impatient buyer.

Just because of our busy schedule and the long list of terms and conditions, we should not skip the same in a rush to make a decision. But, we are making a mistake while buying a health insurance plan. One of the common mistakes that people usually do and you should avoid are as follows:-

Insufficient coverage

Don't go for insufficient cover just because of low premium, it will not be able to provide the desired cover in the hour of need.

The cost that people pay towards his/her health insurance plays a vital role in deciding which policy you should go for. Hence, just because of saving an amount, people end up in choosing a plan with less coverage or you can say insufficient coverage. It is true that cost plays an important role in choosing a health insurance plan but it should not be the only element that you are looking for.

Avoiding the fine print

While many of the individuals are aware of different treatment and expenses that will get the needful cover under your health insurance policy. There is no doubt in saying that having an idea about the coverage area of your health insurance plan but you should not skip the exclusions part of the same. It is equally as important as knowing the coverage part.

Don't rely on single insurer or plan

Don't go with the first insurer that you got. While buying, or renewing the existing health insurance plan it is vital for you to understand that comparison of several plans will help you in getting the best and most suited plan which can easily go well with your needs.

If you get something better than your existing health insurance plan then you should switch the insurer without any hesitation. There are many companies that are offering exciting health insurance plans just to remain at the top and to attract consumers from time to time. Just take advantage of the same and get yourself enrolled in the most suited plan according to your needs and budget.

Hiding medical history

This is the most common mistake that people usually do and this becomes the biggest reason behind the rejection of health insurance claims by the insurer. While looking for a health insurance plan it is very important to be transparent about your medical history, don't hide anything and let your insurer know about all your medical problems in advance.

Not choosing co-pay wisely

If you do not choose copay wisely then you amy end up in the wrong situation at the time of claim. Tere can be a chance of rejection, you might have to pay a big amount from your pocket, not able to get the required coverage and several others.

Buying Over

There is no need of buying many additional riders if you don't need it. Purchasing too many extra riders will only lead you towards the stage of over policyholder. Spend a few minutes on understanding your needs first, write it down and then go for a plan that can easily go well with your needs. Make sure you are not over-policyholder.

Delay in Buying

If you delay in buying health insurance then you might have to pay a high premium, not liable of wider cover, and much more. Moreover, what will you do in foy fall ill with a serious health diseases before buying it. Invest in health insurance as soon as you can. The older you get, the less will be the options to explore as not all insurance companies will be ready to entertain you.

Rely on Insurance Offered by Employer

Don't rely on employer's health insurance for a comprehensive cover. It would not be sufficient enough to get the required treatment on time. There is a possibility that you might be getting health insurance coverage by your employer but it is not necessary that it would be sufficient for you as it is not customized as per your needs. You should also keep in mind that the health insurance coverage that you must be getting from your employer will stop once you changed the company. It is always necessary to opt for a supplemental health insurance plan that would be enough for you. You can also use your employer's health insurance plan to make a claim and enjoy no-claim bonus on your personal health insurance plan.

Health Insurance Claims Settlement Process

There is a term called TPAs and mostly people are aware about it but they don't know how it actually got settled. Once a mediclaim policy is sold, the TPA takes up the baton from insurance company. Some companies offer direct claim settlement process and some take help of TPAs For claims settlement.

Broadly the claim settlement process takes place in two forms which are mentioned below

Cashless

You can avail cashless treatment facilities only in the networked hospitals of the insurance company. The TPA must be notified beforehand in case of a planned hospitalization, or within a specified timeframe in case of an emergency. The hospital's insurance desk helps with all the paperwork. The TPA has to approve the mediclaim amount and the hospital will settle it with the insurer. There are likely to be exclusions i.e. expenses that the TPA won't pay. Such expenses must be settled by the patient party directly at the hospital cash counter.

Reimbursement

The insurer can avail the reimbursement facility both at networked and non-networked hospitals. Here, you can avail treatment facilities and settle the bill directly with the hospital. You can then claim reimbursement of the expenses from the TPA by submitting the relevant bills and receipts.

Steps to Follow- Cashless

  • Inform the insurance provider on a call or through email.

  • Show the health card as provided by your health insurance company along with the identity proof.

  • The hospital will examine the identity of the policyholder and will submit the pre-authorization form to the health insurance company.

  • Insurance company will examine all documents and if everything is fine according to their norms then it will process the claim.

  • A few health insurance companies provide a field doctor to help you with the whole procedure.

  • After the completion of all formalities, the claim is settled as per rules of the company

Steps to Follow- Reimbursement

  • Inform the insurance company about your hospitalization as soon as possible

  • Keep all your documents ready with the bills of hospitals.

  • Submit the documents along with the claim forms. Don't forget to attach bills of hospitals.

  • The insurance company will check all the submitted documents and process the claim according to the terms and conditions of the health insurance policy.

  • After the completion of all formalities, the claim is settled as per the terms and conditions of the policy.

Top Health Insurance Schemes By Government Of India

The government of India is focusing on increasing healthcare awareness and thus for the same, it came out with several new plans for the people of the country. They are basically designed to improve the healthcare access for the unorganized sectors and for those who come under the Below Poverty Line (BPL) category. Here is a list of health insurance schemes provided by the government:

Ayushman Bharat

One of the most effective National Health Protection Scheme which is offering the required health cover to almost 10 crore poor and vulnerable families. It is designed in a way that can offer required cover to around 50 crore beneficiaries. A cover of around 5 lakh rupees per family per year for secondary and tertiary care hospitalization will be there. This effective health programme will subsume the current centrally sponsored schemes - Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

Rashtriya Swasthya Bima Yojana (RSBY)

The Ministry of Labour and Employment introduced a new health protection scheme just to provide the helpful cover just to offer the needful health insurance coverage especially for BPL families. With this effective healthcare plan, all beneficiaries can avail hospitalization whenever it requires of up to Rs.30,000. To enroll under this effective health insurance plan, there is no specific age limit and you will be liable to get the cover of pre-existing diseases from day 1 of the policy. It can cover up to 5 members of the family includes spouse, children, and dependents. Beneficiaries have to pay only Rs.30 as registration fee. The central and state government to the insurance company will take care of the rest unpaid premium.

Pradhan Mantri Suraksha Bima Yojana

The universal fact is that accidents are unfortunate incident which can happen at any place, anytime to anyone. It does not discriminate against people on the basis of rich and poor. In such a scenario, the one who suffers the most is the poor section of the society, who are unable to afford an effective and adequate health insurance policy. To provide the needful assistance to the poor section, the government has come out with this effective health insurance plan called Pradhan Mantri Suraksha Bima Yojana. It offers wider cover at affordable premiums and provide compensation to the family of the deceased or if the policyholder has been disabled partially or permanently following an accident.

Central Government Health Scheme (CGHS)

It was introduced a long time back ago and since its inception it is providing great assistance. It is now available in CGHS covered cities like Allahabad, Bhopal, Chandigarh, Ahmedabad, Lucknow, etc. The plan is basically designed to cover central government employees and pensioners. UNder the same, the dependants member of the government employee would also be able to reap the benefits of this plan.The insurance policy provides coverage against domiciliary care, specialist consultation facilities, laboratory tests, hospitalization, and health education to beneficiaries.

Aam Aadmi Bima Yojana (AABY)

A social security scheme launched in October 2017 with an aim to provide required healthcare facilities to all the rural and landless households. The head of the household or the earning member of the family will be covered under the scheme. The central and state government will pay premium of Rs.200 per year is paid by the central and state government. The beneficiary should be between 18 to 59 years of age. With the same beneficiary will receive Rs.30,000 upon natural death of the policyholder member, Rs.75,000 upon accidental death or permanent disability, and Rs.37,500 on partial permanent disability.

Janashree Bima Yojana (JBY)

This insurance policy was launched in 2000 on 10th August after replacing the Social Security Group Insurance Scheme (SSGIS) and Rural Group Life Insurance Scheme (RGLIS). This policy is specially designed for those people who come under the BPL category and slightly above BPL category in 45 occupational groups covered under the scheme. Some of the occupations that would be liable to get the cover are Beedi workers, carpenters, power loom workers, cobblers, handicraft artisan, agriculturists, construction workers, etc. Aam Admi Bima Yojana and Janashree Bima Yojana have been merged into one scheme and called as Aam Admi Bima Yojana since 2013.

Employment State Insurance Scheme (ESIS)

Again a social security scheme that is designed especially to offer the socio-economic protection to the working class and their dependents. The policyholder and his family who will receive complete medical care from day one. Under the policy, the beneficiary will receive cash benefits in times of sickness and temporary or permanent disablement that leads to the loss of earning capacity. This policy will also be covered by the policyholder's dependents as if the dependant is disabled on the job, a monthly pension called the dependents benefit is provided under the ESI scheme. The scheme is applicable to non-seasonal factories, theatres, shops, restaurants, hotels, road motor transport undertakings, and newspaper establishments employing more than 20 people. Recently, private medical and educational institutions employing more than 20 people in certain states and union territories have also been included under the scheme.

Universal Health Insurance Scheme (UHIS)

A new health insurance plan that is py-1 font-15 specially designed to provide needful healthcare services to a wide area of the country and to cover poor section effectively. Under this plan, beneficiaries will receive reimbursement for medical expenses up to Rs. 30,000 and accidental death cover up to Rs. 25,000. This policy is there for the BPL families only. The insurance premium for this scheme is Rs. 200 per person, Rs. 300 for a family of 5, and Rs. 400 for a family of 7. The four public sector/government health insurance companies in India are The New India Assurance Co Ltd, United India Insurance Company, National Insurance Co. Ltd, and Oriental Insurance.

Health Insurance FAQs

Before buying health insurance, we are sure you must be having a lot many questions in your mind. Do not worry as we at PolicyX.com are here to help you figure out the best insurance policy for you.

1. What is health insurance?

As the name implies, health insurance is a type of insurance which covers your medical bills. It's also popularly known as mediclaim in India and is a contract between an insurer and a person or a group of individuals, where the insurer pledges to provide specific medical insurance cover, against a fixed amount of "premium", which is usually paid annually.

2. What forms of health insurance are available in India?

The most popular form of health insurance policy available in India is the one that covers expenses incurred in case of hospitalization. However, several other products are available from various insurance companies that offer an exhaustive range of health covers, depending upon the choice and need of an individual. The insurer, in most cases, directly pays off the hospital (known as cashless facility). It may also reimburse the cost associated with injuries or illnesses or disburse a fixed amount on occurrence of an illness. The amount and type of healthcare costs to be provided by the insurer under the plan is specified in advance in the offer document.

3. Why is Medical insurance important?

Every individual must buy a health insurance policy for all the members of his/her family, according to need and capacity. Subscribing to Medical insurance will cover you from sudden and unexpected cost of hospitalization, and other serious health issues, like critical illness. Not having a health insurance policy could hugely impact your income and household savings, and may even land you in debts.

All of us are exposed to different types of health hazards. Medical emergencies are known to strike sans any warning. Healthcare, at the same time, has become increasingly expensive. New procedures, technological development, and better medicines have triggered a rise in the cost of healthcare. These expenses are beyond the reach of most of us, and buying a health insurance policy is much more affordable, to pay off the medical bills.

4. What type of health insurance plans is available today?

Health insurance is available for Rs 50,000 of sum insured in case of micro-insurance policies to as high as Rs 50 lakhs or even more than that in case of some critical illnesses. Most insurance companies offer health covers between Rs 1-5 lakhs of sum insured. With cabin rent and other costs payable by insurance companies being increasingly linked to the sum insured, it's advisable to take an adequate cover as early as possible, especially because the sum insured may not be increased in the event of a claim. Besides, while most Medical insurance policies are for a one year duration, there are schemes that cover for up to five years as well. Longer duration policies are also available. A hospitalization policy either covers partly or fully the treatment cost incurred because of hospital admission during the policy period.

There's also a wider coverage that includes expenses both before and after hospitalization. Such policies are usually available on family floater basis, or individual basis. In the former, the sum insured is spread over the family members. Another scheme, the hospital daily cash benefit policy, extends a daily fixed sum of money for each day in hospital. There could also be a higher daily benefit cover for some specific illnesses or ICU admissions.

A critical illness policy extends a lump sum amount when an individual is diagnosed with a particular illness. The amount is used to pay off several direct and indirect monetary consequences because of a critical illness. The plan ceases to be in operation once the lump sum is paid off.

5. What is cashless mediclaim?

These days, most insurers have arrangements with various hospitals spread across the country as part of a network. An individual, if policyholder under a policy which offers cashless facility, can get treated in any hospital of the network without paying hospital bills because the same is paid directly by a third party administrator (TPA), on behalf of the insurer. However, all expenses beyond the sum insured or the ones not covered under the policy, have to be paid by the policyholder directly to the hospital. Cashless facility is not available if the hospital is not included in the network. In such cases, payment by the insurance company to the hospital, is usually carried out on reimbursement basis.

6. What are the tax benefits of health insurance?

You can claim several tax benefits if you subscribe to a health insurance scheme. Such benefits are extended by section 80D of the Income Tax Act. Presently, subscribers to a health insurance, who purchased the policy by a payment mode other than cash, are eligible for Rs15,000 annual deduction from their taxable income for payment of health insurance premium for self, dependent children, or spouse. The deduction is higher for senior citizens at ?20,000. Also, since the 2008-09 financial year, an additional deduction of Rs15,000 can be claimed for mediclaim premium paid for parents. It's Rs20,000 if parents are senior citizens.

7. What factors affect the premium payable for a health insurance policy?

Age is the biggest factor which determines the premium payable. The older you are, the higher will be your premium, because you'll be more prone to illness. Your medical history is another factor that will go into determining the premium. If you don't have any medical history, the premium would be naturally lower. You are eligible for a discount on further premium payable for the years for which there has been no claim of the insurance money. Some insurance companies cover add-on benefits like free medical checkups and/or diagnostic tests in case of no claim.

8. What are the things not covered under a health insurance policy?

Read the offer document/prospectus and understand it fully before signing on the dotted lines. What's not included will be clearly written in the prospectus. Any pre-existing illness, usually, is not covered under a policy. But read the offer document to understand what the insurer means by pre-existing illness. Also, the majority of the policies generally exclude certain types of diseases in the first year of coverage. A waiting period is also often imposed on such diseases. Some expenses not covered under most health insurance policies include cost of contact lenses, spectacles and hearing aids, dental surgery (unless it requires hospitalization), general debility, convalescence, venereal disease, congenital external defects, use of drugs and alcohol, intentional self-injury, expenses for diagnosis, AIDS, X-ray and/or laboratory tests not connected with the illness requiring hospitalization, treatment related to pregnancy or childbirth, including C-section, naturopathy treatment and others as deemed exclusive by the insurer.

9. What about the waiting period?

As already said, there is usually a 30-day waiting period when you buy a new policy, starting from the day you enrolled in the health insurance scheme. During this period, the insurance company won't pay any hospitalization charges. But this is not applicable in case of an emergency hospitalization arising out of an accident. The waiting period is not applicable for renewal of the policy for subsequent years.

10. What is a pre-existing condition?

It's a medical condition or ailment that existed before you took the health insurance policy. This is a significant point in all policies because insurers don't cover such conditions within 48 months prior to taking the first policy. It means a pre-existing condition may be considered for payment, only after the completion of 48 months of continuous insurance cover.

11. If I don't renew my policy before the expiry date, can I be denied renewal?

The policy can be renewed if you pay your premium within the grace period, which is usually 15 days from the date of expiry of the policy for most insurance companies. However, you will not be entitled to any coverage for the period during which the insurance company did not receive any premium. Also, the policy would lapse if premium is not paid within the grace period.

12. Is my health insurance policy transferable, sans losing renewal benefits?

Yes. According to a circular issued by the Insurance Regulatory and Development Authority (IRDA), with effect from 1 October, 2011, the insured can transfer a policy from one insurer to another, and also from one plan to another. The insured will lose no renewal credit for pre-existing health conditions which he/she enjoyed in the incumbent policy. But the credit would be limited to sum insured and the bonus eligible under the present policy. Check with your insurance company for the detailed clauses in this regard.

13. What happens to the coverage amount when a claim is filed?

Once an insurance claim is filed and settled, the coverage gets reduced by the amount paid on settlement. For instance, if you take an Rs5 lakh mediclaim policy in January, and in April, the insurance company pays? 3 lakhs towards your hospitalization and treatment, then you will be eligible for the balance Rs2 lakhs as coverage for the remaining duration i.e. May to December

14. What about "any one illness"?

This means a continued period of illness and includes relapse within a specified number of days, subject to the terms and conditions written in the policy. It's usually 45 days.

15. How many claims are allowed in a year?

There's no limit to the number of claims in a single year, unless there's a specific cap laid down in the policy. The sum insured, however, is the maximum claimable limit under the mediclaim policy.

16. What is a family floater?

In a family floater scheme, a single policy covers the hospitalisation expenses of the entire family. Such a policy has only one sum insured which can be utilised by a single or all members collectively in the family. The limit of coverage is capped at the sum assured. Family floater plans are considered better than buying a separate health policy for each member of the family. It takes care of all medical expenses including surgeries, sudden illness and accidents.

17. What is a health checkup facility?

Some insurance companies reimburse general health checkup expenses usually once in every four years.

Latest Health Insurance News

Mental Ailments to be a Part of Health Insurance Now

November 12, 2018

Mental Healthcare Bill 2017 has a positive impact on the health insurance company. IRDAI has passed new rule for the inclusions of all mental illnesses as a part of health insurance plan. With the increase in the rate of mental ailments, this reform was much needed. This will force many people to buy a health insurance plan for themselves. As per the National Mental Health Survey 2016, almost 15% Indian population suffers from depression that is close to 150 million people. Out of this section, most of them are in the age group of 30 to 49 years. Amidst worsening situation of mental health, access to the right treatment is what a mental patient need.

The inclusion of mental illness in the health insurance plan can provide patients with much-needed access for the right treatment. Latest Health Wellness Survey highlighted the preference of many people for seeking mental wellbeing to lead a stress-free life. With the inclusions of mental ailments in the health plans, they can get access to psychologists and counselors which may be beyond the reach of many because of their exorbitant cost now. People can expect a customized solution for any sort of mental illnesses. This new amendment in health insurance is expected to curb mental illness growing at a rapid rate. Above details were shared by Ashish Mehrotra, Managing Director & Chief Executive Officer – Max Bupa to the Financial Express team.

IRDAI Permits Health Insurance Sector to Standardize Disease Exclusions

November 05, 2018

According to the latest amendments in the Insurance Regulatory and Development Authority of India (IRDAI) health insurance industry is permitted to exclude certain pre-existing diseases. Some of the diseases that can be excluded are Epilepsy, Stroke, Chronic liver diseases, Kidney diseases, Hepatitis B and a few others. Recently IRDAI has made it mandatory to include a few diseases such as Alzheimer, Parkinson disease, AIDS, Morbid Obesity etc.

However, if these diseases are pre-existing than it can be excluded as well. In case of non-disclosure of any pre-existing disease, there’s a waiting period of 4 years. Currently, the waiting period is of 2 years, but insurance companies got the authority to lay a hiatus of up to 8 years as well. The proposal made by IRDAI is subject to review on an annual basis.

Ayushman Bharat Marching Ahead With Coverage of One Lakh Beneficiaries

October 23, 2018

Within a span of just one month time after its launch Ayushman Bharat has got 1 lakh people covered under its umbrella. Ayushman Bharat- Pradhan Mantri Jan Aarogya Yogna (AB-PMJAY) is a revolutionary nationalized health insurance plan launched for rural Indians and selected urban population. Its primary motive is to cover people under the poverty line and helpless Indians. Prime Minister Shri Narendra Modi announced this plan almost one month ago i.e. on 23rdSeptember 2018.

His vision of introducing this useful health insurance plan is to cover at least 50 crore people. This health insurance plan has no cap on the age and size of the family. The plan is designed to include more women and older people in the family. The scheme was launched on 23rd September in Ranchi; Jharkhand by the Prime Minister. It was proposed way back on the eve of 72nd Independence day by our honorary Prime Minister Narender Modi.

AB-PMJAY assures to facilitate sum insured of Rs. 5 lakh per family. The objective of this plan is to provide an affordable hospital for the poor. A 46th old person from Rewa, MP complete the counts of one lakh beneficiary for AMPMJAY plan. The latest beneficiary got admitted in Vindhya Hospital and Research Center for the treatment of Posterior Cervical recently.