- Definition
- Types of Health Plans
- Benefits of Buying Health Insurance
What is Health Insurance?
Health insurance is your safety net for any medical emergency and planned medical expenses. You pay the premiums every year and you will get coverage for years to come. It is a contract between a company and the consumer. This coverage typically includes hospitalisation costs, doctor visits, surgeries, and prescription medications. Health insurance provides financial security and peace of mind, ensuring that individuals can access necessary medical care without facing overwhelming financial burdens. Not only individuals, but you can also cover your entire family under a family floater health insurance plan.
To learn more about health insurance, visit here
traordinary Facts
To promote the importance of health insurance globally, the UN has added Universal Health Coverage (UHC) by 2030 to their Sustainable Development Goals (SDGs). The motto is to encourage ‘promotive, preventive, curative, rehabilitative and palliative’ healthcare services among all global communities.
What Are The Types of Health Insurance Plans in India?
There are seven types of health insurance plans in India. These different types of health insurance are made to meet the different needs of individuals. Have a look below to understand more about each type of health insurance plan.
Individual Health Insurance Plans
As the name suggests, under an individual health insurance plan, you can only cover one person. It is the most common type of medical insurance sold in India. You need to pay a minimal amount as a premium and get coverage for a lifetime. Under these policies, you can get coverage for pre and post-hospitalisation, OPD, ICU, second medical opinion, e-consultation, etc.
Family Health Insurance Plan
A family health insurance plan covers the family as a whole under one sum insured. So, you can buy this family floater plan to cover your parents, wife, kids, and siblings. However, you will get a higher sum insured under a family floater health plan, accordingly the premiums will also be on the steeper side. You can get coverage for AYUSH treatments, modern treatments, maternity, childbirth and vaccination, etc. Some family health plans also offer global coverage including air ambulance.
Senior Citizens Health Insurance Plan
Senior citizen health insurance plans are specialised health plans that give coverage to individuals who are above 60 years old. Senior citizens are more prone to health ailments which is why premiums are usually higher than other health insurance plans. Under this plan, you can get tax benefits of approx. Rs. 75000 under Section 80(D) of the Income Tax Act.
Critical Illness Health Insurance Plan
This plan is specified for diseases like cancer, kidney failure, heart attack, and others. A critical illness plan offers you a lump sum amount if you are diagnosed with the listed critical ailments. So you need to read the policy documents for this list.
Maternity Health Insurance Plan
Maternity health plans are specifically designed for women. It covers delivery expenses, pre-natal, post-natal, newborn baby medical care expenses, vaccinations, and much more. It is a good idea to invest in a good maternity health insurance plan if you are going to start a family.
Also, read the top 5 maternity health insurance plans to know about top-selling maternity health plans in India.
Group Health Insurance Plan>
A group health insurance plan covers a group of people from the same organisation, cooperative group, or members from the same group. Mostly it is opted by the employers for their employees.
Top Up Health Insurance Plan
A health insurance plan is like a supplement to your main health insurance plan. Top Up health insurance plan will come in handy when your base policy is exhausted.
Do you know these also super top-up health insurance plan that falls under the same category? Read here the difference between super top-up and top-up health insurance plans.
Benefits of Buying Health Insurance Plans
There are several benefits of buying health insurance plans in India:
Financial Protection
Health insurance acts as a safety net against unexpected medical expenses. It covers a significant portion of your healthcare costs, such as hospitalization, surgeries, doctor’s fees, and medications, preventing you from depleting your savings or incurring debt.Access to Quality Healthcare
Health insurance provides access to quality healthcare services, including renowned hospitals, specialists, and advanced medical treatments. It ensures that you receive timely and appropriate medical care without compromising on quality due to financial constraints.Tax Benefits
In India, health insurance premiums are eligible for tax deductions, reducing your overall tax liability and providing additional financial savings.Preventive Care
Many health insurance plans offer coverage for preventive care services, such as regular checkups, screenings, and vaccinations. This encourages proactive healthcare and early detection of potential health issues.Cashless Hospitalization
Most health insurance plans offer cashless hospitalization facilities, allowing you to receive treatment without upfront payments. This streamlines the hospital admission process and reduces financial stress during a medical emergency.Coverage for Pre and Post-hospitalization Expenses
Comprehensive health insurance plans often cover expenses incurred before and after hospitalization, including diagnostic tests, medications, and follow-up consultations. This ensures comprehensive care and a smooth recovery process.
Like a coin has two sides, health insurance also has some cons. Read here to learn about the pros and cons of health insurance plans.
Why Do I Need A Health Insurance Plan?
Having health insurance is like having a sword in this battle of life. Medical emergencies can happen without intimation. Here are some reasons why you need health insurance.
To fight against financial inflation
As you know health care costs are increasing day by day. You will get more patient-friendly facilities that can increase the expenses. Without the protection of health insurance, you might have to spend out of pocket which can drain your lifetime savings.You will get a good facility
if you have a health insurance policy. When you are ill, you need complete and quality care that can be costly. But insurance can save you, by covering the cost of healthcare and sometimes, related expenses.Health insurance can be helpful in any medical emergency
An emergency can happen at any time, health insurance gives you security during these challenges.Suffering from chronic diseases
For those who are suffering from chronic diseases like asthma, hypertension, or diabetes, health insurance can be your safeguard during medical visits and chronic disease management
How to Choose the Best Health Insurance Plan?
Choosing the best health insurance plan involves careful consideration of your individual needs and circumstances. Here are some key factors to keep in mind:
Coverage
- Comprehensive Coverage: Ensure the plan covers a wide range of medical expenses, including hospitalization, surgeries, doctor’s fees, medications, and diagnostic tests.
- Specific Needs: Consider any specific medical conditions you or your family members have and choose a plan that provides adequate coverage for those conditions.
- Pre-existing Conditions: If you have any pre-existing conditions, check the waiting period for coverage and any exclusions that may apply.
Sum Insured
- Adequate Coverage: Choose a sum insured that is sufficient to cover potential medical expenses, taking into account rising healthcare costs and future needs.
- Top-up Plans: Consider a top-up plan to increase coverage beyond the primary policy’s limit.
Network Hospitals
- Preferred Hospitals: Check if the plan has a wide network of hospitals that includes your preferred healthcare providers.
- Cashless Hospitalization: Ensure the plan offers cashless hospitalization facilities at network hospitals for a hassle-free experience
Premium
- Affordability: Choose a plan that fits your budget without compromising on essential coverage.
- Compare Premiums: Compare premiums from different insurers to find the most competitive rates.
Waiting Period
- Pre-existing Conditions: Check the waiting period for coverage of pre-existing conditions.
- Maternity Benefits: If you are planning to start a family, check the waiting period for maternity benefits.
Claim Settlement Ratio
- Reliable Insurer: Choose an insurer with a good claim settlement ratio, indicating their reliability and efficiency in processing claims.
Policy Renewability
- Lifetime Renewability: Opt for a plan with lifetime renewability to ensure continuous coverage throughout your life.
Add-on Covers
- Optional Benefits: Consider adding optional covers like critical illness cover, personal accident cover, or maternity benefits to enhance your protection.
Customer Service
- Responsive Support: Choose an insurer with excellent customer service and a responsive claims process.
Read the Policy Document
- Understand Terms and Conditions: Carefully read the policy document to understand the terms, conditions, exclusions, and limitations of the plan.
Bottom Line
Health insurance is a crucial investment for individuals and families in India. By understanding the different types of plans available and carefully considering your specific needs and budget, you can choose the best policy to safeguard your financial well-being and ensure access to quality healthcare in times of need. Remember to review your policy regularly and make adjustments as your needs evolve.
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What is Health Insurance?: FAQs
1. What is the difference between a health insurance plan and a medical insurance plan?
Usually, these both can be used interchangeably. However, health insurance usually refers to the broader coverage that includes preventive care, wellness programs, and sometimes even mental health services, whereas medical insurance primarily focuses on covering medical expenses like hospitalization, surgeries, and doctor visits.
2. What is the difference between individual and family floater health insurance plans?
Individual plans cover only one person, while family floater plans cover a family under a single sum insured, usually with a higher overall limit.
3. What is the waiting period in health insurance?
The waiting period is the time frame after policy inception during which certain conditions or procedures may not be covered. Common waiting periods include pre-existing conditions, maternity benefits, and specific surgeries.
4. Does my health insurance cover dental expenses?
Dental coverage is usually an optional add-on and not included in standard health insurance plans.
5. Does my health insurance cover alternative therapies like Ayurveda or homoeopathy?
Coverage for alternative therapies varies by plan. Some plans may offer limited coverage, while others may not cover them at all.
6. What is the difference between a room rent limit and a sub-limit?
The room rent limit sets a maximum daily allowance for hospital room charges. Sub-limits restrict coverage for specific expenses like ICU charges, surgical procedures, or specific medical conditions.
7. How do I file a health insurance claim?
Claims can be filed online, through the insurer’s website or app, or by submitting the required documents to the insurance company.
8. What documents are required for a health insurance claim?
Common documents include hospital bills, discharge summaries, doctor’s prescriptions, and medical reports.
9. How long does it take for a health insurance claim to be processed?
Claim processing times vary depending on the complexity of the claim and the insurer’s efficiency. Most cashless claims take 2-4 days to be completely processed.
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Written By: Simran Saxena
An explorer and a curious person, Simran has worked in the field of insurance for more than 3 years. Travelling and writing are her only passion and hobby. Her main agenda is to transform insurance information into a piece that is easy to understand and seamlessly solves the reader’s query.
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