Health Insurance is an important investment for every individual as it not only secures you and your family from any medical care expense but also ensures that you have access to the best medical facilities like hospitalization expenses, doctor consultations, day care procedures, and other medical bills that are almost impossible to bear without a good health insurance plan. Additionally, in case you are diagnosed with a critical illness it will further drain your savings disrupting your financial strength. Read this article further in order to explore health insurance plans, benefits of medical insurance and more.
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Health Insurance plans are systematic contracts between insurers and customers that offer financial coverage for various medical care features like hospitalization, day care procedures, health management and wellness programs, and more. Health Insurance plans offer two different types of claims such as reimbursement and cashless claims for all individuals. Let us understand this with an example:
Mr. Ramesh holds an insurance plan from XYZ health insurance company and is hospitalized in a network hospital due to an accident. He files a claim from XYZ insurance company within the allowed time and the company provides a cashless claim settlement and pays the bill directly to the hospital.
Mr. Akash holds an insurance plan from XYZ health insurance company and is hospitalized in a non-network hospital due to an accident. He pays the hospital bill out of his pocket, gets discharged and then files a claim from XYZ insurance company within the allocated time along with all the bills and documents. The xyz company goes through the documents and provides a reimbursement claim.
A fixed premium plan that offers coverage up to 3 Lakhs and offers protection against the expenses incurred during OPD and hospitalization.
Coverage for HIV/AIDS
Genetic Disorders covered
Internal Congenital Diseases covered
Arogya Plus Plan (Pros)
Up to 7.5% discount
Pre & Post Hospitalization
141 Daycare Treatments
Arogya Plus Plan (Cons)
Injury Due To Illegal Activity
Injury Due To Hazardous Activities
Adventure Sport Injuries
Arogya Plus Plan (Other Benefits)
Arogya Plus Plan (Eligibility Criteria)
Entry Age - 3 Months
Max Entry Age - 65 Years
SI - 1 L to 3 L
Waiting Period - 30 Days
Eligibility Criteria of Health Insurance
The eligibility criteria of a medical health insurance across insurers are as follows:
Minimum: 18 Years Children: Newborn to 25 Years Maximum: 65/70 Years
1 L to 6 Cr
Pre-Policy Medical Check-Up
Not Applicable up to a certain age which varies from insurer to insurer.
Benefits of Health Insurance
There is a common misunderstanding that purchasing health insurance is a waste of money as most people think they are healthy and do not require a health insurance plan. However, there are multiple benefits of health insurance plan that must not be neglected that are mentioned below
Avail Best Medical Care
Individuals usually neglect purchasing a health plan but they must realize investing in a medical insurance policy will ensure your loved ones with the best medical care facilities from hospitalization coverage to critical illness cover. Coverage for hospitalization expenses, room rent, ICU, AYUSH treatments, modern treatments are all covered under a mediclaim insurance policy.
Covers Daycare and Modern Treatments
Investing in a health insurance plan will ensure that you are covered for daycare procedures that take less than 24 hours of hospitalization such as cataract, dialysis, radiotherapy and more which, when paid out of pocket, will amount to a large part of your savings. Additionally all modern treatments that require the latest technology are covered under a health insurance plan.
Critical Illness Cover
Many times families have a genetic history of critical illnesses like cancer, heart ailments, neurological ailments, and others. Purchasing a health insurance plan along with rider benefits like critical illness only safeguards you against expensive treatments for these diseases.
Under section 80 D of the Income Tax Act, individuals are promised a tax benefit of up to INR 1.5 Lakhs when investing in a mediclaim policy.
Additional Cover Apart From Employer Insurance
Many individuals consider having employer health insurance to be their primary health insurance plan. However, that should not be the case. As you exit your job, the benefits of the health insurance provided by the employer will also no longer be applicable. Hence purchasing a good health insurance plan ensures additional security apart from the health cover provided by the employer.
Importance of Health Insurance Plans In India
One of the most common questions individuals ask themselves when making a purchase decision is “Do I really need a health insurance plan?” or “Is it really important?”. Let us decode the importance of health insurance plans which in turn will help you make a better purchase decision.
Will Help You With Medical Inflation
Health insurance is more expensive today than it was 5 years ago. With rising lifestyle related health ailments the cost of healthcare is on a constant rise. Investing in a health insurance plan will help you deal with medical inflation safely without the need to break your bank or pull funds out of your pocket.
Protect Your Family
With a vast pool of health insurance plans available in India you have the flexibility to opt for the best one for yourself and your family. With additional cover-ons, rider benefits, and premium payment options, health insurance companies have made sure that individuals in India invest confidently in health insurance plans and avail of the best medical facilities.
Get Treated At the Hospital Of Your Choice
Investing in the best health insurance plans will ensure that you can opt for the best treatments in the hospitals of your choice. With a long list of network hospitals associated with health insurance providers, you can opt for the hospital of your choice.
Fixed Rewards And Bonuses
If you are someone who purchased a health insurance plan but have not made a single claim throughout the tenure of your health plan, the insurer will reward you with a no-claim bonus. No-claim bonus will provide you with additional sum insured value at the time of policy renewal.
Peace Of Mind
Investing in the best mediclaim insurance policy not only safeguards your finances but also gives you the satisfaction of cashless hospitalization which means that in case of emergencies when you do not have the resources of paying for your medical bills, your health insurance plan will be your saviour.
Health Insurance Plan In India Tax Benefits
Purchasing a medical insurance plan not only ensures safety and security of your loved ones but also gives you the power of saving tax. Investing in any kind of insurance be it life, term or health is an efficient financial tool for most people in India. Unfortunately, many people are still oblivious to the fact that health insurance plans can save them up to INR 1.5 Lakhs. Insured individuals can save tax under section 80D. Any insurance holder is entitled to this tax rebate for health insurance plan premiums paid for self, spouse, parents, or dependent children. You can save up to INR 25,000 if you are paying premiums for self, partner, dependent children, while for parents aged less than 60 years, an additional exemption of INR 25,000 is available. However, if your parents are aged above the age of 60 years you can avail of a tax rebate of up to INR 50,000.
How To Compare Health Insurance?
Before purchasing any health insurance plan it is necessary to consider some deciding factors or compare one health insurance provider with the others to make an informed decision. We have listed down below some of the comparison factors that you must consider before purchasing a health insurance plan
What To Look At?
How Will It Affect?
Claim Settlement Ratio
Claim Settlement Ratio of a health insurance plan provider is the clear indication of how many claims have been settled in a financial year against the number of claims filed by the customers. The higher the claim settlement ratio the more reliable a company is.
Network hospitals are a major deciding factor for any health insurance plan purchase as it ensures that you will be able to avail of the best medical care in a health facility of your choice. If a health insurance provider does not have good hospitals or the hospital of your choice in their network hospital list, it can be a factor of concern and you may want to rethink your purchase decision.
Rider Benefits and Add-on Covers
When comparing health insurance plans make sure you compare the available riders and add-on covers. You as a customer should have the flexibility to avail of additional riders and covers as per your needs and requirements at minimal additional premium charges.
Although most health insurance plans have a set standard of waiting periods for PEDs, Specific illnesses and more, you must opt for mediclaim insurance that offers benefits with a minimal waiting period.
There are multiple health insurance plans that apply mandatory co-pay which means that you will have to pay some amount out of your pocket at the time of treatments availed. It is essential to consider co-payment as a major deciding factor before purchasing a health plan.
Pre-Policy Medical Check-up
Before investing in a mediclaim policy make sure to check with your provider if the insured individual needs to undergo a pre-policy medical check-up and if they will reimburse the amount for the same.
Why Compare Health Insurance Plans Online in India ?
Every individual must compare health insurance plans online before investing as it saves time, money, and efforts. Here's why comparing health insurance/medical plans online is the way to go.
Quick glance at policy quotes for free: Before you invest money in any insurance plan you should get to know the health insurance premium for a particular policy. Free quotes are available on PolicyX as well as on the insurer's website.
Understand plan features: Take the time out to check the features and quotes of a health insurance policy on the internet on your smart devices. This helps you to save your precious time wasted in visiting an agent's office to buy or select a health plan.
Make confident decisions: After gaining the necessary information available online, you can go through inclusions and exclusions, compare, and find the best match.
Benefits of Comparing Health Insurance Online
Listed are the benefits of spending some time researching online and comparing health plans before buying them.
Buy the best health insurance plans: An individual understands their health risks and future possibilities and hence prepares accordingly to secure themselves and their loved ones. This is how you make an informed decision and buy what you need rather than buying what you are sold.
Find plans worth your money: When you aim to buy the cheapest health insurance plan you miss out on essential features and coverage that a good health insurance plan offers. Comparing health insurance plans online helps you find a plan that balances not only your health needs but also your health requirements.
Analyze health insurance plans to your satisfaction: Analyzing all the factors in a health insurance plan online such as room rent, waiting period, claim process, and more gives you a sense of satisfaction before buying the plan.
What to Keep in Mind When Comparing Health Insurance?
The following pointers play a significant role when you select a health insurance plan. Make sure you go through all these factors when comparing a health insurance plan for yourself:
Adequate amount of sum insured: This refers to the maximum amount that the insurer will cover for you. Very often, a policy that provides a low premium might also offer a low SI. Before you get insured make sure you choose an adequate sum insured to provide you with assistance in time of need.
Coverage provided by an insurer: It is something that goes beyond the sum insured. It comprises of the inclusions and exclusions in a health insurance policy along with the sum insured.
PAN India network hospitals: While comparing a health insurance plan you must go through the list of network hospitals provided by the insurer. It is essential to invest in a plan that provides PAN India network hospitals for maximum efficiency in any case of emergency.
Co-pay clause in a policy: A co-pay clause in a policy indicates that you have to contribute towards claim settlement. A co-pay has an upside as it reduces the policy premium by sharing the burden of claim settlement between you and the insurer.
Add-ons and riders: Many times insurers provide additional features as a part of a comprehensive health insurance plan which can, in turn, make insurance premiums expensive, which is why you must choose your add-ons carefully while comparing health insurance plans.
How Many Types Of Health Insurance Plans Are Available?
Health Insurance plans are available in various forms and one can opt for one as per their unique needs. We have mentioned below the various formats of health insurance plans available to the customer.
These policies are bought by an organization for their employees or members and are paid by the employer only.
There are other health insurance plans like disease specific plans that cover Vector borne diseases, Corona and more, personal accident plans, daily hospital cash plans, along with others.
Health Insurance Plan Inclusions
There are various questions a customer must ask before purchasing a health insurance plan regarding what will be covered, sum insured available, discounts and other facilities. Let us understand more about the coverage provided by health insurance plans to its customers.
Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy treatment are covered.
Surgeries using modern technology such as robotic surgeries, stem cell therapy, etc. are covered.
Health Insurance Plan Exclusions
In the previous segment we discussed all the features that are provided by a health insurance plan. However, it is also necessary to understand the exclusions under a mediclaim insurance policy that are mentioned below:
War - Any injury or health hazard caused due to the involvement in war activities/ terrorism/ invasion or more.
Breach of Law - Criminal intent/ self-injury/ or attempted suicide are all activities that are not covered under a health insurance plan.
Substance Abuse - Any medical conditions created due to substance abuse such as over consumption of hallucinogens/ alcohol or drugs are not covered under a health insurance plan.
Cosmetic Surgeries - Cosmetic procedures like laser hair removals, skin peels, micro-needling and plastic surgeries (if not prescribed after an accident) are not covered under health insurance.
Health Insurance Riders
Health Insurance riders are additional features that are opted by the insured individual to enhance the base coverage of a health insurance plan. We have mentioned below the riders available with health insurance plans
Personal Accident Rider
It offers a lump sum amount to the policyholder or their nominee in case they suffer from partial/total disability or die due to an accident
Critical Illness Rider
Critical Illness riders offer a lump sum amount to the policyholder on the diagnosis of a critical illness such as cancer, kidney failure, brain surgery, heart attack, or more listed ailments in the policy.
Daily Hospital Cash Rider
The reduction in waiting period rider offers the insurance holder a reduced waiting period for most PEDs. For example without the rider if a PED was covered after 4 years, with the Waiting period rider it will be covered after 2 years.
OPD riders cover medical expenses incurred due to doctor’s consultation fee, X-rays, ECGs, and other diagnostic tests, medicine bills and more.
PED Coverage From Day 1 Rider
PEDs like diabetes, hypertension, and asthma are covered from day 1 on purchase of the PED rider.
Factors To Consider While Health Insurance Plan Purchase
Ensuring the safety of your loved ones and yourself is a decision one must make after considering all aspects of a medical insurance policy. Selecting a health insurance plan is not an easy task. It must be tailored to perfection and customized as per your health care requirements. Here are some factors that must be considered before purchasing a medical insurance policy:
An essential factor when purchasing a medical insurance policy, more network hospitals ensure easier availability of hospitalization no matter where you are. Easy cashless claim settlements are also available when you are admitted in a network hospital. So, choose a plan which is offered by a health insurance company with the largest network of hospitals.
Type of Health Insurance Plan
If you are someone who does not have a lot of liabilities, you can select an individual health insurance plan but if you are someone with a family you must opt for a family floater health insurance policy. Similarly, if you have a family history of critical illnesses like cancer, heart ailments or any other you must opt for health insurance plans with CI coverage.
When purchasing a medical insurance policy it is essential to consider the sum insured amount provided under the plan. It is among the most important deciding factors when purchasing a medical insurance policy. The ideal sum insured suggested by most health insurance companies to its customers is 100% of your annual income.
Health Insurance plans offer a multitude of features such as hospitalization expenses, room rent, domiciliary hospitalizations, day care procedures, AYUSH treatments and more. Before purchasing a health insurance plan you must ensure that all the coverage features required by you and your family are covered in the policy and opt for the best medical insurance policy.
Claim Settlement Efficiency
When purchasing a health policy it is of utmost importance that you understand the claim settlement ratio of a company. A good claim settlement ratio is proof that when in need your medical insurance policy will provide you with a smooth claim settlement process. Claim Settlement process is a clear indication of the number of claims received by an insurance company and the number of claims settled in a financial year. A good CSR is anywhere above 90%.
Health Insurance Plan Average Cost In India
There are various factors that affect the premium rates of a health policy. Given the fact that the concept of nuclear families is on the rise and on an average a family includes 4 members, a health insurance policy premium depends on various factors like age, number of family members, sum insured chosen, riders or add-on covers, and more. On an average a sum insured of 10 L for a family of 4 may cost them around 15,000 to 25,000 per annum if they opt for an annual payment mode. In order to determine the premium charges of a medical insurance policy you must keep in mind the following factors:
Health Insurance plans are available for 1/2/3 years and this time period is known as policy tenure or policy term. Once you opt for a policy term, it will be renewed after the tenure is over. Premium charges of a policy will also increase with the increase of policy tenure. However, many health insurance plans offer long term discounts if you purchase a health insurance policy for a longer period of time.
Medical Condition of the Insured Individual
Most health insurance plans in India are flexible and do not require a pre-policy medical check-up. However, many health insurance plans have conditions applied to them which states that after a certain age of 45 or 50 years individuals have to undergo a pre-policy health check-up. In case you are diagnosed with any medical condition after the pre-policy medical check up the premiums will be affected accordingly.
Riders and Add-On Covers
When purchasing medical insurance, make note of the riders or add-on coverage options that you require for yourself and your family. Riders or add-on covers are additional coverages at a minimal additional fee. There are various riders like personal accident riders, critical illness riders, hospital cash riders, and more.
Sum Insured Chosen
Health insurance plans in India provide insurance holders with holistic coverage and a high sum insured. There are multiple insurance providers that are providing medical insurance with a sum insured as high as INR 6 crores. Opting sum insured that suits your demands and needs is the key factor in deciding the average cost of your health insurance and how much you will spend on the same per annum.
The zone or city that you stay in is a major deciding factor for the average cost of health insurance. If you are someone who lives in Tier 1 cities such as Delhi, Mumbai, Bangalore, Calcutta and so on it is possible that the health insurance premiums will be expensive as compared to tier 2 & 3 cities.
Offers you financial protection in the face of any medical emergency and also helps you with planned hospitalization expenses.
Many times health insurance plans are not claimed and the user might feel that the premiums paid are wasted. However, you get a no-claim bonus for filing no claims during the policy tenure.
You can avail treatments in the best healthcare facility as health insurance plans have a long list of network hospitals.
Many times you may not find your choice of hospital in the list of network hospitals provided by your health insurance plan, which is why it is important to opt for a health insurance plan with all factors in mind.
Health and wellness management is an additional feature of health insurance plans that help insured individuals to stay in shape and prevent any major health ailments by offering preventive health check-ups, giving reward points for taking part in marathons and more.
Your health insurance plans might get rejected if you have a major pre-existing illness and did not have a health plan before getting diagnosed with the same.
Insurance holders can avail tax benefits of up to INR 1.5 Lakhs under section 80D of the Income Tax Act.
There are multiple exclusions within a health insurance plan such as infertility treatments, HIV/AIDS treatments, injuries or illnesses due to war/terrorism and more
Investing in a health insurance plan offers you the flexibility to customize the plan as per your needs and requirements with riders and add-on covers of your choice, premium payment terms of your choice, sum insured, and other factors
Many times health insurance providers reject your application due to your area of residence. There are many pincodes in the country that are not granted health insurance plans or it is difficult for residents of those cities/villages to acquire health insurance plans
Health Insurance Renewal
All health insurance plans are valid for a tenure of 1/2/3 years post which the policy needs to be renewed. It is important for insurance holders to renew their health policy on time so that the coverage offered by a mediclaim insurance policy does not get lapsed. Most health insurance providers offer a simple renewal process that can be fulfilled online/offline as per the convenience of the insured individual. Simply visit the official website of the health insurance provider you purchased your policy from and fill in your policy number and pay your premiums in order to enjoy continued coverage and benefits.
How To Port A Health Insurance Plan?
Most health insurance providers offer you the benefit of porting your health insurance policy . IRDAI announced health insurance portability benefit in the year 2011 wherein the customer can carry forward all the benefits and coverage features to another health insurance provider without any compromise. It is the same concept as taking your old phone number from one network provider to the other without changing your existing phone number. You can apply for health insurance portability 45 days prior to your current health plan expiring. There are certain documents that will be provided to you to commence your health insurance plan portability that are mentioned below
Policy Portability Form
Proposal Form for New Policy
Current Health Insurance Documents
Proposal Acceptance Letter
Documents Required When Purchasing Medical Insurance
When purchasing a medical insurance you will need a few documents readily available such as:
Proof of Identity
In order to purchase a health insurance plan it is essential to submit your proof of identity such as
Voter ID Card
Proof of Address
You will have to offer the insurance providers with a proof of address while purchasing a medical insurance which includes
Proof of Age
One of the most essential documents is the proof of age which can be provided by giving the following documents
Voter ID Card
Common Myths related to Health Insurance in India
Online Health Insurance is the most sought-after solution for the Indian population yet it is one of the most misunderstood financial products which stems from a lack of knowledge and understanding about insurance in general.
Below listed are a few common myths about health insurance policies, and the reality behind them.
Health Insurance is not needed when I am young and healthy, I will think about it when I am old!
The truth is that when an individual is young and healthy it is the best time to compare health insurance and buy the best option available. Young insurance holders can get coverage at an affordable premium because the risk of getting hospitalized at a young age is minimal.
The best health insurance policy is the one that is cheap!
Individuals make their insurance buying decision based on the premium. While it is fine to buy health insurance with a low premium, you must be aware that such policies have restricted offerings and may not be able to provide you with adequate coverage according to your needs.
I am a smoker. I can not buy Health Insurance.
Most health Insurance providers are concerned about pre-existing medical conditions. If you are a smoker and have suffered from any medical condition due to smoking you must disclose this as a pre-existing medical condition. The insurance providers may charge a higher premium but they will not deny health cover.
My health insurance benefits will be void if I do not renew the health insurance on time.
This is in fact one of the most common myths when individuals purchase Health Insurance. It is of utmost importance that you renew your health insurance every year before the due date to maintain the continuity of health benefits. However, every insurance provider has a grace period of 30 days wherein you can renew your policy.
My employers have provided me with Health Insurance, I do not need to buy another one.
Multiple organizations do provide employees with health insurance, however, don't ignore the importance of having individual health insurance. Even though corporate policies are useful, they might not extend cover to your aged parents/dependents. In addition to that, your policy will only be in effect till the time you are employed with the organization.
How To Claim Health Insurance
One of the most important aspects of a health insurance plan is the claim settlement as many people have this question of "How to claim Health Insurance?”. There are two types of claim settlement process which customers can avail of. In order to understand the difference between cashless and reimbursement claim settlement and how to claim health insurance refer to the table mentioned below
Cashless Claim Settlement
Reimbursement Claim Settlement
Cashless claims are settled between the hospital and the health insurance provider directly during the time of discharge. You do not have to pay anything out of pocket.
Reimbursement claims are settled after the insured individual has been discharged from a non-network hospital. You are required to submit all the necessary documents to the insurer in order to avail the reimbursement of your hospitalization bill.
How to claim?
Inform your insurer about the treatment availed and submit your e-card, identity proof, and pre-set forms.
After availing of treatment, you must collect all of the important documents like hospital bills, prescriptions, and more. Once you acquire your documents fill the reimbursement claim form and submit it to the insurer along with the documents acquired.
Claim Settlement Process
You do not need to be involved directly after reaching out to the TPA and submitting your policy card and form as the bill is settled directly between the hospital and the health insurer
You must pay for your treatment out of pocket and file for a reimbursement claim which the insurer will reimburse.
Claim Process Duration
Cashless Claims are settled instantly and do not take any extra time for your convenience
Reimbursement claims are initiated after the treatment and require you to submit all the necessary documents which is why reimbursement claims take 2 to 4 weeks
Claim Settlement Approval
You must inform the insurer 72 hours prior of a planned hospitalization and 24 hours post an emergency hospitalization.
In case of reimbursement claims there is no requirement of any approvals. The insured individual can simply avail of the treatment and file for a reimbursement claim later. However, it is best to check if the treatment is covered by your plan.
Policy Card, Pre-authorized form provided by the TPA.
Identity Proof, Age Proof, Residential Proof, Hospital bills, doctor prescription, and more.
How To Purchase A Health Insurance Plan From PolicyX?
Purchasing a health insurance plan is an easy and hassle-free process for any individual. Follow the steps mentioned below in order to avail of the best health insurance plans with quotes which will help you make the best purchase decision.
Step 1 Visit the official website of PolicyX
Step 2 Click on "Buy Now"
Step 3 Fill in all the necessary details such as the number of family members you want health insurance cover for and your age and click on "View Plans"
Step 4 Select your city and click on "Proceed"
Step 5 Further fill in your name and mobile number and click on "Get Free Quotes"
Step 6 You will be directed towards a list of health insurance plans wherein you can compare the plans of your choice and pay for the one you want as per your needs and requirements
Step 7 Fill in the important details before purchasing a health insurance plan like date of birth, gender, tenure, city and calculate the premium for your desired health insurance plan.
Health Insurance Glossary
In-patient hospitalization refers to the hospitalization required for the insured individual for more than 24 hours which can go up to several months. In-patient hospitalization differs to daycare procedures as they are procedures that require hospitalization less than 24 hours.
Daycare procedures such as cataract surgery, dialysis, and others are listed as daycare treatments that requires hospitalization for less than 24 hours.
Expenses incurred during doctor visits, diagnostic tests, X-rays, ECGs, Pharmacy but do not include hospitalizations.
Accidental and Total Permanent Disability
Disabilities caused due to accidents, be it permanent or partial are covered under health insurance plans.
Expenses such as doctor’s consultations, medical investigations and cost of medicines prescribed by the physician for the ailment or injury, before you are hospitalized, are covered in this cover. The extent of time for which health plans cover such Pre-hospitalisation costs is usually 30 days or 60 days, depending on the company’s coverage policy.
Expenses mentioned in pre-hospitalization are the same as post-hospitalization. Health plans usually cover such expenses for up to 60/90/120 days after the discharge from the hospital, depending on the company's coverage policy.
Organ Donor Cover
Organ transplant necessitates two people: insured recipient and organ donor. Treatment expenses of the recipient will be fully paid for up to the sum insured, but coverage for donor's expenses varies from insurer to insurer.
Add On Covers/Riders
Riders and add-on covers are additional coverage options that increase the financial coverage for your base health insurance plan. Some of the most common health insurance riders are Critical Illness rider, personal accident rider, Pre-existing Illnesses Covered from Day 1 Rider, Co-payment rider, Reduction of Waiting Period Rider, and more.
Top-up health insurance plans are health insurance plans that can be bought in addition to the base health insurance policy. Once the sum insured amount of the base health insurance plan is exhausted, a top-up plan comes into action and covers the cost of your treatment.
Waiting period is the fixed time period set by the insurance provider before your health insurance policy is activated and allows you to avail of the coverage features. Usually, health insurance plan features can be availed after 30 days of purchase. The initial waiting period in most health insurance plans is 30 days.
Free Look Period
Insurance plans provide a free look period during which the insurance holder can cancel their health insurance policy after purchase without paying any cancellation charges or penalties.
Grace Period refers to the extended period of time that is offered to insurance holders after the last date of policy renewal has been crossed. The extra time given to policyholders to renew their health policy after the due date is known as grace period
All health insurance companies have a tie up with a set of hospitals that are known as the network-hospitals. Insured individuals can avail of treatment in these network hospitals and raise cashless claims wherein the hospital bills are settled directly between the insurance provider and the hospital without any interference of the insured individual.
The maximum amount that an insurance provider will pay the insured individual in case of any illnesses, injuries incurred due to listed reasons.
A person who has paid for a health insurance plan and is bound by a legal contract to be protected against any medical expenses incurred due to accidental injuries or illnesses.
The health insurance company or provider that is bound by a legal contract to pay for the medical expenses of the insured individual incurred due to accidental injuries or illnesses.
Health Insurance News
An adventure enthusiast? Buy ‘ManipalCigna Accident Shield’
ManipalCigna Health Insurance has recently launched a comprehensive plan for all the adventure seeking customers and offers coverage for accidental death, permanent total disablement, and permanent partial disablement. The sum insured of the plan can go up to 25 crores and comes in 3 variants. The plan also offers a 200 percent of the sum insured as a claim benefit in case of accidental death and permanent total disablement. It also comes with OPD coverage so that the minor injuries are also covered.
ManipalCigna highlights significance of health insurance during festivals via 2 films
ManipalCigna Health Insurance has released 2 films dedicated to the importance of health insurance. The films are released during the festival of Diwali to remind the audience how important it is to safeguard our well-being while we celebrate our favorite festivals.
While the first film talks about how health insurance ensures that “the blessings of Lakshmi stay within our households, safeguarding our family’s health & lifetime goals”, the second one is a tribute to all the health insurance advisors who have guided the customers on their insurance buying journey.
Health Insurance: FAQ's
1. How to select the best health insurance plan?
There are various factors affecting health insurance plan selection such as:
Customer Care Services
Claim Settlement Ratio
2. Are there any discounts and rewards available when purchasing the best medical insurance policy?
Yes, there are multiple health insurance providers that offer multiple discounts on premiums on certain conditions such as a good health discount for individuals who have excellent health vitals, discounts for females and non-smokers, discounts for long term policy, and more.
3. What is the correct age to invest in a health insurance policy?
It is advised to purchase mediclaim insurance at a young age as it drastically affects your premium prices and provides you with an extended coverage. The earlier you invest in a health insurance policy the lower are the premiums as there is a lesser risk of developing any health issues.
4. Are pre-policy medical check-ups mandatory before purchasing a health insurance plan?
No, most health insurance plans do not require the insurance holder to undergo a pre-policy medical check-up. However, most medical insurance policies have a certain age limit up to which there is no need for a pre-policy medical check-up. The usual age is up to 45 years but varies depending on insurer to insurer.
5. Can I include my children in a family floater health insurance policy?
Yes, you can include your kids in a family floater health insurance policy right from day 1 up to the age of 20 to 25 years varying from insurer to insurer.
6. What is the ideal mediclaim insurance sum insured required by a policyholder?
In order to fulfill the medical care needs for yourself and your family it is best to select 100% of your annual income as the sum insured amount for the health insurance plan you purchase.
7. What is not covered by the health insurance plan?
There are multiple exclusions associated with your mediclaim insurance. The various conditions that are excluded are:
Injuries due to act of war and terrorism
Hospitalization or injuries due to substance abuse and intoxication
Injuries caused due to adventure sports
Sterilization and Infertility Treatments
8. What are the coverage benefits offered under a health insurance plan?
There are various coverage features provided to insurance holders under health insurance plans like
Pre and Post Hospitalization Expenses
9. What are the various bonuses and discounts available to customers when purchasing a mediclaim policy?
Multiple discounts and rewards are enlisted within the health insurance plan which you can avail when purchasing health insurance plans like:
No Claim Bonus
Female Policyholders Discount
10. How will smoking affect the premiums of my health insurance plan?
It is common knowledge that people who smoke are prone to serious health ailments like bronchitis, asthma, and even lung cancer. Hence, health insurance plans are available to smokers at high premiums as they are a bigger liability on the health insurance providers.
11. What are the various riders available under Health Insurance Plans?
The various riders available with health insurance plans are
Critical Illness Rider
Daily Hospital Cash Rider
Personal Accident Rider
Global Coverage Rider
Reduction in waiting period Rider
PED coverage from day 1 rider
12. Can I port my health insurance plan?
Yes, insurance holders can port health insurance plans from one insurance provider to the next 45 days before their existing policy expires. To do the same you simply have to submit a few documents
Policy Portability Form
Proposal Form for New Policy
Current Health Insurance Documents
Proposal Acceptance Letter
13. Can I add riders in the middle of my health insurance policy tenure?
Insurance holders can add a rider of their choice and availability during the time of purchase of the plan, or during the time of renewal. However, adding a rider in the middle of the policy tenure is not available.
14. What is sum insured of a health insurance plan?
Sum insured means the maximum amount that the insurance provider will pay you in case you are diagnosed with an illness, or are hospitalized due to any injury or accident. It is the maximum amount that you can claim in case any medical emergency or planned hospitalization arises.
15. Can an individual purchase more than one health insurance plan?
Yes, individuals can have more than one health insurance plan. For example many individuals in India who are salaried employees already have a health insurance policy through their employer. However, if they want to avail additional coverage, they can purchase a super top up or top up health insurance plan.
16. What are the various documents required for purchasing a health insurance plan?
You do not need any particular documents at the time of purchase of a health insurance policy. However, it is essential to showcase documents at the time of filing a claim like
17. Can I increase the sum insured amount of my health insurance plan?
Yes, if you feel that you have additional responsibilities and your current sum insured amount can not fulfill your requirements you can ask your health insurance provider to increase the sum insured at the time of renewal. However, with increased sum insured the premiums will also be increased.
18. What do I do in case I am unable to renew my health insurance plan at the date of renewal?
Health insurance providers offer a grace period during which insurance holders can pay their renewal premiums in case they have missed their renewal due date.Your health insurance policy along with the benefits it offered will be lapsed in case you miss the grace period.
19. Are there any discounts available during the policy renewal?
Yes, there are many advantages and discounts you accumulate during the entire policy period that can be beneficial to you during policy renewal. In case you have not applied for any claims during the entire policy period, you are entitled to a no-claim bonus which means your sum insured amount will be increased at the time of renewal. You may also be eligible for family discounts and long term discounts if you opt for long term policy tenures.
20. Will my health insurance policy lapse if I do not renew my policy on time?
Yes, your health insurance policy will lapse in case you do not renew your policy on time and you will lose all the benefits incurred throughout the policy.
21. How can I file a claim if I am admitted to a non-network hospital?
You can file a reimbursement claim after you have availed a treatment in a non-network hospital. Once you complete the course of your treatment, you can file for a reimbursement claim by filling a form and submitting documents related to your treatment and any other documents asked by the health insurance provider.
Simran is an insurance expert with more than 3 years of experience in the industry. She may have all the answers to your insurance queries. With a background in Banking, she proactively helps her readers to stay on par with all the latest Insurance industry developments.
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