Health Insurance
Health Insurance is a contract between the policyholder and the insurer where the health insurance company provides financial coverage to the insured up to the sum insured limit. It offers medical coverage for healthcare expenses incurred during an emergency or planned hospitalization. It also provides tax savings on the premium paid to the insurance company under Section 80D of the Income Tax, 1961.
Health Insurance buying checklist
Waiting Period
You should buy a health insurance policy with a minimal waiting period. The lower is the waiting period, the sooner you will be able to avail coverage. You should go through the policy terms & conditions carefully and check the waiting period before buying a policy.
Preventive Health Check-up
You must choose a health insurance plan that offers free preventive health check-up facilities every year. With this benefit, you don’t need to pay for annual medical examinations. You can check the policy benefits while buying to know about preventive health check-up facilities.
Restore Benefits
You should purchase a health insurance plan that offers 100% restore benefits. With restore benefit, your sum insured amount will be fully restored as soon as it gets exhausted after a claim. You can check the policy documents to know if the restore benefit is available
Sub-limits
You should buy a health insurance plan that comes with no sub-limits. Without sub-limits, you will be free to raise a claim up to the sum insured amount. You can go through the policy wordings to find out about any applicable sub-limits under the health plan.
Co-payment
You should opt for a health insurance plan with no co-payment. Without co-payment, you will not have to make any out-of-pocket expenses for each claim. You can check the policy documents to know about any applicable co-payment before buying the policy.
Natural Calamity
Any damage to the insured property due to any natural calamity such as storms, typhoons, etc. is covered under the policy.
Grace Period
You should buy a health insurance policy that offers the maximum grace period. A bigger grace period gives you more time to renew your policy after the due date has passed. You can read the policy wordings to find the exact grace period available under the policy.
Top Reasons to Buy a Health Insurance Plan
Medical inflation is increasing every day making treatments expensive. If you get hospitalized for a critical illness or lifestyle disease, you may end up losing all your savings. The only way to afford quality medical treatment during a health emergency is by buying a health insurance policy. Take a look at some of the top reasons to buy a health insurance plan below:
Beat Medical Inflation
A health insurance policy can help you pay your medical bills, including pre and post-hospitalization expenses, today as well as in future despite the rising medical costs.
Afford Quality Medical Treatment
It helps you to afford the best quality medical treatment and care so that you can focus only on getting cured.
Fight Lifestyle Diseases
It allows you to pay for the long-term treatment of lifestyle diseases like cancer, heart attack, etc. that have been on the rise with the changing lifestyles.
Protect Your Savings
It helps you to protect your hard-earned savings by covering your medical expenses so that you can avail the required treatment without any financial worries.
Avail Cashless Hospitalization Facility
It allows you to obtain a cashless hospitalization facility at any of the network hospitals of your insurance provider by raising a cashless claim.
Get Tax Benefits
It enables you to save tax on the health insurance premium that you’ve paid under section 80D of the Income Tax Act for better financial planning.
Ensure Peace of Mind
It allows you to obtain medical treatment with peace of mind as you do not have to worry about paying the hefty hospital bills.
Key Benefits of Health Insurance Plans in India
Health insurance plans offer a variety of health benefits to the insured depending on the plan. Following are the key benefits of buying a health insurance plan in India:
Hospitalization Expenses -
A health insurance plan covers the medical expenses incurred on getting admitted to a hospital for more than 24 hours. It includes room rent, doctor’s fee, medicine cost, diagnostic test fees, etc.
Pre & Post Hospitalization Expenses
It covers the medical expenses that you may have incurred on an illness before getting hospitalized as well as follow-up treatment expenses incurred after getting discharged. The pre-hospitalization and post-hospitalization expenses are covered up to a fixed number of days as specified in the policy document.
ICU Charges
A health insurance plan also covers the cost of availing treatment in an ICU during hospitalization.
Ambulance Cost
It covers the cost of ambulance services availed to reach the nearest hospital during a medical emergency.
Cashless Treatments
All health insurance providers in India offer cashless treatment facilities at their network hospitals. You do not have to worry about arranging money to pay the hospital bills if you get admitted to a network hospital as it will be settled by your insurer under cashless claims.
Get Tax Benefits
It enables you to save tax on the health insurance premium that you’ve paid under section 80D of the Income Tax Act for better financial planning.
Day Care Procedures
It also covers the cost of availing day care treatment that requires hospitalization for less than 24 hours.
Ayush Treatment
It covers the cost of availing medical treatment through AYUSH school of medicines that includes Ayurveda, Unani, Homeopathy, Siddha and Yoga.
Medical Check-ups
Most health insurance companies in india offer free preventive health check-up facilities to the insured at regular intervals depending on the policy terms and conditions.
What is Not Covered in a Health Insurance Plan?
The following medical expenses and situations are not covered in a health insurance plan:
Beat Medical Inflation -
A health insurance policy can help you pay your medical bills, including pre and post-hospitalization expenses, today as well as in future despite the rising medical costs.
Afford Quality Medical Treatment -
It helps you to afford the best quality medical treatment and care so that you can focus only on getting cured.
- Unless there is an accidental emergency, claims arising during the initial 30 days of buying a health insurance plan are not covered.
- Coverage of pre-existing diseases is subject to a waiting period of 2 to 4 years
- Critical illnesses coverage usually comes with 90 days waiting period
- Injuries caused by war/terrorism/ nuclear activity
- Self-inflicted injuries or suicide attempts
- Terminal illnesses, AIDS, and other diseases of similar nature
- Cosmetic/plastic surgery, replacement of hormones surgery, etc.
- Dental or eye surgery expenses
- Bed rest/hospitalization and rehabilitation, common illnesses, etc.
- Treatment/diagnostic tests and post-care procedures
- Claims arising out of adventure sports injuries
Note: It is recommended to check your policy wordings to get a detailed list of exclusions.
Eligibility Criteria to Buy a Health Insurance Plan
The eligibility criteria to buy a health insurance plan depends on a number of factors such as the age of the policyholder, pre-existing diseases, etc. In most health insurance plans, the following eligibility criteria should be met:
Age Criteria-
The entry age criteria for adults and children varies and can range from 18-65 years and 90 days to 25 years respectively. The actual age can vary from one medical insurance policy to another.
Pre-medical Screening-
Pre-medical examination is required for applicants mostly above the age of 45 years or 55 years. However, most of the senior citizen health plans require pre-medical tests before policy issuance.
Pre-existing Diseases-
Any pre-existing illness is covered after the completion of the waiting period i.e. 2-4 years. Most health insurers ask the applicant if they are going through any medical conditions like blood pressure, diabetes, cardiovascular diseases, kidney problems, etc. at the time of buying a health insurance plan. If you are a smoker or an alcoholic, then you need to disclose it to the insurance company. Do not keep it as a secret as it may cause problems at the time of claim settlement. It can even lead to rejection of you claims. Based on this criterion the insurance company decides to offer medical coverage to the applicant.
FAQs About Health Insurance
Q: What are the discounts available in Policybazaar in health insurance policy?
Ans: Health insurance plans available at Policybazaar offers various kinds of discounts to people. You can avail family discount, long term discount, loyalty discount as well as online discount while buying a health insurance plan on Policybazaar depending on the policy terms and conditions. Moreover, you can also avail cumulative bonus during policy renewals at Policybazaar if you had not raised any claims in the last policy tenure.
Q: What is the right age to buy health insurance?
Ans: There is no right or wrong age to buy a health insurance policy. However, it is suggested to buy it as early as possible to keep your premium low. The earlier you buy health insurance, the lesser would be the premium because you have a lesser risk of health issues at a young age as compared to someone who is in their mid-50s or 60s as they are more prone to critical illnesses. Therefore, if you get health insurance in your 30s, you will be able to avail maximum insurance benefits that too at a lower premium.
Q: Is a medical test mandatory to buy a health insurance policy?
Ans: Medical tests are not mandatory before buying a health insurance policy. However, most health insurance companies in India require medical test reports if the age of the applicants is above 45 years. The type of medical tests required can vary depending on the age of the applicant and the insurer’s requirement.
Q: What does cashless hospitalization mean in a health insurance policy?
Ans: Cashless hospitalization means that the in-patient treatment charges availed by the insured are paid by the insurance company directly to the hospital. All insurance companies in India have a tie-up with a large network of hospitals where the insured/policyholder can avail cashless treatment for an illness or accidental treatment.
Q: At what age can I include my children in my health insurance plan?
Ans: You can include your children in a family floater policy from day 1. In some health plans, children are covered from 91 days onwards. Nonetheless, you are advised to go through the terms and conditions of a health plan carefully to know about the entry age for children.
Q: What is a free-look period in health insurance?
Ans: A free-look period in health insurance refers to the period of the first 15 days of the policy commencement. During this period, you can review your health insurance policy features, coverage, etc. and decide if you want to continue with it or not. You can also opt for add-on covers during this period. If you decide to discontinue the policy during this period, you will not attract any cancellation fee.
Q: What is the sum insured in health insurance?
Ans: Sum insured refers to the maximum amount that the insurance company pays to the policyholder in case a claim is raised due to an illness or accidental injury. It is the maximum claim amount that the insurer will pay under your health policy to cover your incurred medical expenses. It is also referred to as maximum coverage under health insurance.
Q: What are pre-existing diseases or conditions?
Ans: Any health problems or illnesses diagnosed prior to buying a health insurance policy is called pre-existing diseases. Insurance companies are reluctant to cover such diseases as it is a costlier affair for them. Therefore, pre-existing diseases are covered mostly after a waiting period of 2 to 4 years. Besides, every insurance company has its own terms & conditions regarding such illnesses. While some firms prefer to check a person’s entire medical history to know pre-existing condition status, other insurers look for medical records over the past four years
Q: Can a person have more than one health insurance policy?
Ans: Yes, you can buy more than one health insurance policy in India. For example, if you are covered under a corporate health plan then you can get an individual or family floater health insurance policy as well. Similarly, if you already have individual health insurance, you can get another top-up health plan or a senior citizen health insurance plan for your parents.
Q: I have my employer's group policy; do I need to buy a separate health insurance plan?
Ans: Yes, you must buy a separate health insurance policy in addition to your employer’s health insurance policy for better coverage. The sum insured under an employer’s health insurance is usually between Rs 2 lakh and Rs 5 lakh, which might not be sufficient under the current medical inflation. To cover the various expensive treatment costs, it is important to have a separate health insurance plan of a minimum of Rs 10 lakh.
Q: How to add my family members to my existing medical policy?
Ans: You can add your family members to your health insurance policy at the time of renewal or at the time of purchase. You, your spouse, dependent children, parents and parents-in-law can be covered in a family health insurance plan as per its terms & conditions.
Q: What are the documents required for purchasing a health insurance policy?
Ans: There are no documents required as such for purchasing a health insurance policy. You may only have to undergo a pre-policy medical check-up if you are a senior citizen. However, you must have valid proof of your identity, address, age, etc. when you need to file a claim with your insurer.
Q: Can my friend buy a health insurance policy if he/she is not an Indian national but living in India?
Ans: Yes, foreigners living in India can apply for a health insurance policy. However, the coverage will be applicable within India only.
Q: What if I already have a health insurance policy, but just want to increase my sum insured?
Ans: If you want to increase the sum insured of your existing health insurance policy, you can do so at the time of policy renewal. In case sum insured enhancement under your ongoing policy is not possible, you can buy a top-up plan or another health policy to extend the scope of coverage.
Q: What are pre and post-hospitalization expenses in health insurance?
Ans: Pre-hospitalization expenses refer to the medical expenses incurred before getting admitted to a hospital. Post-hospitalization expenses refer to the cost of follow-up tests and consultation treatment charges incurred after getting discharged from the hospital. Health plans in India mostly cover pre-hospitalization expenses up to 30 to 60 days and post-hospitalization expenses up to 60 to 90 days, depending on the plan.
