Health Insurance is an insurance policy that ensures that you get cashless treatment or expense reimbursement, in case you fall ill. A health insurance policy reimburses the insured for medical and surgical expenses arising from an illness or injury that leads to hospitalization. The insurance company provides the insured with the facility of cashless hospitalization at a network hospital or provides a reimbursement for the incurred expenses. Furthermore, health insurance cost is subsidised to the insured in the form of tax exemption under section 80D.
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There is no debating the importance of having insurance in a country like India that ranks very low on human life index. Everyone must buy a good health insurance policy that includes medical outlay, hospitalisation costs, medication and laboratory test costs, including critical illness. Don’t get confused with questions like – Which health policy to buy? Does this consider every eventuality? What illnesses are excluded from this cover? PolicyBazaar is here to resolve all such confusions.
Just compare health insurance policies from top health insurers on our website and buy the best plan. Let us know your basic requirements and we will find the best-suited health insurance quotes. You can, then, compare health insurance policies side by side, based on parameters like health insurance cost, riders etc., and choose the best health insurance plans for yourself and/or your family members.
The treatment cost is getting more expensive by the day. A Health insurance policy prevents a medical emergency from turning into a financial emergency. It makes sure that one's health care needs are taken care of without depleting one’s savings and compromising on one’s future goals. The contract of medical insurance requires the provider to pay some or all of one’s health care costs in exchange of a periodic imbursement. Additional advantages of health insurance policies include regular health check-ups, cashless services, pre and post hospitalization expense reimbursement etc.
Health insurance policies allow you to save thousands on taxes under section 80D of Income Tax Act, 1961. The premiums paid towards the policy reduces your annual tax liability, thereby reducing your taxable earnings per year.
Everyone needs to secure their own and their family's health. With the increasing cost of healthcare in India, buying a health insurance policy has become almost mandatory for everyone. Medical insurance makes sure not only medical security but also a hassle-free claim resolution. In today’s world of options, people have different choices when it comes to purchasing health insurance. There are various plans readily available in India to include every aspect of a medical emergency. Some popular types of policies are explained below:
Individual Health Insurance Policy:
This health insurance policy provides coverage to an individual against certain illnesses, offering advantages like cashless hospitalisation and various add-ons. The entire sum assured is available for only one individual and the premium is determined by the age of the insured. Under this policy, each insured member is entitled to receive the entire amount separately.
Family Health Plan:
With family health plan, you can include all your family members against multiple diseases under a single cover. This Family Floater Mediclaim Policy offers a fixed sum assured for the family members, which can be availed either by one or all members of his/her family for one or more claims during the tenure of the policy. Family health plans come at a marginally incremental expense.
Senior Citizen Health Insurance:
Senior Citizen health insurance is designed particularly for anyone with age above 60 years, offering protection from health issues during old age. According to IRDAI, every firm must include people up to the age of 65 years.
Surgery & Critical Illness Insurance Plans:
This plan is usually brought as a standalone policy or a rider for the treatment of various critical illnesses, such as kidney failure, paralysis, cancer, heart attack etc. As the medication of such illnesses is expensive, the imbursement is also very high. A critical illness is a serious, possibly terminal disease, strictly defined by the provider. Most critical illness policies provide a lump-sum benefit if the insured is diagnosed with one or a number of the specified terminal conditions.
Maternity Health Insurance:
Medical insurance companies today cover such additional costs, including both pre and post-natal care, child delivery (normal or caesarean), which sometimes includes vaccination of newborn babies. This insurance covers the newborn baby up to the validity of this policy. It also covers transportation fee for ferrying the mom-to-be to the nearest network hospital of choice.
Personal Accident Cover:
These personal accident plans are frequently provided as riders to standard health plans. They include hospitalisation and bear medical outlay, in the event of an accident. These are issued as fixed benefit policies, where specified sums are paid on occurrence of unforeseen events, such as accidents. Such events that can result in death or disability of the person. However, the payout is not related to the expenditure.
Pre-Existing Disease Cover:
After a time of 2-4 years, various policies consider pre-existing diseases, e.g. diabetes, hypertension, kidney failure, cancer etc. Pre-existing disease cover includes the illness that the insured had before purchasing the policy.
Undoubtedly, healthcare is very expensive and nobody wants to fall ill; anyway. So, now we have preventive health care that takes care of you before you fall sick. This policy considers preventive care, such as regular health check-ups, concession in X-ray fees, consultation fee etc. By offering various healthcare provisions, this plan aims at keeping you healthy. Preventive care is medical care rendered not for a specific complaint but focuses on prevention and early-detection of ailments.
Unit Linked Health Plan:
Unit- Linked Health Plan (ULHP) has been introduced recently, which offers a unique combination of health insurance and investment. Despite giving health protection, ULHPs also contribute in building a corpus that can be used to meet expenditures not covered by health insurance policies.
Among the ULHPs available in Indian market, ICICI Pru's Health Saver, LIC's Health Protection Plus, Birla Sunlife's Saral Health and IndiaFirst's Money Back Health Insurance Plan are worth investing your money in. The limit of the cover depends on age, health, gender or other mentioned variables. By opting for this plan, one can save a certain amount to be used to pay for the treatment of pre-existing illnesses that are not covered by a normal health policy during the waiting period.
The cost of healthcare in the modern days is increasing at a crazy rate while one’s earnings do not seem to match up that level. And, so do regular health checkups. A patient looking forward to availing frequent health check-ups is no longer expected. A comprehensive health insurance comes packed with features. Understanding the following features makes purchasing medical insurance policy easy:
Every medical insurance organization has tie-ups with various nursing homes across the country or 'empanelled hospital'. If you are admitted, you don’t need to pay anything. You only need to mention your policy number and everything else will be taken care of by the hospital and your insurer. This type of plan is mostly preferred because there is no stress of claim resolution and arranging documentation. However, if your expenses go beyond the sub-limit specified by the insurance cover or marked as not covered by the provider, then they have to settle it directly with the hospital. Another important thing to remember is that cashless Mediclaim is not available if one gets treatment in a hospital that is not part of the hospital network of provider.
Pre and Post Hospitalization
This feature of a health insurance policy takes care of both pre and post hospitalisation fee over a time of 30 to 60 days, depending on the plan purchased. It takes into account costs incurred during a certain number of days both prior to and post hospitalization for a specified period from the date of discharge as part of the claim, provided the expenditures are related to the disease/sickness.
The person is free from burden of transportation fee, as it is borne by the firm. This is an add-on benefit and you should opt for it while purchasing.
No Claim Bonus
NCB (or No Claim Bonus) is an advantage provided if the person does not file a claim for any treatment in the previous year. Advantage could be in any form, either as an increment in the sum assured or as a discount in the cost. You can avail this advantage on renewal.
Medical Check- Up
A Medical plan entitles the insured to receive regular medical check-ups. Free check-up is provided by few insurers, provided you have a good history of no claim bonus.
Room Rent in Your Health Insurance Sub-limits
A healthy insurance policy may have various sub-limits associated with it; room rent is one of those sub-limits. General Insurance Companies provide you with coverage max up to sum assured. However, they can deliberately trim down their liability by introducing the sub-limit clause in the coverage for the room rent.
A sub-limit on room rent in case of hospitalization works on per day basis. For instance, if your medical insurance policy covers your daily room rent up to a maximum of Rs. 3,000 and the particular room costs you Rs. 5,000 per day, then you will have to pay the remaining Rs. 2,000 out of your own pocket. Besides, the room charges are directly associated with the type of room you are availing, i.e. a single room or on a sharing basis. Everything else is calculated proportionately.
If the total cost incurred for your treatment at the hospital is Rs. 5, 00,000, the table shown below illustrates the proportionate expenses to be borne by your insurer and you, respectively.
According to this feature, you can lower the health insurance cost. Medical insurance plans offer co-payment option that pre-defines the voluntary deductibles to be borne by the firm. So, in the event of medication, some amount is paid by the customer and the rest by the provider. It is a cost-sharing requirement under a health policy, which states that the organization or the person will bear a certain share (in percentage) of the total admissible cost. However, the co-payment option does not have any effect on the sum assured. It allows you to reduce your premium to a certain extent (subject to the insurer and insurance policy).
Tax Benefits of Health Insurance
Health insurance policies entitle you to receive tax benefits under section 80D of income tax act, 1961. The premiums you pay towards insurance plans for yourself or your family members get you a tax rebate, irrespective of whether they are dependent on you or not. The tax benefit offered, with respective to the premiums, is subject to the age of the person and there is a cap of maximum benefit that can be availed. You can save max up to Rs. 25, 000 in taxes a year unless your age is above 60 years. If your age is above 60 years, then this cap of maximum tax benefit increases to Rs. 30, 000.
If you are paying the insurance premiums for your parents as well as of your own, then you are eligible for tax exemption of up to Rs. 55, 000 a year under section 80D, provided your parents are senior citizens.
Health Insurance by Employer
More than 80% of employers in today’s age provide health coverage for their employees. The health insurance offered by an employer covers hospitalization expenses of the employee and his/her family including spouse, children or parents. It is a wise decision to opt for mediclaim offered by your company as you don’t need to pay the premium. This comes under a group health insurance policy and the premium is paid by the employer, basis the group size and benefit opted.
However, it might be that you feel your employer’s medicliam policy is insufficient to fulfil your medical needs or what if you change your job? You’re no more a member of this plan once you leave the job. Hereby, it is necessary to understand the policy terms thoroughly. You can communicate with the HR department regarding what’s covered and what’s not in your health insurance. Mostly we observed employees are more than satisfied with their company providing health insurance, only to find out later that the plan is not sufficient. So, before it’s too late, take your call!
Third Party Administrators
The TPA concept is the brainchild of Insurance Regulatory and Development Authority of India (IRDA), to assist both the insured and the insurer. While it benefits the insurer by reducing their overheads or administrative costs, fake claims and claim ratios, the insured can avail the benefit of improved and fast healthcare services.
TPAs are the important players in the sector of health insurance. It excels the capacity to handle all or a portion of the claims related to mediclaim insurance. They have tie-ups with the health insurer or self-insuring companies to manage services such as premium collection, enrollment, claim settlement or other administrative services. Often hospitals or organizations outsource health-related responsibilities to a TPA to lower the burden. In this, an employer may prefer to provide the health care expenses to its employees via a TPA to manage various aspects of employer-funded healthcare policy.
There are few factors that you should consider closely to make the right decision and choose the best.
Caps and sub-limits
The amount you pay for a health policy has impositions of co-payments, sub-limits, and other caps, which would alter the benefits in the long run. To make the most of your health insurance policy, you must understand these factors before you pay for a plan.
Claim settlement record
This is an important criterion to assess the credentials of an insurer. You should always go with a company with a good claim settlement record. Thus, you can ensure that your claims would not be wrongly withheld. Always ask for the company’s claim settlement ratio before purchasing their health plans and save yourself from unnecessary harassment.
Scope of cover
Don’t buy a plan by just comparing health insurance cost. Less cost does not necessarily mean a good plan. On the contrary, such a plan might not consider your needs properly. Closely look at what the plan includes. Buy a comprehensive plan.
It is important to see how many years the plan proposes to protect you. You should not be left without a safeguard when you need it the most, say during your old age. Mediclaim policies are usually annual contracts. The automatic re-establishment of in-force status affected by the cost is known as renewal. In other words, issuing a new policy or the continuation of the current policy, once the old policy’s plan year ends, is termed renewal. At the end of the policy term, the policy has to be renewed by the insured. There should be continuous renewal of the policy because if there is a break, then the person will lose the benefit of insurance, in the event of a contingency.
Cashless Hospital Network
Check if a hospital around you is included by the company you are considering to buy from. You and your family won’t be required to run around collecting documents and filling reimbursements. The provider or its Third Party Administrator has a tie-up with a range of nursing homes. The insured can get admitted in any of these nursing homes and medication for a disease covered by the policy. However, cashless mediclaim resolution is subject to limits and sub-limits, which are subject to the sum assured of the policy.
Loading is an additional cost built into the insurance policy to consider losses, which are higher than anticipated, for an insurance company, arising from insuring a person who is prone to a form of risk. Premium Loading is the amount an insurer needs to consider its expenses and generate profit. We strongly recommend you check the terms and conditions pertaining to premium loading. This will save you from paying a high incremental premium post making a claim. This aspect, though ignored in the beginning, usually becomes a bone of discontentment later. The best practice would be to verify the cost fluctuation data of the plan for the previous 5 years at the very least.
Check for plans from firms, who have a dedicated internal team for handling Mediclaim. This comes in handy while expediting the Mediclaim resolution process. Most of the players use a third-party administrator to process the claims and do the paperwork. Even though most of these Administrators provide great services, the fact that they are a third party slows down the process. There are certain rules and regulations to be followed when an administrator processes a claim before it is handed over to the insurance company. These affect the turnaround time.
Floater (family) Size
Everyone has a different family size, so you should always look for the family size allowed under the plan before purchasing it. If you are a person in your late 20s and your parents in their 40s, 50s or 60s, then purchasing for yourself does make sense. Alternatively, if you are married with or without kids and have dependent parents, parents-in-law, siblings etc., then a family health plan is best for you. Checking the cost, family size covered, critical illnesses or other benefit will ensure that you are able to purchase the plan you need.
Health Insurance Portability
It is wise to choose a health insurance company that offers health insurance portability. Earlier, policyholders had to stick to a policy just to retain the advantage. Now, the policies allow you to switch from one insurance company to another without losing the waiting period advantages earned in your current policy. Moreover, with insurance landscape changing so regularly, insurance companies regularly come up with better policies and it may make sense to opt for health insurance policy portability. Although health insurance portability is free, some companies may charge you a certain fee if you are to port out of their plans to those of some other players. Therefore, make sure you do not pay any charges for medical insurance portability. Health insurance portability is a good thing to check when you are finding the best health policy or mediclaim.
With 'restore benefit' facility in your health care plan, you can restore your basic sum assured, in case you have already spent the same or the multiplier advantage during your policy tenure. Mostly, the benefit cannot be obtained on the same ailment, if you exhaust the limit.
Restoration assistance proves to be helpful for a family floater health plan, where the entire sum assured is used in the treatment of only a single family member. This leaves the remaining policy members with zero policy cover in case of hospitalisation for the remaining policy year. In such a case, the other family members can avail policy coverage for the illness other than the one for which the expenses have already been compensated by the insurer.
Well, while finalising your health insurance plan, you should consider other influencing factors such as waiting period, sub-limit, claim settlement procedures etc. You can replace restore benefit with a super top-up plan at an affordable price. Moreover, top-up plans are more comprehensive since it comes with less or no restrictions.
Top up Plans
With the rise of medical inflation, having a large medical cover is prudent. But not all can afford it, due to the high premium. This is where a top-up plan comes into the picture. A top up plan reduces the deductibles cost i.e. the portion of claim you pay willingly for the damages before the insurer compensates the rest or up to the sum assured. With a top up policy, you don’t pay until a hospital breaks its defined limit. A top up plan is considered far cheaper than a standalone medical policy.
For instance, if the medical bill is 6 lakh with a deductible of 2 lakh, you are required to pay only the latter amount and the remaining 4 lakh will be paid by the insurer. But you can utilise your health policy to pay the liable amount. Again, the blending of a top up plan with a medical cover is helpful as the premium you pay is much more affordable than the single plan. For example, if you pay 6,500 as a premium for Rs. 5 lakh regular cover, a top up coverage of Rs. 15 lakh will entail to an additional premium of 5,000, which is anyhow cheaper than a separate policy of identical cover.
As per the insurance norms, every insured must serve a defined waiting period for any pre-existing illness. It is usually a 30-day period from the day your health insurance policy is initiated. If any claim falls during the waiting period, the insurer has the right to reject the claim for any hospitalisation, except in the case of an emergency. A hospitalisation that arises out of an accident can be registered as a claim and the insurer will compensate the hospitalisation cost. However, the insured is not required to serve the waiting period for subsequent years.
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A home loan is an amount of money that any bank or an NBFC gives to an individual at a certain rate of interest, which s/he can pay on EMI basis.
Loan amount will be fixed on the basis of 5 times of annual farm income or 50% of the value of land mortgaged, whichever is less, subject to maximum limit Rs.10.00 lakh.
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A home loan is an amount of money that any bank or an NBFC gives to an individual at a certain rate of interest, which s/he can pay on EMI basis. This loan can be used to purchase a house that’s already constructed, under construction, or has been approved for construction in the coming future. Home loans are available on all approved properties irrespective of their size or location.
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