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Health Insurance Plans: Features to Look Out for

Buying a Health Insurance Plan: Here's What You Should Know!

It's alarming that merely about one-fifth of Indians have sheltered themselves under health cover. Is it the lack of awareness or general indolence? Let's discover why Health Insurance should be a prominent choice.

With fluctuating ways of life and ever-increasing occurrences of unfortunate accidents and mishaps, Health Insurance isn’t any longer a élite privilege of aging people. The way things are moving, a medical disaster can attack anybody, anytime, regardless of age, gender, and location. From newborn infants to youths to aging parents, medical treatment, and hospitalization plays an essential part while safeguarding the well-being of our loved ones.

What is Health Insurance?

Imagine a situation, where you have to shell out all your life-long savings to tackle any emergency hospitalization. Health insurance is nothing but a Messiah in such demanding times. In simple terms, it’s an agreement between you and your insurer who bears your hospitalization and all associated medical expenses as per the terms and conditions you’ve both agreed upon. All this at the cost of an annual premium that you pay to the insurance company.

Why is Health Insurance Essential?

In line with the recently circulated results of a cross-national analysis on health steered by the National Sample Survey Office (NSSO) in the first half of 2014, the cost of treatment rocketed at a double-digit speed of growth, outstripping normal inflation together in urban and rural India compared to the past decade. As the growing number of patients swarm private health centers and hospitals for consultation and subsequent treatments, they have been confronted with mounting medical bills. The cost of therapy fluctuates considerably across the country.

Factors to Watch Out Before Comparing Health Insurance Plan

Numerous health insurance companies offer multiple policies-each assuring better than the other. However, it's imperative to recognize that each policy has a different premium, covers different aspects, and are regulated by different policy provisions. With the number of options available, it’s unwise to settle for the first policy that comes your way. When you can secure the best deal at a lower premium with a bit of research and comparison, why not?
Selecting a suitable health plan to protect everyone in your family is not an easy task (Unless, you have been buying only to save on tax so far).

Thus, always compare health insurance plans on the basis of the following crucial factors:
Premium v/s coverage
PREMIUM VS COVERAGE
Assess if the cover and sum assured are suitable against the premium paid. Choose add-ons as per your needs.
Network Hospitals
NETWORK HOSPITALS
Be sure of the insurer's network hospitals in your area. You can avail of cashless services only at these hospitals.
Room rent limit
ROOM RENT LIMIT
Since hospital room rents vary, some insurance plans pay only a part of the actual rent. It's always best to go for higher or no room-rent limit plans.
Exclusions
EXCLUSIONS
Check what is permanently excluded and which treatments are possibly covered after waiting for a certain period.



Understanding What is Covered in Health Insurance

Must-know inclusions before buying health insurance plan
  • Zero Depreciation Cover
    HOSPITALIZATION

    If you are admitted for treatment in a network or a non-network hospital for more than 24 hours.

  • Pre-post hospitalization
    PRE & POST HOSPITALIZATION

    Medical expenses including diagnostic reports, medicines etc. for the treatment you are hospitalized.

  • Day care procedures
    DAY CARE PROCEDURES

    OPD treatments are not included, but procedures such as cataract and kidney stone removal are covered (even if they don't need 24-hour hospitalization).

  • Accident cover
    ACCIDENT COVER

    For medical and other out-of-pocket costs in case of an accidental injury. In fact, this cover is active from the very first day of policy issuance.

Why Should You Buy Health Insurance Plans Online?

Car Insurance icon

We are spoilt for choice and don't like to compromise on quality. This applies to the insurance we would want to buy too. From the neighbourhood insurance agent to the banks we frequent - we would want to explore all options. But, with the revolutionary innovation in the e-commerce sector, an online broker should be your definitive choice. Why?

Expertise

As the brokers are skilled professionals, licensed by IRDA, they are the finest to approach for any insurance needs. Above and beyond, as they deal with diverse insurance products, they are accountable towards providing accurate solutions as per distinct requirements. Their entire business model is to offer essential service to the consumers on priority.

User-friendliness

Some insurance brokers like Coverfox.com boasts of exceedingly user-friendly and convenient gateway where even a newbie can access and purchase the insurance policy as per his requisite. The facility to compare and make the correct choice is what they exult in. The ease offered is noteworthy and with such astounding features, why look back?

Post Sales Service

For the whole kit and caboodle associated with your health insurance policy, you can contact your broker, and they are capable enough to deal with the same. Brokers are accredited to handle the requests on behalf of their customers by dealing with the insurance companies. So, next time you want to move your residence, and if you have bought your health insurance policy through a broker, why fear when the broker is here? A phone call is all it’ll take.

Claims assistance

Brokers like Coverfox has a far-reaching Claims Team that handle all queries, concerns related to the claims of their customers. Even before submitting the documentation to the insurance company for claims dispensation, they scrutinize them for accuracy and completion to evade back and forth coordination with the insurance companies. Claims Team Experts are on your side and walks step-by-step with you to settle down the claim.

Best Health Insurance Plans in India

While there are a lot of health plans available in the market, we have collated a list of top insurance plans below:

Health Insurance PlanAgeType of PlanSum InsuredBenefits
Religare Care PlanChildren 5 years
Adults Min- 18 Years Max- No Age Limit
Individual Plan
Family Floater Plan
Rs. 2/3/4/5/7/10/15/20/25/50/60 Lakhs
  • Recharge benefit equal to 100% of the sum insured
  • Health check-up once every year, irrespective of claims made, for individuals of age 18 years and above
  • No-claim bonus super add-on cover which makes no claim benefit equal to 60% of the sum insured
  • Specific treatments (listed in the policy document) anywhere in the world for sum insured Rs. 50, 00,000 and above.
Max Bupa Companion Health Insurance PolicyChildren 91 Days
Adults Min- 18 Years Max- No Age Limit.
Individual Plan
Family Floater Plan
Rs. 2 lakhs to Rs. 1 crore
  • The policy is tailor-made for Individual, Couple, Nuclear Family & Extended Family
  • Comprehensive cover up to Rs.1 Crore
  • Lifetime renewability
  • Smart Top-up options for additional coverage
  • Cashless treatments in more than 3500 network hospitals
  • 12.5% discount on second year’s renewal premium if you opt for a two-year policy tenure
  • Tax benefit on premium paid under Section 80D of the Income Tax Act.
Oriental Happy Family Floater Mediclaim PlanChildren 91 Days
Adults Min- 18 Years Max: 65 years.
Family Floater PlanSilver: Rs. 1 lakh to Rs. 5 lakh, Gold: Rs. 6 lakh to Rs. 10 lakh
  • One sum insured for the whole family including parents and parents-in-laws.
  • No pre-policy medical test for individuals up to the age of 60 years
  • Based on the benefits, policy is available in two options – Silver & Gold
  • Personal Accident Cover and Life Hardship Survival Benefit available at extra premium
  • If you do not prefer the TPA (Third Party Administration) services, you can get additional 5% discount on the premium.
Senior Citizen Red Carpet PlanChildren- N/A
Adults : 5 Years Min : 60 years Max: 75 years
Individual Plan
Family Floater Plan
Rs. 1 Lakh to Rs. 10 Lakh
  • No pre-policy medical check-up required
  • Covers for any medical consultations as an Out Patient in a Network Hospital
  • Lifetime Renewability
iHealth PlanChildren in Individual Plan 3 Months- 23 Years
Family Floater Plan Children- 6 years – 23 Years
Adults Individual Plan Above 18 Years
Adults Family Floater Plan Above 18 Years
Individual Plan
Family Floater Plan
Rs. 2 Lakh to Rs. 10 Lakh
  • Does not have limit on room rent expenses
  • Does not have co-pay for any claim.
  • This plan offers no-claim bonus equal to 10% of sum insured up to a maximum of 50% after every claim free year.

So, all those soon-to-be health insurance policyholders, here's your chance…

With numerous choices to pamper you, as a consumer, there's perfect sense in cherry-picking the one that will provide you with not just a meager health policy but an all-inclusive package. Unless you're born with a golden spoon, it's high time you should consider investing in a good health insurance plan and provider that will not only offer you the ease and convenience to compare quotes but will stand by you in times required; especially during claims management.

Coverfox advantage Coverfox Advantage

Still Confused? Get the Experts to Help You Out

Assessing so many health insurance companies against numerous parameters can be as daunting and confusing as it sounds. If you are in a fix and cannot decide the best health insurance company for yourself, it is time to involve experts.

Expert Advice
Expert advice and an informed, unbiased opinion that clears the confusion and helps you buy that perfect plan for you. Can it get any easier?
POST-SALES ASSISTANCE
Service Managers who assist you with all your post-sale requirements - from claims processing to renewals! They are like superheroes, but only better.
You happy. We happy.

"My first experience with Coverfox was an absolute delight. Their positive response and effective actions changed my opinion of the entire insurance segment. Hope they keep it up!"

Ramachandran D

"What I’ll never stop being thankful for is the fact that my claim for total loss was settled in such less time. Thank you so much for all the support from your side!"

Arun H

"Their prompt replies, seriousness about policy deliveries and commitment to their job are just some factors that make Coverfox shine through. But their complete transparency in their calls clearly is the icing on the cake!"

Navneet

"Having been a customer for over a year, I feel relaxed as far as health insurance is concerned. Their customer service personnel guided me through each step of my process while helping me finding the best plan!"

Manoj Kumar Jain
FAQs on Health Insurance

What are the things to look for while choosing a health insurance plan?

While choosing a health insurance policy there are a few things which you should be consider:

  • Number of members and relations to be covered- Because this will be the basis of buying the policy.
  • Type of coverage – Individual, family floater or group.
  • Sum insured or coverage amount – Ensure that you consider future expenses too.
  • Room rent – Check for the capping amount or criteria defined, if applicable.
  • Sub-limits or co-pay applicable – Check for the sub-limits applicable for some specific list of ailments or package treatments. Also check if the plan has co-pay feature.
  • Network hospital list – Check for the list of network hospitals and try buying a policy which covers your regular hospitals.
  • Policy wording – Most important thing to check before buying a policy. In case you are not sure about certain terms or conditions you can always contact the insurer for clarification.

Can I get a single health insurance floater policy which can cover my parents or in laws too?

Yes. There is health insurance plan like Heartbeat family first which covers 14 relations including in-laws and parents.

What are some of the important exclusions under a Mediclaim policy?

There are four important types of exclusions in a Mediclaim policy. These are:

  • Time-related exclusions: e.g. Waiting period- general, specific ailments and pre-existing.
  • Non-medical expenses: e.g. Registration charges.
  • Illegal reasons: e.g. drugs, alcohol abuse, self-inflicted injuries.
  • Out-of-scope: e.g. unproven medical procedures, HIV, adventure sports, etc.
  • Room rent: This may not be an exclusion, however, do check for the capping amount on room rent, if applicable.

Can I cancel my policy? If yes, will I get my premium back?

Yes you can cancel a policy after you buy it. A free look period of 15 days is provided to you after buying a policy to understand the terms and conditions. In case there is any objectionable clause, you can cancel the policy and get a refund. Stamp duty, expenses on medical check-up and proportionate risk premium (the number of days that the insurance company was at a risk of bearing your health expenses) would be calculated while the premium amount is refunded. Refer the policy termination or policy cancellation section in your policy wording to know the amount that would be refunded.

Note: For a refund, there shouldn't have been any claim during the policy period.

Does a health insurance plan cover maternity?

Health insurance policy is designed to cover unforeseen medical expenses, but a normal health insurance policy does not cover maternity expenses. Coverage for maternity expenses is one of the additional features offered by some of the health insurance plans at a higher premium and waiting period. To know more about maternity health insurance, please read more here.

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