What is Health Insurance?

A health insurance policy or a medical insurance policy is like a contract between the health insurance company & you. You need a medical insurance policy because after purchasing the policy, the insurance company helps you to pay for your medical costs & expenses. This helps you save a lot of money. There are generally two ways through which the company pays for your medical expenses.
1. You can pay your medical expenses first & then later ask for reimbursement from the insurance company.
2. Take a cashless treatment where you don't have to pay. The insurance company pays the hospital directly.

What is the Importance of a Health Insurance Policy?

Unless you’ve been living under a rock, you are probably aware of the rising costs of medical care. A simple outpatient procedure can make your wallet considerably lighter. An insurance policy will help you get the best medical care and you don't have to worry about expenses. A best insurance plan ensures you don’t have to dig into your savings in the time of a medical emergency.

It also helps cut down the cost of medical expenses in cases such as daycare procedures & routine check-ups. At the cost of a small premium every year, you can protect yourself and your family from huge financial losses in the time of a medical emergency. Here are some of the reasons why you should get a health insurance policy:

• Protects You Against Financial Losses: One of the smartest decisions you'll ever make would be to buy medical insurance. Even the most simple medical procedures & treatments may at times cost lakhs of rupees. When you possess a proper health insurance plan, the insurance company will pay for your viable medical expenses. You will be able to protect yourself & your family from huge financial losses.
• Modern Lifestyle is Unhealthy: The current modern lifestyle is quite an unhealthy one. It includes bad eating habits & lack of sleep combined with a lot of stress. Eventually, this lifestyle takes a toll on a person's body. As a result, young men & women in the age group of 20 yrs to 30 yrs are unfortunately contracting serious health & medical issues. These issues include heart ailments, high blood pressure, diabetes and many other conditions. All of these become a strong reason why a person should buy a health insurance policy.
• Low Cost: Spending on a small premium amount on an annual basis can save a person from huge financial liabilities in case of medical emergencies. Insurance companies provide us with a wide range of health insurance policies. It is surprising that even the policies with the highest amount in terms of coverage have premium so low that they are nothing as compared to the outpatient hospital expenses. A basic & simple medical insurance policy will cost a person much less than small party or night out with friends.
• Best Way To Ensure Protection For Your Family: A medical insurance policy helps you to protect yourself & your family members against unforeseen medical emergencies. Health insurance policies are particularly essential for those people that have a large family or those who have older members in their family. Health plans are also extremely important for people who are sole earners in their families.
• Tax Benefits: Most health insurance policies can be used as a tax-saving tool. You can claim tax deductions up to ₹ 25,000 or more depending on the policy you choose. While this is not the main reason why you should invest in a medical insurance policy online, it’s definitely an added benefit.

Health insurance comes with a plethora of benefits that are not just limited to offering financial cover during medical emergencies. Here are the most important benefits pertaining to online medical insurance:

• Comprehensive Cover

  Your health insurance policy generally covers all your medical expenses resulting from your hospitalization for more than a period of 24 hrs. These expenses include diagnostic test fees, doctor's fee, medicine cost, room rent, etc.

• Cashless Treatment

  Most health insurance companies have tie-ups with hospitals and medical centres. If you get admitted to one of these network hospitals, you will not have to pay anything. The insurer will handle all the bills and all you have to do is mention the policy number. This not only saves you from the hassle of arranging money in an emergency but also saves you a lot of time running around filling forms while you can be focusing on what’s important.

• Quality Medical Care

  This is one of the most underappreciated benefits of medical insurance. One of the things that stop many people from opting for quality healthcare during emergencies is the rising cost of medical care. But with an online health insurance by your side, you can opt for quality medical care instead of settling for cheaper options. Many health plans also offer cover for health check-ups which will help you keep your health in check.

• Ambulance Cover

  The cost related to ambulance services during medical emergencies is mostly covered in all health insurance policies. Check your policy to know more about ambulance cover before you buy insurance.

• Tax Benefits

  A health insurance policy offers the policy holder with a lot of tax benefits that fall under the section 80 D of IT Act (income tax act) of 1961. The deduction on taxes offered to the policy holder depends on factors like the premium amount, insured person's age and many other aspects. Based on these given factors, a policy holder can claim for tax deductions & this can be from anywhere between Rs.25,000 to Rs.50,000.

  SCENARIOS	DEDUCTION
  For Self	Rs.25,000
  For Self & Spouse	Rs.25,000
  For Self, Spouse, dependent children up to age 25	Rs.25,000
  For Parents	Rs.25,000
  For Senior Citizens	Rs.50,000
  For Self, Spouse, dependent children up to age 25 & Parents	Rs.50,000 (Rs.25,000 + Rs.25,000)
  For Self, Spouse, dependent children up to age 25 & Parents	Rs.75,000 (Rs.25,000 + Rs.50,000)
  For Self & Parents (Includes all Senior Citizens)	Rs.1,00,000 (Rs.50,000 + Rs.50,000)

  *The tax benefits are subjected to changes in tax laws.

• Portability

  You and your family members also become eligible for free health checks at the nearest network hospital of the insurance company.

• Financial Security

  Without insurance policy, it takes just one serious medical emergency to deplete your life savings. A health plan not only offers you peace of mind but also offers financial security. With the right health insurance policy, you can avail quality medical treatment without having to break into your savings.

• Convenience

  Unlike the old times, today one does not need to move from one health insurance company to another, if one wants to buy the right health plan. Today we have the provision to search for our preferred health plans, compare them with each other, do our assessment & then buy the right medical insurance plan online. The icing on the cake is that you also get discounts on online health insurance purchases.

There are a variety of medical insurance plans in India. Listed below are some of the popular plans:

1. Individual Health Insurance Plan

   As the name suggests, An individual health insurance plan offers cover for the individual only. This plan covers your medical expenses for hospitalisation, injury, room rent, and more. This policy offers sum insured which can be used by only one person i.e. the individual covered under the plan.

2. Family Floater Insurance Plan

   Under a family floater plan, you can cover your entire family under a single policy. The sum insured for these policies are usually higher than regular individual health insurance plans. The sum insured is available for all the family members insured under the plan. The best part about this plan is that you can get cover for your entire family for a small premium amount.

3. Group Medical Insurance Plans

   Group health insurance plans are highly popular in the corporate sector. Medium and large-sized enterprises use this insurance policy to offer cover for their employees in time of a medical crisis. It is a benefit that most employees expect when joining a company and this helps the employer retain their employees.

4. Critical Illness Medical Insurance Plan

   Critical illness health insurance policy offers cover specially for critical illnesses such as stroke, kidney failure, organ transplant, cancer, and more. Treating critical illnesses can get expensive and a policy like this can save a lot of money if you ever were diagnosed with a critical illness. The insurance pays a predetermined amount towards the treatment when the insured is diagnosed with a critical illness.

Here is a comprehensive list of top Medical Policies.

Disclaimer: The above table has been compiled by sourcing information from the insurance company’s website. The Incurred Claim Ratio has been sourced from IRDAI Annual Report 2018-19. Last Updated 15-04-2021.

Main factors to choose the Best Health Insurance Policy

The decision to acquire the correct medical insurance policy is an important one and requires an in-depth examination on your end to ensure it meets your needs. The following factors must be considered closely to make the right decision:

• Coverage Offered: The insurance coverage and the amount insured will determine the type of illnesses and operations that can be claimed during the policy term. Pay close attention to the benefits offered like hospitalization expenses, daycare expenses, covid 19 coverage, etc. before choosing the policy.

• Adequate Sum Insured: The sum insured must be equivalent to your requirements. It is important to choose the plan with the highest coverage for your needs. In the current situation where covid 19 coverage is crucial, an insured sum between 10 lakh to Rs 1 Crore is recommended. If you are acquiring a family floater plan, the higher the sum, the more beneficial it is.

• Type of Policy: It is vital to choose the right type of medical insurance policy online as each policy serves specific needs. As per your requirement, you can select an individual plan, a family floater plan, a group medical insurance, or a critical illness plan.

• Waiting Period: The waiting period is the time you cannot file a claim under your medical insurance coverage. You have to wait for the deadline to expire. The waiting period typically applies to pre-existing illnesses, maternity benefits, etc. Thus, look at the Waiting Period when buying health insurance policy online and choose the one with the least waiting period.

• Co-Payment Clause: Some medical health insurance policies online consist of a Co-Payment clause. Under this clause, a portion of your coverage is borne by you. This does not reduce the total medical insurance coverage but can put pressure on you as you could be paying a part of the expenses out of your pocket when the need arises. The clause does result in a reduction of the premium amount. If you do not wish to opt for this, look for another policy.

• Network Hospitals: Network Hospitals are directly associated with health insurance companies. They help you avail of cashless facilities at the time of need. Take a look at the network hospitals of your insurance company when choosing a medical insurance policy online.

• Lifelong Renewability: Health insurance policies are generally renewed every year. The renewal process is simple, entirely online, and requires the payment of your medical insurance premium. Choosing health insurance coverage with a life-long renewal option can prove beneficial.

• Claim-Settlement Ratio: It is an ideal criterion to assess the credibility of your health insurance company. The higher is the ratio, the more confident you can be that your claim can be fulfilled at the time of need. Ideally, a car insurance company with a claim settlement ratio of 80% is a good option.

• Exclusions: Exclusions are the conditions under which the claim cannot be fulfilled. Such exclusions must be examined beforehand by the policyholder. An ideal health insurance policy is the one that meets your requirements, provides adequate coverage, and requires minimum medical insurance premium. But before that, it is essential to know the type of insurance policy suitable according to your needs. Mentioned below are some health plans based on your needs:

Types of Coronavirus Health Insurance

Apart from this IRDAI has directed insurance companies to launch two special standard health insurance products, namely Corona Kavach and Corona Rakshak, were launched.

Corona Kavach Policy

It covers coronavirus hospitalization (minimum 24 hours) cost, home treatment expenses, and AYUSH treatment bills up to ₹ 5 Lakh. The cost of consumable items like gloves, masks, ventilators, oxygen cylinders, PPE kits is also covered.

The benefits provided under the Corona Kavach Policy shall remain the same across all the insurance providers.

Corona Rakshak Policy

On being diagnosed with Coronavirus during the Corona Rakshak Policy term, it gives a lump sum payment on hospitalization (for a minimum period of 72 hours). The policy duration is minimum of 3.5 months and a maximum of 9.5 months.

While every medical insurance policy is unique, most of them have the same cover. Listed below are some of the most common inclusions under medical insurance plans:

• Hospitalisation expenses
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Outpatient procedures
• Health checkups
• Ambulance charges
• Donor transplant expenses
• Preventive services
• Critical illness
• Chronic illness treatment
• Prescription medication

While health insurance offers cover for most health ailments and diseases, there are still some exclusions under the policy. Listed below are some of the common exclusions under health plans:

• Cosmetic procedures
• Dental procedures
• Pre-existing conditions
• Congenital diseases
• Injuries incurred from war, terrorism, & suicide
• Non-prescription drugs

Health insurance policy eligibility criteria depend on pre-existing illnesses (if any), current medical conditions, the customer’s age, etc. The medical insurance companies also conduct a medical test to check if the applicant already has some health diseases or not. Commonly these eligibility criterion needs to be met:

Age Criteria:
The entry age for Adults: 18 to 65 years (70 and above, depending on the plan and the insurer).
The entry age for Children is 90 days to 18 years, and in some plans, it goes up to 25 years.

Pre-medical Screening:
In most cases, the applicant’s age has to be above 45 years, but it might vary depending on the insurer and the kind of medical insurance plan. Most senior citizen health plans need pre-medical tests to determine if the applicant meets the eligibility criteria for insurance cover. The criterion for an individual and family floater health plans might vary according to the policy terms and conditions.

Pre-existing Diseases:
While buying a medical insurance policy, you must inform the insurer about the health diseases you have or any pre-existing illness that you or your family members have. It would be best if you did not keep it a secret as it can create problems at claim settlement time. It can even lead to the rejection of your claims.

Most health insurers question the applicant if they have any medical conditions such as blood pressure, diabetes, kidney problems, cardiovascular diseases, and other diseases. You also have to inform about your smoking or alcoholic habits (if you have the habit); based on these factors, the insurance company will decide if you are eligible to get medical cover or not.

If one insurer rejects your application, you can also check with another or buy a specific health plan as per your medical conditions. Check the policy for terms and conditions to have a better understating of the eligibility criteria.

Different health insurance companies offer various impressive features, and it can become challenging to choose the right policy.

Comparing health insurance policies online helps you to choose from the best plans, as per your needs. Confusions regarding the best health insurance plans ease out when you compare the plans. Coverfox provides you with the best medical insurance policies in India with detailed aspects of all. Here are some of the significant advantages of comparing and buying a medical insurance online:

• Access to Accurate Information: Coverfox provides you all the information you require from the best health insurance plans in India. This also saves your time from dealing with agents who may provide you with biased information.
• Time-Saving and Convenient: You no longer have to revisit agents to compare different plans. You can sit in the comfort of your own home and choose from the best health insurance plans in India. Our website and reliable customer support system provide you with all the information you need to make the right choice.
• Easy on Pocket: With Coverfox, you no more have to pay brokerage, commission, or any other agent-free. When you buy a health plan online, you can compare the premiums and choose the one that fits your pocket.
• Available for Provider/Plan Reviews: Reviews of health insurance providers help you make a sound decision. You can also check out the claim-settlement ratios of insurance providers online on Coverfox. Getting an understanding of the insurer’s reputation will help you make an informed choice.

Comparing plans with Coverfox is very easy. All you need to do is provide us with your basic and authentic details like phone number, gender, city, etc., and you shall get access to the best health insurance coverage plans in India. With Coverfox, you can check the history of the insurance company from which you are planning to buy your health insurance plan. It is best if you select the insurance company based on the following primary parameters:

• ICR: Incurred Claim Ratio or ICR falls under one of the most important parameters to check while comparing India’s health insurance companies. Considering the ICR of an insurance company, look for the average ICR of all the companies online on Coverfox.com and go for the one closest to this average for a few years.
• Customer Experience: You should always consider the mass opinion. Look for customer reviews online.
• Know about the Claim Process: Although a health insurance claim process is the same across most insurance providers, knowing the process can help save much hassle at the eleventh hour.

Before believing the information, it is imperative to check the facts and then buy a medical insurance policy. Here are a few popular myths that most people believe about health insurance policies:

I am Healthy; therefore, I Don’t Need a Health Insurance?

Even if you are healthy, there are many unforeseen circumstances like seasonal illnesses, malaria, dengue, or an accident that can hit anyone at any time. These days, hospitalization expenses are not easy to pay. Even 2-days of hospitalization would cost you between ₹ 60,000 to ₹ 1 lakh and even more (depending on the illness).

My Health Insurance will provide for all the Medical Expenses?

According to the IRDAI regulations, all insurance plans come with a set of exclusions/limitations. You must check all the policy details mentioned in the plan. The insurer will only cover the expenses covered in the policy and up to the specified limit only.

Declaration of Pre-existing Diseases

You must declare all the pre-existing diseases in the proposal form before buying a health insurance policy. Inadequate information can lead to claim rejection and can cost you more than the expected amount.

Smokers can not Buy a Health Insurance Plan?

According to the survey, almost 49% of the applicants who consume alcohol or smoke are perplexed to buy a health insurance policy. But some insurance companies give medical insurance coverage to them. But considering the risks, alcohol consumers and smokers will have to undergo a stringent pre-medical examination process and pay a higher premium to get health insurance coverage.

Medical Insurance will only Include Hospitalization Expenses?

Although most of the health insurance plans cover medical expenses towards hospitalization for more than 24-hours, some plans have a capping on the duration of hospitalization. But most of the insurers cover daycare procedure where you don’t have to be hospitalized for 24-hours. It includes cataract surgery, varicose vein surgery, and similar medical procedures.

I am Covered by a Group or Corporate Health Insurance Plan!

Most people depend on the health insurance plan that their employer provides. You should be well aware of the fact that a group medical insurance policy comes with limitations. Group health insurance policy will not offer coverage to all your family members in most cases; the sum assured will generally not be sufficient, and it will not cover critical illnesses.

Buying Health Insurance online with Coverfox is easier than ever. Coverfox provides you with detailed insights, ready on-call customer service, and a highly efficient tech-enabled interface to make your process of buying health insurance policy online smooth and easy. We get you expert advice along with an informed, unbiased opinion that will clear all your doubts and help you buy the perfect plan.

Follow the given steps below to buy medical insurance online with Coverfox

Step 1: First, select gender (Male/Female) and enter your full name.

Step 2: Feed in your correct phone number, and then click on view plans and choose your age.

Step 3: Now click on continue and enter your city where you are living along with the pin code.

Step 4: Select Yes or No if you take any medications.

Step 5: Choose the best health insurance plan from the options that are displayed.

Step 6: Now select and compare the different health insurance plans on Coverfox. You can also choose the personalized plans options.

Step 7: Once you select the plan, you can pay the premium or speak to our customer care representative to take you through different options.

Step 8: Do make an informed decision and pay the premium. Once all the steps are done, the policy will be emailed on your registered email-id.

Once you select the plan which meets your needs with the least amount of premium, you can go ahead and pay the health insurance premium or talk to our customer service to avail of the insurance policy. While it is understandable to choose the policy with the least insurance premium, it is essential to know that various factors can affect your medical insurance premium. Some elements that influence a health insurance plan’s premium include the sum insured, proposer’s age, medical history, family health history, lifestyle, smoking habits, etc. These factors are considered before the premium amount is determined. It is important to take note of these to make an informed decision.

It is essential to pay a fixed premium regularly in order to keep the policy in force. Have you ever wondered how this premium is calculated? Certain factors affect health insurance premiums like your family’s medical background, your personal medical history, and so on.

Depending on that, you might want to calculate your premium to know how much you would have to pay for the policy. It can be done via a Health Insurance Premium Calculator. A premium calculator is an online tool that calculates the premium to be paid as per your information. At Coverfox.com, you can calculate your medical insurance premium easily.

As the medical facilities are advancing, so are the health care costs. The primary benefit of health insurance is that it takes care of healthcare costs. It gives financial security to you and your family if any unanticipated serious illness or accidental injuries draining all your savings. Learn how the cost of your insurance premium is determined:

• Medical History: Medical history is a major determinant of the health insurance premium. Pre-medical tests are mandatory by almost all insurance provider in India (after a certain age) before buying a health insurance policy. While a few insurance companies don’t make medical screening mandatory, they consider your current medical conditions, lifestyle-related health risks, and the medical history of your family. That is the reason why medical insurance premium for smokers is higher than other people.
• Gender and Age: Age is an important aspect of determining the medical insurance premium. The premium differs based on the age of the insured person. That is why it is suggested to buy a policy at a young age because the premium cost is low for young applicants. Older adults are vulnerable to cardiovascular diseases and other critical illnesses like kidney problems, cancer, etc.; thus, senior citizen medical insurance premium is generally higher. Additionally, the cost of the premium for women’s health insurance is lower than the male candidates due to the lower risk of stroke, heart attack, etc.
• Policy Term: The premium for a health insurance plan for 2-year will be more than a 1-year plan. However, nearly all insurance companies offer a discount on long-term medical insurance plans.
• Type of Health Insurance Plan: The kind of health insurance policy you choose also changes the cost of the premium. The higher the risks, the higher will be the premium and vice-versa. An online medical insurance premium calculator will help you compare the premium for different plans.
• No-Claim-Discount: If no claims are made from your end in your policy term, you can earn NCB or No-claim-bonus from 5 to 50 per cent. This is also considered to be one of the most important factors that are considered while calculating the cost of the premium.
• Lifestyle: If you regularly drink or smoke, the chances are high that you will be charged a more premium amount. In that case, the insurer can even reject your medical insurance policy request.

Arogya Sanjeevani is a health insurance policy offered by every Indian health insurance company. Arogya Sanjeevani policy covers your primary medical insurance needs. It is a good option for those who do not have medical insurance cover, particularly in smaller towns.

As mandated by the IRDAI, the Arogya Sanjeevani policy offers health cover ranging from ₹ 1 lakh to ₹ 5 lakhs. A primary waiting period of 30 days is applicable from the date of policy issuance. The waiting period for specific illnesses ranges from 24 months to 48 months, depending on the disease.

Benefits of Buying Arogya Sanjeevani Policy:

• The policyholder under Arogya Sanjeevani gets coverage for Coronavirus related hospitalization expenses.
• It reduces the complications that crop up while selecting from several health plans with varied inclusions, exclusions, and sum assured. Therefore, it is easier for ordinary people to buy a health cover without any difficulty to understand the policy terms and conditions.
• Lifelong Renewal facility, No Claim Bonus (NCB), Cashless hospitalization is provided.
• Easily portable from one insurer to another.

Features available under an Arogya Sanjeevani Plan:

• Arogya Sanjeevani plan provides cover for people aged 5 months and 65 years.
• It has a minimum sum insured of ₹ 1 lakh, and the maximum sum insured is ₹ 5 lakhs. It is an ideal health plan for people who live in rural areas and cannot pay a larger premium.
• Cover for in-patient hospitalization expenses, daycare treatments, ICU expenses, Ayush treatment, Ambulance charges, Cataract treatment etc.
• 5% co-pay is applicable irrespective of the age of the policyholder.

Health insurance plans have additional benefits of cashless treatment and expense reimbursement by the insurer. You can check out the entire claim settlement process in detail and know about the documents required for making a claim on our dedicated page, "Health Insurance Claims"

If the policyholder is hospitalization he/she needs to submit certain documents as mentioned below for making a reimbursement claim:

• Discharge card provided by the hospital
• In-patient hospitalization bills signed by the hospital for authenticity
• The doctors’ prescriptions, along with medical store bills
• Claim-form signed by the insured
• A valid investigation report
• Doctor's prescribed consumables and disposables with complete details
• Doctor's consultation bills
• Copy of the previous year insurance policy and the current year/copy of ID Card of TPA
• Any other document(s) needed by the TPA

You don't have to continue with your current health insurance provider if you do not want to since IRDAI now allows you to change your insurer without losing any existing or accumulated benefits.

Now IRDAI allows you to switch from one insurer to another while the new insurer will have to consider the credits you have gained from your previous insurer, where the credits refer to the completed waiting period in pre-existing conditions. The same thing applies if you switch from one plan to another within the same insurance company.

What can you do

• Switch from health insurance companies.
• Family floater/individual policy can be switched.
• Get insurance cover by your new insurer up to the sum assured as the old policy has.
• Both insurers should mutually complete the formalities as per the IRDAI timeline.

Criteria

• A policy can be ported at the time of renewal only.
• There must not be any break between policy renewals.
• You need to submit a formal porting request to your current insurer at least 45 days before the renewal’s due date.
• With a new policy, the terms and conditions and the premium are at the new insurer’s discretion.
• You must mention the name of the new insurer you are willing to switch to.