What is Health Insurance?

Health insurance is a financial contract between the policyholder and the insurer, where the insurer covers medical expenses in exchange for a premium. It includes coverage for treatments, surgeries, prescriptions, and hospitalization costs, ensuring financial security during medical emergencies.

Role in Financial Security

With rising healthcare costs and medical inflation, having a health insurance policy protects you from draining your savings during unexpected medical crises. It acts as a financial safety net, ensuring access to quality healthcare without out-of-pocket expenses.

A well-chosen health insurance policy provides comprehensive coverage and financial relief. Here are some key advantages:

• Protection Against Medical Inflation: Covers escalating medical costs.

• Cashless Hospitalization: Get treatment at network hospitals without paying upfront.

• Income Protection: Prevents financial strain during medical emergencies.

• Pre- and Post-Hospitalization Coverage: Includes diagnostic tests, follow-ups, and medications.

• Daycare Procedure Coverage: Covers advanced treatments that don’t require 24-hour hospitalization.

• No-Claim Bonus (NCB): Get increased coverage for every claim-free year.

• Critical Illness Cover: Provides lump-sum benefits for serious diseases like cancer, stroke, and heart conditions.

• Mental Health Coverage: Covers treatment for mental illnesses as per IRDAI guidelines.

• Organ Donation Coverage: Covers expenses related to organ transplants.

• Ambulance Charges: Provides coverage for emergency transportation.

Before buying a health insurance policy, check the important factors mentioned in the list below. If a health insurance policy fulfills all the necessary benefits, it means the policy is truly good.

Modern health insurance policies offer comprehensive features to maximize your healthcare benefits. Key features include:

• Comprehensive Hospitalization Coverage: Expenses for in-patient hospital stays are fully covered.

• Pre- and Post-Hospitalization: Costs for medical tests and follow-up care are included.

• Daycare Procedures: Advanced treatments that don't require 24-hour hospitalization are covered.

• No-Claim Bonus (NCB): Get increased coverage for every claim-free year.

• Cashless Claims: Access treatment at network hospitals without upfront payments.

Different health insurance plans cater to varied needs. Here are the most common ones:

• Individual Health Insurance: Covers a single individual.

• Family Floater Plans: A single plan covering all family members.

• Critical Illness Insurance: Provides a lump sum on the diagnosis of severe illnesses.

• Top-Up & Super Top-Up Plans: Additional coverage beyond the base plan.

• Senior Citizen Health Insurance: Tailored plans for elderly individuals.

Medical Inflation

Healthcare costs are rising at an alarming rate. Without health insurance, even a single hospitalization can drain savings.

Access to Quality Healthcare

Medical insurance offers access to better hospitals and treatments without financial strain.

Tax Benefits

Premiums paid for medical insurance are tax-deductible under Section 80D of the Income Tax Act.

Protection for the Entire Family

Family floater plans offer coverage for spouses, children, and parents under one policy.

During any medical contingency, a cashless treatment facility comes in extremely handy. Some of the major benefits of cashless treatment include:

Easy access to fast treatment

With the help of a cashless health insurance plans, you can easily access quality healthcare immediately without financial worries. You need to inform the authorities within 24 hours of emergency hospitalisation and 48 hours of planned hospitalisation.

Comprehensive benefits

With the aid of a cashless treatment facility, you can utilize all the comprehensive benefits of your medical insurance plan.

Coverage during travel

If you, unfortunately, fall sick while travelling, you can avail of a cashless treatment facility at any network hospital throughout the country.

Buying health insurance online is quick and convenient. Follow these steps:

• Visit the Insurer’s Website: Choose a trusted provider like Coverfox.

• Enter Personal Details: Input age, family members, and coverage requirements.

• Compare Plans: Evaluate premiums, benefits, and features.

• Select & Customize: Choose a suitable plan and add necessary riders.

• Make Payment: Use credit/debit card, UPI, or net banking.

• Get Instant Policy: Receive the policy document via email.

So far it is clear that medical insurance is ideally extremely helpful. Some of its most highlighting benefits include:

• Hospitalisation charges: All standard health plans cover hospitalisation costs. However, claims are settled only for those health issues that were not present during the policy purchase. Several insurance providers offer plans like critical illness plans, offering coverage for listed critical ailments, accidental coverage plans, etc.

• Zero capping on ICU charges: Several insurance providers offer plans without any room rent capping on ICU charges. The beneficiary can opt to live in a private cabin at the cost of the insurance provider. However, if it exhausts the plan terms, he/she has to settle the excess dues.

• Mental illness coverage: Health insurance plans also cover mental illness treatment costs. This has become mandatory as per the IRDAI norms considering the steep rise in mental health issues.

• Bariatric surgery costs: Only a specific handful of health insurance plans offer coverage for obesity treatment. The premium rates are slightly higher.

• Zero room rent capping: Health insurance plans usually cover room rents during hospitalisation. They previously disclosed the total disbursement amount in this context.

• Daycare procedures: These are those medical procedures that require less than 24 hours of hospitalisation like cataract surgery, angiogram, dialysis, etc. Most health insurance plans cover these.

• Ambulance charges: General health insurance plans allow road ambulance cost coverage incurred during medical contingency.

• Refilling sum insured: Under such health insurance plans, you can make up to 2 claims per year within the specified sum insured limit, provided the health issues differ in both cases.

• Daily cash cover: Best health insurance plans also offer daily cash allowance to compensate for the income loss incurred during the term of hospitalisation.

• Zone upgrade: In terms of medical insurance, zones are classified as per the average medical expenses in the concerned city. They tend to be comparatively higher in the metro cities than towns and other smaller cities. This particular add-on allows you to consider the cost disparity costing slightly additional premium charges. However, it subsequently saves your total premium payment cost by nearly 10% to 20%.

• Domiciliary cost coverage: Certain treatments may require domiciliary treatment rather than hospitalisation as per the doctor’s advice. Some medical insurance plans even offer coverage for such treatments too.

• Organ donation costs: If any major organ like the liver or kidney requires replacement, it becomes extremely expensive. However, health insurance plans cover organ donation costs depending on the terms of the plan.

Investing in health insurance is not just a financial decision—it’s a crucial step toward securing your health and peace of mind. Here are the top reasons why purchasing a health insurance plan is essential:

1. Financial Protection Against Rising Medical Costs

The cost of quality healthcare is rising exponentially due to medical inflation. A health insurance plan ensures you can access the best treatments without depleting your savings. From hospitalization to medication, your policy acts as a financial cushion during unexpected medical emergencies.

2. Access to Cashless Hospitalization

Health insurance allows you to avail of cashless treatments at network hospitals, reducing the financial burden during emergencies. You no longer need to arrange funds upfront; the insurer directly settles your bills with the hospital.

3. Comprehensive Coverage for Modern Lifestyle Diseases

The prevalence of lifestyle-related diseases such as diabetes, hypertension, and cardiac conditions has increased due to sedentary habits and stress. Medical insurance offers coverage for these ailments, including routine check-ups, preventive care, and treatment costs.

4. Pre- and Post-Hospitalization Benefits

Most medical insurance policies cover not only hospitalization expenses but also the costs incurred before and after hospitalization. These include diagnostic tests, follow-up consultations, and medications.

5. Coverage for Critical Illnesses

Modern health insurance plans provide critical illness coverage, offering a lump-sum payout if diagnosed with severe conditions like cancer, stroke, or organ failure. This ensures you’re financially prepared for advanced treatments.

6. Tax Benefits Under Section 80D

Purchasing medical insurance helps you save on taxes. Under Section 80D of the Income Tax Act, you can claim deductions of up to ₹75,000 (for senior citizens) on premiums paid for yourself and your family.

7. Peace of Mind for You and Your Family

With the right health insurance plan, you’re prepared for any medical emergency. This peace of mind allows you to focus on recovery rather than worrying about financial burdens during challenging times.

8. Easy Portability and Add-Ons

Health insurance policies today come with portability options, allowing you to switch insurers without losing accumulated benefits like the no-claim bonus. You can also enhance your plan with add-ons like maternity coverage, OPD benefits, or room rent waivers.

Renewing your health insurance policy online is a quick and hassle-free process. Follow these steps to ensure uninterrupted coverage:

• Visit the Insurer’s Website: Go to your health insurance provider’s official website or login to your policy account.

• Enter Policy Details: Provide your existing policy number and registered details to fetch your policy information.

• Review Policy Terms: Check your current coverage, sum insured, add-ons, and policy benefits. Make any necessary modifications if required.

• Compare and Upgrade (If Needed): Assess whether you need to enhance your coverage, add riders, or switch to a better plan.

• Check No-Claim Bonus (NCB): If you haven't made any claims in the past policy term, ensure that your NCB is applied for a higher sum insured or a premium discount.

• Make the Renewal Payment: Choose a suitable payment method (credit/debit card, UPI, net banking, or EMI) and complete the transaction.

• Receive Instant Confirmation: After a successful payment, you will receive an instant confirmation via email/SMS along with the renewed policy document.

• Download and Store the Renewed Policy: Save a copy of your updated health insurance policy for future reference.

While health insurance provides extensive coverage, certain exclusions exist:

• Pre-existing conditions during the waiting period.

• Cosmetic surgeries and aesthetic treatments.

• Dental and oral treatments (unless accident-related).

• Illnesses within the initial waiting period (30-90 days).

• Injuries from war, terrorism, or hazardous activities.

• Substance abuse-related complications.

• Non-medical expenses like toiletries and administrative fees.

Comparing different policies before buying ensures you get the best deal. Here’s why it’s crucial:

• Better Coverage: Identify policies with maximum benefits.

• Cost-Effectiveness: Ensure premium affordability.

• Understanding Exclusions: Avoid surprises during claims.

• Customization Options: Select add-ons to enhance coverage.

• Value for Money: Get the best benefits within your budget.

Comparing similar health insurance plans offered by different companies is very crucial for understanding the scenario well and acquiring the most suitable plan at the most affordable rate:

• Ensuring optimum coverage: There is no single plan that equally fits everyone well. Comparative analysis is essential to understand which plan suits you the best.

• Effective cost management: You must compare different plans to ensure receiving the best coverage at the most affordable rate.

• Plan terms and conditions: Once you begin your comparative study among different plans, you get a better grasp of the nature of policy terms and conditions. This aids you in making an informed decision.

• Additional benefits: Comparing different policies will help you explore different additional benefits and riders.

• Customised coverage: When you compare health insurance plans you pave the road to utilise customised coverage, a perfect plan that satisfies most of your requirements.

• Value for money: When you purchase a health policy after careful comparison, you ensure to get optimum value for money.

• Command: When you compare different health policies before purchasing, you remain in command to secure the perfect match considering your requirements.

Claiming health insurance can be done in two ways:

1. Cashless Claim Process

• Inform the insurer and submit a pre-authorization request at a network hospital.

• Once approved, receive treatment without paying upfront.

• The insurer settles the bill directly with the hospital.

• Pay only for non-covered expenses.

2. Reimbursement Claim Process

• Pay the hospital bills out of pocket.

• Submit necessary documents (bills, prescriptions, reports) after discharge.

• The insurer verifies and transfers the claim amount to your bank account.

1). Documents Required for Buying

• Age proof like passport, birth certificate, etc.

• Identity proof like passport, Aadhaar Card, etc.

• Address proof like passport, DL, utility bills, etc.

2). Documents Needed for Claim

• A duly filled and signed claim form

• Recent passport-size photo

• All the hospital bills, receipts, documents, reports, prescriptions

• Pre-authorised claim form for cashless claim

• Identity proof

3). List of Documents Necessary to Claim Under Reimbursement

For reimbursement claim, you need the following documents:

• Discharge summary from the hospital

• All the receipts, bills, prescriptions, reports, and documents, issued during hospitalisation

• Identity proof

• Cashless Claims: Seek treatment at a network hospital, present the insurance card, and let the insurer handle expenses.

• Reimbursement Claims: Pay bills out of pocket, submit documents, and get reimbursed.

• Documents Required: Discharge summary, hospital bills, prescriptions, and investigation reports.

Purchasing medical insurance requires careful consideration to ensure you get maximum coverage and a smooth claim process. Use this checklist to evaluate the best plan for your needs:

Enhance your health insurance plan with useful add-ons, including:

• Room Rent Waiver: No cap on the type of hospital room you choose.

• Maternity Benefits: Coverage for childbirth, pre-natal, and post-natal care.

• OPD Coverage: Reimbursements for outpatient consultations and medicines.

• Critical Illness Rider: Lump-sum payout upon diagnosis of life-threatening illnesses.

• Accidental Disability Cover: Compensation for disability caused by accidents.

"I'm Young and Healthy; I Don't Need It."

Reality: Accidents and sudden illnesses can happen at any age. Early purchase locks in lower premiums.

"It Only Covers Hospitalization."

Reality: Modern plans cover OPD, daycare treatments, pre- and post-hospitalization, and mental health care.

"Pre-Existing Conditions Aren't Covered."

Reality: They are covered after a waiting period of 2-4 years, and policy portability can reduce this time.

"It's Too Expensive."

Reality: Affordable options, top-up plans, and tax benefits under Section 80D make it cost-effective.

"My Employer’s Plan Is Enough."

Reality: Employer coverage ends when you leave the job and may have a low sum insured. A personal plan offers lifelong protection.

The importance of health insurance cannot be exaggerated. Some of the most significant factors that highlight the importance of health insurance especially considering the current-day scenario include:

• Competent coverage of medical expenses: Health insurance allows medical emergency coverage without any need for immediate upfront payment.

• Cashless hospitalisation facility: You can access cashless hospitalisation facilities throughout the country among network hospitals.

• Family protection: You can ensure family protection using a family floater plan.

• Combatting medical inflation: Health insurance policies allow you to combat medical inflation most effectively, ensuring efficient finance management.

• Critical illness coverage: Some health insurance policies even allow critical illness coverage.

• In-patient care: In-patient hospitalisation coverage is allowed under health insurance.

• No Claim bonus: Health insurance policies allow NCB for non-claim years, eventually raising the sum insured amount at no additional cost.

• Additional riders: You can add befitting riders to enhance the coverage span.

Coverfox is a commendable name in the health insurance India industry. Some of the significant reasons for purchasing best health insurance plans through Coverfox include:

• User-friendly: Coverfox maintains a simple and easy-to-understand interface for easy online health insurance purchases in India. You can even use their official site to renew health insurance online in India.

• Ample options: Coverfox offers best health insurance options considering the varied requirements of the wide customer base.

• Affordable: The health insurance options available on Coverfox are comparatively much more affordable and offer competent comprehensive coverage.

• Network hospitals: Coverfox maintains a wide network of hospitals throughout the country for easy cashless hospitalisation facilities.

While wrapping up, we must emphasise that health insurance has become a necessity considering the current circumstances of steep medical inflation. So, it is best to purchase one at the earliest. You can easily buy best health insurance online with a few simple clicks and taps on your computer or smartphone. However, consider all the tips and tactics mentioned here to ensure optimum coverage without burdening your pocket.