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Health Insurance

Health insurance for you and for your family.
Buy Confidently

With 25 insurers and 100+ products to choose from, Coverfox works actively to find a plan that is ideal for you—basically, the best one, the right one. From providing you with all the right information to offering unbiased comparisons, we do it all. Hey, you don't even need to engage with the insurer yourself.

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What is Health Insurance?

Things you need to know
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Health insurance is a type of insurance that fully or partially covers an individual's medical and surgical expenses. It's an agreement between you and your insurance company, where for an annual premium, the insurer pays for your hospitalization and other medical expenses as mentioned in your policy.

BASIC HEALTH PLAN

This provides for the hospitalization expenses you might face in case of accidents, day-care procedures, surgical treatments or critical illnesses. However, the features, limits and sum assured will vary from insurer to insurer.

SUPER TOP-UP HEALTH PLAN

Similar to top-ups for mobile network services, this adds supplementary coverage to your existing health plan. The aim is to increase overall sum assured with its corresponding coverage by paying a relatively lower premium.

Health Insurance in India

How to Compare Health Insurance Plans in India?

There are a number of web insurance aggregators such as Coverfox that help you compare the best health insurance plans for you and your family. Certain parameters that should be considered while comparing health insurance plans include the features of the health insurance plan, the add on benefits offered by the insurance provider, the sum insured under the policy and the network of hospitals allied with the insurance provider. These factors not only are a major differentiating factor from their competitors, but are also a testament of good service to their end customer.

Selecting a suitable health plan to protect everyone in your family is not an easy task (Unless, you have been buying insurance only to save on tax so far). Thus, always compare health insurance plans on the basis of the following crucial factors:
Choose The Right IDV
PREMIUM VS COVERAGE
Assess if the cover and sum assured are suitable against the premium paid. Choose add-ons as per your needs.
Avail No Claim Bonus
NETWORK HOSPITALS
Be sure of the insurer's network hospitals in your area. You can avail of cashless services only at these hospitals.
Install security devices
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.
Become AAI Member
EXCLUSIONS
Check what is permanently excluded and which treatments are possibly covered after waiting for a certain period.

Use Health Premium Calculator to Find the Affordable Health Plan

As the name suggests, a Health Premium Calculator helps you determine your health insurance premium, which is the cost that you would need to pay for health insurance. This tool is highly effective to understand the amount of money you need to keep aside from your budget to cover your health insurance needs. The premium calculator asks details such as the number of individuals to be insured, their age, sum insured and some other details. Before investing in a health insurance plan, you must always calculate the premium using the health premium calculator so as to choose the plan that best suits your needs and at the same time does not burn a hole in your pocket.

Health Insurance Plan: Check Points

While there are a number of factors one must consider before investing in a health insurance plan, here are our top 10 tips to keep in mind.

  • Coverage level- Foremost, one must check the coverage level of a health insurance policy. While the basic coverage remains the same, some absolute limits tend to vary in different policies. Also, it’s always wise to choose a plan which has features that you may need and not overburden yourself with unnecessary features.

  • Sublimits on the policy- When investing in a health insurance policy, we often tend to overlook the sublimits on certain benefits and then regret later. Hence, it is important to check the limits on ambulance charges, room rent and other expenses so that these don’t end up burning a hole in your pocket later.

  • Waiting period- Waiting period is the limited period where exclusions of certain ailments are applicable. It is always a good idea to check the waiting period before hand as different plans have different waiting periods associated with them.

  • Cashless claim facility- Cashless claim facility is a benefit where a direct settlement of medical expenses happens between the hospitals and the insurance provider. This facility is mostly offered in all health insurance plans when the patient is treated in one of the hospitals, listed in the network of hospitals, listed by the company.

  • Entry age- This factor is particularly important in case you wish to invest in a family floater plan. One must check for the maximum age of dependent children and parents/parents in-law if applicable.

  • Network of Hospitals- When selecting a health insurance policy, it’s always wise to learn about the network of hospitals which are associated with the insurance provider and offer a cashless claim facility. This ensures your mental relief at times of emergencies.

  • Exclusions- It would be extremely disappointing if your ailment or medical condition is not covered in your health insurance policy in the times of an emergency. Hence, it is always wise to read the offer document carefully and be aware of all medical conditions which are excluded from your health insurance policy.

  • Additional benefits- While checking for a health insurance policy, it only makes sense to look for add-on riders attached with your policy in order to increase the scope, coverage and benefits of the comprehensive health insurance plan.

  • Renewability- An ideal health insurance nowadays provides a lifelong renewal on most health insurance policies. Hence, renewability is a crucial factor while selecting the right health insurance policy for yourself and your loved ones.

  • Premium- The premium payable should always be kept in mind before investing in a health insurance policy. The amount payable for your health insurance plan should be justifiable and appropriate in comparison to other plans in the health insurance space.

Health Insurance Claim Process

Health Insurance claims can be made in two ways- the cashless claim process and the reimbursement claim process.

  • Cashless claim process- In order to avail the benefits of a cashless claim policy, the insured has to be treated in one of the hospitals that falls under the network of hospitals that the insurance provider has an affiliation with. Upon presentation of the e-card, details of the health insurance policy or any other physical proof of insurance, the insured can avail the benefit of cashless treatment and hospitalization. This facility can be availed only if the injury or illness is covered in the health insurance policy. On discharge of the patient, the medical bills are sent to the insurance provider by the hospital. The company then evaluates the expenses and settles the payment.

  • Reimbursement claim process- Health insurance companies also reimburse up to the sum insured, the amount initially paid by the insured in times of illness or accidents. This usually happens in case the patient is hospitalized or gets treated from a hospital that does not fall under the insurer’s network of hospitals. The insured then has to initially pay the cost of treatment entirely from his own pocket and then submit the bills of treatment to the insurance provider for claim settlement. The company then evaluates the cost and then, according to the scope of the policy coverage, reimburses the amount up to the sum insured. In case the treatment is not covered in the policy, the claim is rejected. The following documents need to be submitted during the reimbursement claim process-

    • Duly filled claim form
    • Medical Certificate or form which is signed by the treating doctor.
    • Patient’s Discharge summary or card (original), availed from the hospital.
    • Prescription and cash memos from pharmacies/ the hospital.
    • Bills and receipts (original)
    • Investigation report
    • In case of an accident, the FIR or Medico Legal Certificate (MLC) is also required.

Best Health Insurance Plans From Top Insurance Companies

Here is an exhaustive list of the best health insurance plans offered by the top health insurance companies.

Apollo Munich
- Easy Health Floater Exclusive
- Easy Health Floater Premium
- Easy Health Floater Standard
- Optima Restore
Star Health and Allied Insurance
- Health Optima
- Star Comprehensive
Reliance General Insurance
- Health Gain
HDFC Ergo
- Health Suraksha - Gold
- Health Suraksha - Gold with Regain & ECB
- Health Suraksha - Silver with Regain & ECB
- Health Suraksha - Silver
Royal Sundaram Health Insurance
- Lifeline Classic
- Lifeline Supreme
- Lifeline Elite
Universal Sompo
- Individual Privilege
- Universal Sompo Individual Basic
- Universal Sompo Individual Essential
Religare Health Insurance
- Care
- Care Freedom
- Joy
- Enhance
Iffco Tokio General Insurance
- Swasthya Kawach
- Health Protector
- Individual Medishield
Bharti AXA General Insurance
- Smart Health Basic
- Smart Health Optimum
- Smart Health Premium
Cigna TTK Health Insurance
- ProHealth
- ProHealth Select
- ProHealth Cash
- Lifestyle Protection – Critical/Accident Care
Max Bupa Health Insurance
- Health Companion
- Heartbeat Gold
- Heartbeat Platinum
- Heartbeat Silver
Raheja QBE Health Insurance
- Health QuBE Basic
- Health QuBE Comprehensive
- Health QuBE Super Saver

Top Health Insurance Companies in India

The top companies that provide health insurance are -

Apollo MunichStar Health and Allied InsuranceNew India Assurance
HDFC ErgoOriental InsuranceRaheja QBE General Insurance
Religare Health InsuranceMax Bupa Health InsuranceCholamandalam Insurance
Cigna TTK Health InsuranceIffco Tokio General InsuranceBharti AXA General Insurance

Buy Health Insurance Online

While investing in heath insurance is a good idea, it usually is a cumbersome process. The traditional method of buying health insurance was to contact an agent, decipher those complex clauses and not really understand the true meaning of most of them. Also the entire process was time consuming and would involve a lot of paperwork. But with online methods of getting your health insured, one need not worry about any of this. Hence, buying insurance online has become a preferred method of protecting one’s health for millennials. Benefits of buying health insurance online are-

  • Save on time- Investing in a health insurance plan online saves up on the effort of meeting an agent and the time on understanding complex terms and conditions of a policy. With information available at the click of a button, you can check everything related to your needs online and get yourself insured.

  • Availability of information- All crucial information related to your health insurance policy is available online and hence, there is absolutely no chance that your agent can hide or forget to share any information with you. Any information that you might require is easily available on an all exhaustive platforms online.

  • Comparison of health insurance plans- The advent of internet technology has made our lives so much simpler. With the help of web insurance aggregators, one can easily compare the health insurance plans that he considers and then select the one which suits his needs and does not burn a hole in his pocket.

  • Premium calculator- Tools such as a health insurance premium calculator are readily available online. This makes it extremely convenient for the insured to calculate the amount of premium to be paid and efficiently plan his budget accordingly.

  • Reduced premium amounts- A few companies offer lower premium in case you buy a health insurance policy online. As agents are eliminated in this process, the company now is capable of offering a lower premium rate in order to get insured individuals onboard and retain them.

Health insurance for parents

As a child, your parents always invested in raising you well and giving you the best. Hence, now it is important that their needs are catered to so that they stay in the pink of their health in their later years. Therefore, various insurance providers have rolled out special health insurance plans that cater to the medical needs of your parents. These plans cover pre and post hospitalization charges, ambulance charges and a few of them are also inclusive of pre-existing diseases.

Health insurance for women – covering critical illness

Women are subjected to a number of health hazards and medical conditions that the other gender does not have to suffer from. This is basically because of the difference in their biological make and the fact that there are several risks associated with pregnancy, childbirth and menstruation. Many insurance providers understand a woman’s plight and have introduced various health insurance plans that combat critical illnesses associated with the fairer sex of the society. One of them is Bajaj Allainz insurance which offers Bajaj Allianz women specific critical illness plan which covers a number of medical conditions such as breast cancer, cervical cancer, burns, paralysis, fallopian tube cancer, uterine or endometrial cancer, vaginal cancer and ovarian cancer.

Health insurance for senior citizen

As you progress and you reach 60 years of age, your body needs special attention. Hence, it is only wise to invest in a health insurance plan that takes care of your specific needs. Various insurance providers have customized plans that are designed for senior citizens and cater to the needs of older people of the society. Some of the best plans are provided by Star Health Insurance, Bajaj Allianz, Max Bupa, Apollo Munich, ICICI Lombard and Religare Health Insurance.

Should you Opt for Fixed Benefit Health Insurance Plans?

With the change in lifestyle and environment and many other hereditary factors, there has been a drastic rise in people falling prey to critical illnesses. Though medical technology and science has improved tremendously, the cost of medical treatments too has reached sky high! So much so, that a middle class sole earner finds it difficult to save his hard-earned money during medical emergencies in absence of a health insurance policy. Unfortunately, opting for personal loans from banks and at times from friends and relatives has created much distress among many families.

What are fixed benefit health insurance plans?

To encounter such financial hardships to treat critical illnesses, it is essential to introduce something called as ‘fixed benefit health insurance plans’. These plans take care of two major expenses such as hospital room charges as well as the entire cost of the surgery. But, remember these plans do not pay the expenses that include pathology, radiology and medical consultation.

How does a fixed benefit health insurance plan work?

An amount equal to the sum insured is paid off by the insurance company to the insured in case he suffers from an illness which forms a part of the policy wordings. This amount however is fixed and guaranteed. Here, a lump sum amount is offered irrespective of the actual expenses to the policy holder in case of a claim. In short, fixed benefit health insurance plans don’t include ‘indemnity’. The pre-existing ailments are covered only after the waiting clause comes to an end.

The survival period clause mentions that it is necessary for the policyholder to survive for certain period post diagnosis of the critical illness to make a legitimate claim.

Standalone Heart/ Cancer Insurance Plans, Critical Illness Insurance Plans etc. are few products that form a part of the fixed benefit health insurance plan.

Let's illustrate the functioning of this plan with the help of an example:

Rahul had bought a Critical Illness Health Insurance Plan with a sum insured of Rs.20 lakh. During the term of the policy, he got diagnosed with kidney failure. Since this was a legitimate claim, the insurance company paid out the entire sum insured of Rs.20 lakh to Rahul, irrelevant of the actual hospitalization and medical treatment expenses being only Rs.8 lakh. Thereafter, the policy got terminated.

Is it essential to buy a fixed benefit health insurance plan?

Yes, with the surge in critical illnesses and rising medical costs, it becomes essential to buy a ‘Fixed Benefit Health Insurance Plan’. Let’s have a look at the major factors that urge us to buy these plans:

  • Financial safety net The insured gets a peace of mind for having a financial back-up even though the emotional trauma is unavoidable. The fear of the life-long savings getting wiped-off due to diagnosis of a critical illness is thrown away.

  • Lump sum pay out The insurer pays the insured a fixed and guaranteed sum insured amount in lump sum irrelevant of the actual expenses incurred for getting the critical illness treated. It solely depends on the insured how to utilize the sum insured.

  • Zero sub-limits Unlike an indemnity health insurance plan, the fixed benefit health insurance plans don’t have any sub-limits on mandatory co-payment, room rent capping etc. So, the insured has the leverage to manage the funds as per his requirement.

  • Pocket-friendly plan Fixed benefit health insurance plans are pocket-friendly premium wise. You do not have to shell out a huge amount in terms of the annual premium. The competitive pricing makes these plans the most essential plans to buy that cover critical illnesses.

  • Easy renewals Well, you can renew the plans easily. Your plan gets activated once you renew providing you the most required financial security in the hour of need.

  • Tax benefits Section 80D of the Income Tax Act offers tax deduction for the premiums that you pay for the fixed benefit health insurance plan.

Who should buy health insurance plans?

A person who wishes to enhance his existing health cover should definitely opt for the fixed benefit health insurance plan. Besides, a person fearing to face a loss of income due to exorbitant hospitalization expenses should certainly opt for this plan. At times, employers do not offer paid medical leave. This is when a fixed benefit health insurance plan comes as a saviour.

Anyone at any age can fall prey to any critical illness. Having a fixed benefit health insurance plan provides a sense of relief without disturbing your hard-earned savings. A lump sum amount received post making a claim without any sub-limits proves as the financial net for your medical expenses and the years to come!

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FAQS on Health Insurance

Can I save tax with health insurance?

Yes, Health Insurance can help you reduce your taxable income up to Rs. 1 lakh. Tax saving can happen under Section 80D of the Income Tax Act, 1961. As a Policyholder, a deduction of up to Rs. 25,000 per annum can be availed with regards to the premium paid for a health plan. The policy offers a coverage that can be availed by you, your spouse, and dependent children. However, the limit increases up to Rs. 30,000 if you or spouse is 60 years and above. You can also back this by an additional coverage of Rs. 5,000 for hospital related expenses of the family members such as parents, spouse, and dependent children.

Which health insurance plans are available for women?

Women of all walks of life are now progressing and trying to maintain the fine balance between their personal and professional commitments. Hence, it is important that their medical needs are catered to. Various health insurance providers have now come up with unique health insurance plans that specifically cater to female medical conditions such as breast cancer, ovarian cancer, cervical cancer, complications during pregnancy, childbirth or other forms of critical illnesses. Some of the top companies that provide these kinds of health insurance plans are TATA AIG, Bajaj Allianz, etc.

What are cancer health insurance plans?

A cancer insurance plan is a supplement of health insurance that covers the risks associated with cancer and its various manifestations. This kind of plan is devised to mitigate the cost of cancer treatment of a patient.

What are overseas health insurance policies?

Overseas health insurance is covered under international travel plans. These plans usually cover bodily injuries caused, medical illnesses or diseases contracted during an international journey.

Are children covered in health insurance plans?

Yes, According to the current law, your health insurance plan can cover your dependent children., You can now add or keep your dependent children included in your policy, until they turn 26 years old.

Is my spouse covered in my health insurance plan?

Yes. Most employers that provide health insurance benefits to their employees also cover an employee’s spouse and children. However, if the employer does not provide any such health insurance plan, the spouse can be enrolled for an individual health plan from a health insurance provider or you can cover your spouse in your family floater health insurance plans.

Does my health insurance plan cover my parents?

In certain cases, yes, health insurance plans also cover the parents of the insured. Under individual health insurance plan, you cannot add any dependents, including your parents. However, if you have a family floater plan, you can also opt to add adult dependents for coverage under the same.

Which plans cover parents in health insurance?

Family floater health insurance plans usually cover parents in India. There are specific plans designed by various health insurance providers that cater to medical needs of parents of 55-60+ years of age. Some of the top providers of such unique plans include Star Health Insurance, Bajaj Allianz, Apollo Munich, Max Bupa health insurance etc.

How do I increase sum insured of my health insurance policy?

You can increase the sum insured of your existing health insurance policy at the time of renewal of the health insurance policy. One must keep in mind that sum insured enhancement is not possible in case you have you have made a mediclaim in your previous policy.

Is individual plan better than family floater health insurance plan?

This varies on a case to case basis. Both insurance plans aim to cover the medical expenses in case of medical emergencies. Individual health insurance plans cover a single individual whereas family floater plans cover the medical expenses of the entire family. However, individual plans are more expensive than a family floater plan. Also, family floater plans provide a greater sum insured amount in the event of only one claim in the year as compared to individual plans.

How does smoking affect health insurance premiums?

Smoking has an adverse effect to health insurance premiums. This means that if you are a smoker, you end up paying higher premiums as you are subjected to greater medical risks.

How do I renew my health insurance policy?

You can renew your health insurance policy either offline or online. For offline renewal, you would require to contact your health insurance provider at least 30 days before expiration and make a renewal request. Any change in the health condition must also be notified to the provider at the time of renewal. In case of an online renewal, you must provide your basic details along with your insurance policy number and make the payment online via your debit or credit card, or through net banking.

What if I forgot to pay my health insurance premiums?

In case you forget to pay your health insurance premiums, the provider gives you a grace period that usually varies from one to three months. However, if you fail to pay the premiums during this time as well, your insurance policy lapses and you are no longer entitled to the health insurance benefits of the policy.

Is a medical check-up available in health insurance?

Yes, there is a medical checkup available while applying for health insurance as the insurance provider needs to assess the current health condition of the applicant before they invest in a policy.

Is a pre-medical check-up available before buying health insurance?

Yes, a pre-medical check-up is available before buying health insurance. The pre-medical check-up is a series of tests that the insurance applicant is required to undergo so as to determine the current medical conditions and any pre-existing diseases that the applicant might be suffering from.

Which health insurance plans are available without pre-medical check-up?

Not all health insurance plans mandate a pre-medical checkup. Most insurance providers have a threshold limit of 45 years providing health insurance plans without pre-medical examination. Some of the plans are-

a. Star Health Insurance- Health insurance plans such as Family Health Optima, Mediclassic, Health Gain, Comprehensive or Family Delite require no check-ups are required till 50 years of age.

b. Oriental Insurance- Happy Family Floater plan by Oriental Insurance does not need a pre medical checkup till the age of 60 years.

c. Religare Health Insurance- This insurance provider has a unique Care plan that does not need any medical screening.

How do I buy medical insurance for a diabetic patient?

There are some insurance providers who have come up with health insurance plans specific to diabetic patients. These health insurance plans cover medical expenses arising from diabetic conditions. One can invest in health insurance plans provided by companies such as Star Health Insurance and National Health Insurance. The procedure of buying health insurance for diabetic people is the same as investing in any other health insurance plan.

Is dental covered in health insurance?

Dental treatments are only covered under mediclaim in health insurance if the insured has to undergo the required treatment or surgery because of an accident and not otherwise.

What is Third Party Administration in Health Insurance?

A Third Party Administrator or TPA looks after claim settlement and investigation on behalf of the health insurance provider.

Should I buy Government health insurance plan?

In India, not everyone can afford to invest in health insurance plans provided by private insurance providers. Hence, the government has come up with certain health insurance policies that benefit the ones in medical need. These plans are extremely cost effective and provide basic medical assistance to the poor and needy. Hence, government related health insurance plans are basically to support the ones who can’t afford health insurance plans by private insurers and promote healthcare in India.

What are the health plans offered by Government of India?

A few health insurance plans offered by government of India are-

a. Central Government Health Scheme

b. Employment State Insurance Scheme

c. Rajiv Arogya Bhagya

d. Meghalya Health Insurance Scheme

e. Deen Dayal Swasthya Seva Yojana, Goa

Is Ayurvedic treatment covered in health insurance?

With the increasing shift in alternative forms of medicine, a number of insurance providers are now providing coverage for Ayurvedic treatments in their health insurance policies. However, this is restricted to only certain health insurance providers till now.

Is cataract treatment covered in health insurance?

Yes, certain health insurance providers cover the cost of cataract treatments in their health insurance policies. However, they are subject to a few exclusions. These exclusions are factored by the waiting period and limit on claim payable. Some insurers that cover cataract expenses are Bajaj Allianz, Religare Health Insurance and Apollo Munich.

Is maternity covered under health insurance plans?

Yes, maternity is covered under health insurance plans. In fact there are special health insurance plans such as Apollo Munich Easy Health Family Floater plan, Max Bupa Heartbeat Family Floater and Star Health Wedding Gift Pregnancy cover that take care of medical expenses related to maternity.

Is dengue covered? – special plans for dengue

Yes, there are special plans that cover the medical expenses incurred in the treatment of dengue. These are called single disease specific plans. No pre medical checkups are required to invest in these plans and the premium paid for the policy remains the same, irrespective of your age.

What is top-up in health insurance?

As the name implies, a top up in health insurance is an additional cover on the health insurance policy, over and above the current available limit, at lower premiums.

What are super top-ups and why you must buy?

A top-up plan has certain limitations which can be resolved by choosing a Super top up plan. One must buy a super top-up plan because while a top-up plan pays only if the threshold limit on a regular policy is exceeded in a single claim, a super top up plan covers the threshold in multiple cases. A Super Top-up policy provides for multiple claims in a year.

What is room rent and why does it matter?

Room rent limit is a maximum per day room charges that an insured is eligible for in case of hospitalization. It is important as it affects the premium one pays for a health insurance policy.

What is claim settlement ratio in Health Insurance?

Claim settlement ratio is the ratio of the total value of claims paid or settled based on the total premium collected in the year. Claim settlement ratio in health insurance is calculated as Total Claims Settled/ (Total Reported Claims + Outstanding Claims at Start of Year – Outstanding Claims at End of Year)

What is waiting period in health insurance?

Waiting period in health insurance is the duration of time specified that must pass before your coverage can begin. Claims cannot be admitted during this waiting period.

What is the procedure to cancel my health insurance policy?

You can cancel your health insurance policy by reaching out to your health insurance provider by calling their customer care number. You must have your policy number and identity proof ready. Simply follow the procedure suggested by the health insurance provider and you would be able to cancel your policy seamlessly.

What is portability in health insurance and how do I port it?

Portability in health insurance is defined by the transfer of an existing health insurance policy from one insurer to another. The steps to port it are-

  • Apply for portability within 45 days of the current policy expiring
  • Fill up the forms for porting policies with all relevant documents ready for inspection
  • Once the new insurer checks the details which enables portability within 7 days
  • The insurer then feeds all required information while porting health insurance policies, to the IRDAI portal
  • The insurer will then frame a proposal according to their underwriting norms
  • The application is processed and you will be provided with their proposal within 15 days. In case that does not happen, the new insurer is obliged to accept your request for porting the policy.

What is meant by co-pay in health insurance?

A co-payment or co-pay is a fixed amount that a person pays from his/her own pocket towards the claim raised against the Health Insurance plan. For example, if a health plan has 10% co-pay and the total bill is Rs. 1 lakh, then you will have to pay Rs. 10,000 and the insurer will pay the remaining Rs. 90,000

What is NCB in health insurance?

A No Claim bonus (NCB) is a discount in premium offered by the health insurance provider or an increase in the sum insured in case a claim is not made within one policy year.

How to avail NCB in health insurance?

You can avail NCB in health insurance either as a cumulative bonus, or at the time of renewal or transferring of the health insurance policy.

What does the term Network Hospital mean?

Network Hospital means the number of hospitals associated with the insurer that will provide in-patient treatment care and day care treatment of illnesses and injuries on a cashless basis.

What is cashless health insurance policy?

A cashless health insurance policy is a type of insurance where the insured can be hospitalized, avail the relevant treatment and be discharged without having to pay anything from their pockets.

What is the difference Health Insurance and Mediclaim?

While the two terms can seem similar health insurance and mediclaim are distinctively different from each other. Hospitalization is a mandate for mediclaim, whereas health insurance is a lot more comprehensive. Also, the upper cap on mediclaim is up to Rs. 5 lakhs, whereas no such limit is set for health insurance and hence, claims can go up to Rs. 60 lakhs as well. Mediclaim allows the insured to make ‘n’ number of claims whereas specific health insurance plans pay the entire amount in one go.

What is difference health insurance & Critical Illness Plan?

A health insurance plan is more comprehensive and general in nature as compared to a critical illness plan. Health insurance covers a variety illnesses and injuries, whereas critical illness plans only covers defined critical illnesses such as cancer, heart attack, etc.

Is Critical Illness covered in health insurance?

Yes Critical illness is covered in health insurance. A number of insurers provide specific health insurance plans that cater to the needs of a critical illness.

Is cost of Diapers for adults covered in Health Insurance?

While certain adult incontinence products are covered in health insurance, policies in India do not support the cost of diapers for adults.

What does pre-existing diseases in health insurance mean?

Pre-existing diseases are these ailments that the insured already suffered from at the time of investing in a health insurance policy. These diseases are covered in the health insurance policy after a stipulated waiting period.

What are the features of a good health insurance plan?

Some top features of a good health insurance plans are

a. The plan is designed according to the needs of the individual

b. The policy is cost effective

c. The facility of a lifelong renewal

d. The facility of cashless hospitalization

e. Seamless and hassle-free claim procedure

f. Good network of hospitals

g. Good reviews of the insurer by insurance web aggregators

How to choose health insurance for parents?

When choosing health insurance for parents, one must keep in mind their age, current medical conditions and any pre-existing diseases that they might suffer from. Also, one must factor in the cover offered by the insurance provider as medical treatments in old age are comparatively expensive.

How to save money on health insurance?

To save money on health insurance, one must compare and select the health insurance plan that does not burn a hole in your pocket. Also, invest in policy directly through an insurance provider, to reduce the cost of an agent involved. Moreover, according to government schemes, one must inquire if they are eligible for any schemes.

How to increase the plan cover?

To increase the health insurance plan cover, one can invest in a top-up or super top-up plan and increase the sum insured before the expiration of the policy.

What happens if I claim under a health insurance?

If your illness or injury is covered under the health insurance policy, the insured gets the benefits stated in the terms and conditions of the policy. However, in case of death of the insured, the nominee gets the benefits of the health insurance policy.

What is difference between health insurance and Mediclaim?

Health Insurance and Mediclaim are terms that are often used interchangeably. However, both terms are not the same with a major difference being that Mediclaim is limited only to the hospitalization expenses, whereas health insurance is more encompassing and covers pre and post hospitalization expenses among other items.

How to select best health insurance?

Consider the following when selecting health insurance

  • Sum Insured.
  • Minimum Waiting Period for Pre-existing Illness.
  • Max Age-renewal.
  • High Claim-settlement Ratio.
  • Plans with NO Sub-limits and deductibles.
  • Premium affordability

What is the average cost of healthcare per person in India 2018?

India’s per capita expenditure on health stands at INR3500.

What is the waiting period in health insurance?

The waiting period concept in a health insurance policy is the period of time that needs to pass, lest some or most of your health care coverage starts. During this period, a claim is not considered admissible. This period varies from insurer to insurer and disease to disease. The general waiting period ranges from 2 to 4 years.

What should I try detecting for zeroing on the best health insurance?

The factors that you must consider before zeroing in on the best health insurance are

  • Claim Process
  • Waiting Period
  • Family Health Insurance
  • Selecting the right insurance amount
  • Network hospitals
  • Maternity benefits
  • Pre/post hospitalization
  • Cumulative bonus
  • Lifetime Renewal
  • Free Medical Check-up

What is the deductible for health insurance?

This is the amount one pays for health care service before his/her health insurance gets applicable. For instance, when your plan's deductible is INR 75,000, you pay 100 percent of eligible health care expense, until the bill becomes INR 75,000. Post this, you get cost by paying co-insurance.

What age is ideal to opt for health insurance?

There is no ideal age for getting health insurance. The earlier you start, the better. The premium is dependent on the age and the older you are, the higher you pay. However, the ideal age varies between 18 and 25 years.

How much does health insurance cost for 1 month for 1 person?

The cost of health insurance is based on the sum insured chosen and age of the insured person. Hence, it is difficult to arrive at a generic number, as each person and his needs are different from the other person. However, monthly health insurance premium can be as low as Rs. 100 to 300 for an average person.

What all is covered under health insurance?

  • Cashless: The insurance company issues an identity card to the insured and on showing this card on the networked hospital, he/ she can avail cashless system. This means the holder of insurance does not owe anything to the hospital. Here, the insurer has a tie up with most hospitals to facilitate cashless facility.
  • Hospitalization cash pros: Every day hospitalization expenses are covered to reduce the financial burden of the insurance holder. This helps the insured, since this amount compensates for the loss in earnings and other cost.
  • Before and after hospitalization charges: Usually, pre and post hospitalization expenses are covered up to 60 to 90 days and some insurance company even approve up to 140 days.
  • Ambulance costs: These are covered by various insurance companies, and hence, the policyholder does not have to worry about these.
  • Health Tests: In case there is no claim for certain number of years, some companies even provide free health check up to the insured.
  • Pre-existing diseases: Usually pre-existing diseases are not covered under health insurance policy; however, diabetes is covered, if the insured renews the Policy for 3 or 4 consecutive years.

Is health insurance plan from employer sufficient?

Salaried employees often enjoy benefit of the employer-provided health cover. This group cover is often provided at zero cost to the employees. Yet, it is always advisable to maintain your own independent health cover.

What is the waiting period for health insurance?

Most often, health insurance wait duration is 30 days for every policy except for accidents. There is 3 months wait duration for infants or new born babies. Some insurance carriers offer maternity benefits, yet with a waiting period ranging from 9 to 36 months. Pre-existing diseases have a waiting period ranging between 2 to 4 years.

Which are various types of health insurance plans?

The various types of health insurance plans are

  • Individual Health / Mediclaim Insurance Plans
  • Family Floater Health / Mediclaim Insurance Plans
  • Group Health / Mediclaim Insurance Plans
  • Critical Illness/Disease Specific Health Insurance Plans
  • Senior Citizen Health Insurance Plans

What are the benefits of health insurance policy?

  • Convalescence Benefit: Also known as recuperating or recovery benefit, insurers take care of the insured’s recovery expenses under this head.

  • Alternate Treatment: In recent times, the fad of alternative treatment has risen manifold. This has prompted many insurance companies to cover alternative treatments, such as Ayurveda, homeopathy and yoga.

  • Expense Related to Organ Donation: The cost of kidney transplant could range between INR 3 lakhs and INR 5 lakhs. Having a health insurance in place ensures that you will not have to worry about your and your donor’s medical expenses before undergoing an organ transplant surgery.

  • Domiciliary Treatment: Many insurers have expanded their insurance cover to include treatment taken at home under medical supervision.

  • Attendant Allowance: Insurance companies offer attendant allowance to adults accompanying the insured at a hospital, provided the insured is a child.

Is health care and Health insurance the same thing?

Yes. Mostly, health care and health insurance is referred to as the same thing.

How to buy health insurance online?

As a one-stop platform to check all available health insurance plans, the internet offers quick, hassle free and convenient option to buy the best health insurance plan at a mouse click. Unlike earlier days, today’s life is fast paced and many of us don’t bother to buy a health plan due to daunting and tedious paper work. All you have to do visit the insurer or online broker website, provide a few details about the members being insured, select the coverage amount, fill-up the proposal form and pay the premium. Your Health Insurance plan will reach you at the earliest possible.

How should I buy health insurance plan in case of pre-existing conditions?

DOs and DONTs

  • Do tell the insurance companies about your pre-existing disease
  • Do get a voluntary health check-up done
  • Do not hide your pre-existing
  • Do not buy a policy without comparison

To make sure that your health insurance gives you adequate cover, do not hide any ailment and clearly declare them before buying the policy. This ensures that you go through a systemic settlement process for all future claims.

Is health insurance premiums eligible for tax deduction?

Yes, health insurance premiums are eligible for tax deductions up to Rs. 1 lakh under Section 80 D of the Income Tax Act, 1961.

What is the difference between personal accident cover and health insurance?

While personal accident insurance is a type of liability insurance plan, there are certain parameters that distinguish the two. They are-

  • Medical expenses- Health insurance plans cover medical expenses arising from injury, illness and other medical conditions. Whereas, medical expenses are not covered under a personal accident cover, not even the expenses arising from accidents.

  • Pre and Post Hospitalization- A health insurance policy covers pre and post hospitalization charges for a specific number of days, whereas there is no such benefit available for personal accidents

  • Death coverage- A personal accident policy covers accidental death and the beneficiary receives 100% benefit. However, not all health insurance plans provide death coverage.

  • Disabilities coverage- A personal accident policy provides coverage against disabilities cause due to accidents whereas, not all health insurance policies cover disabilities.

How do I port my health insurance policy from one insurance company to another?

According to IRDAI regulations, a health insurance policyholder can transfer an existing health insurance policy to a new provider. Also, the new policy can be customized to take care of the insured’s medical needs. The following steps are involved in the process-

  • One must apply for portability within 45 days of the current policy expiring
  • Fill up the forms for porting policies and keep all relevant documents ready for inspection
  • The new insurer checks the details which enable portability within 7 days
  • The insurer feeds all required information while porting health insurance policies, to the IRDAI portal
  • The new insurer then frames a proposal according to their underwriting norms
  • The insurer then processes the application and provides you with their proposal within 15 days. In case that does not happen, they are obliged to accept your request for porting the policy.

How to claim cashless health insurance service during medical treatments?

In order to claim your cashless claim policy, you must submit your policy card to the hospital and fill out relevant details in a pre-hospitalization form. Once the form is submitted, the insurance personal of the hospital scrutinizes the form for authenticity. Note that this facility will only cover illnesses and injuries that are stated in your insurance policy.

How do I buy medical insurance for a person having Hypertension or Blood Pressure?

People suffering from Hypertension or Blood pressure usually invest in a cardiac health insurance plan as risks associated with both these conditions are the similar. Based on a medical examination, the patient is classified and accordingly the cost involved in the health insurance plan is calculated.

What is subsidized health insurance?

Subsidized health insurance is benefit provided where the premium is at a subsidy or zero cost, for individuals whose incomes are less than a basic level. For instance, schemes like Rashtiya Swasthiya Bima Yojana, Aam Aadmi Bima Yojana, Employment State Insurance Scheme (ESIS), and Central Government Health Scheme (CGHS) etc. are available in India.

Why you should have health insurance?

A health insurance covers various health costs and offers various other benefits. A health insurance protects beneficiaries from various unexpected medical expenses. When you have a health plan or a mediclaim policy or any other valid health coverage, you won’t have to pay the medical bills from your own pocket.

What is a health insurance in India?

In India, a health insurance is something that pays for hospitalizations, medical expenses incurred for an in-patient, sometimes out-patient and for the treatment through alternative modes like Ayurveda, etc. The first health policies in India were Mediclaim Policies.

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