Health Insurance

Falling sick is bad enough, what’s worse is the medical bills that follow after. You might not be able to avoid unforeseen health issues, you can definitely protect yourself from financial losses incurred from it. A health insurance policy offers you protection against medical expenses when you fall ill. There are a variety of health insurance plans offering different coverages. In this article, we will delve into every aspect of health insurance. Read on to know all about these policies.

What is health insurance?

Insurance policies are generally designed to protect you from financial losses incurred from certain unforeseen incidents in life. Similarly, a health insurance policy offers protection against medical bills when you fall ill. Hefty medical bills are the last thing one would want to worry about after recovering from an illness. Health insurance guarantees peace of mind by taking care of your medical expenses.

Most health insurance plans cover pre and post-hospitalization expenses in addition to other medical-related expenses. Most policies also offer cashless claims which ensures you do not have to worry about arranging cash to close your bills. A comprehensive health insurance policy is a saviour in times when you fall ill.

What does Health Insurance offer?

As mentioned above, a health insurance coverage plan is designed to provide financial protection in case you, your parents or any one of your family members require planned or emergency hospitalization.

The cost of medical treatment is covered under your health plan that is provided by a general insurance company. In addition, you can avail of cashless as well as reimbursement mode of payment at a nearby/network hospital.

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. A health insurance policy will help you get the best medical care and you don't have to worry about expenses. A good health 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 against financial losses - Buying Health insurance is one of the most clever financial decisions one could make. Even the simplest medical procedures can cost lakhs. When you have a health insurance policy, the insurer will pay the medical bills. By paying a small annual premium, you will protect yourself against huge financial losses in the future.
• Modern Lifestyle - The modern lifestyle is definitely not the healthiest. Lack of sleep coupled with bad eating habits and stress takes a toll on one’s body. Young people in their 20’s and 30’s are falling prey to serious health issues such as diabetes, high blood pressure, heart ailments, and more. This is another compelling reason as to why you should get a health insurance plan.
• Inexpensive - A small annual premium can save you from a huge financial liability during medical emergencies. There are a variety of health insurance plans but even the one with the highest coverage will cost you less than an outpatient procedure at a hospital. A basic health insurance plan will cost you less than a night out with your friends.
• Best way to protect your loved ones - With a health insurance plan, you can also protect your family against medical emergencies. These policies are especially crucial for those who have large families, elders in the family, or are the sole breadwinner.
• Tax benefits - Most health insurance policies can be used as a tax-saving tool. You can claim tax deductions up to Rs. 25,000 or more depending on the policy you choose. While this is not the main reason why you should invest in a health insurance policy, it’s definitely an added benefit.

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

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.

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.

Group health 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.

Critical illness health 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 health insurance plans.

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.

Health insurance comes with a plethora of benefits that are not just limited to offering financial cover during medical emergencies. Listed below are some of the most popular benefits of health insurance:

• Comprehensive cover

Health insurance policies offer a comprehensive cover, meaning you are protected against a myriad of health issues. In addition to that, you also get cover for pre and post hospitalisation expenses, medications, and more. All this at the cost of a small annual premium.

• 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 health 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 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 ambulance charges for transferring the patient to the hospital are covered upto a specified amount say Rs. 5000/- or upto a certain limit like 1% of the sum insured capped with a maximum amount.

• Health Insurance Tax benefits

Health insurance policies offer tax benefits under section 80D of the Income Tax Act, 1961. The tax deduction offered depends on the age of the insured, premium amount, and other factors. Depending on these factors you can claim tax deductions from anywhere between Rs.25,000 to 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 health insurance, 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 old times, you do not have to go from one insurance provider to another to find the right plan. You can compare, assess, and purchase health insurance plans online from the comfort of your home. What’s even better is that you can even get discounts when you purchase policies online.

Main factors to choose the best health insurance policy

There is no one-size-fits-all health insurance plan. The right insurance policy not only fits your budget but covers all your needs. So how do you choose the right health insurance plan? Here are some things to consider before purchasing a health insurance plan:

• Ensure you have the right coverage

The first thing you need to check with any health insurance policy that you are considering. Ensure that your prospective plan offers cover against a wide range of medical expenses. We also suggest taking into account your family medical history while choosing a policy. For instance, if there is a history of diabetes or heart issues in your family, ensure you have adequate cover for the same in your policy.

• Check if it is affordable

What many people fail to understand is that health insurance policies come with a financial commitment. You will have to pay the premiums for your policy diligently to maintain the policy. So when choosing a policy, make sure that the premiums are affordable and you can continue paying it for a long-term.

• Look for flexibility

Another thing to look out for when purchasing a health insurance policy is flexibility. Ensure that your policy can be customised with additional riders.

• Compare between plans

As we have already mentioned, a health insurance plan is a serious long-term commitment. So it is wise to not choose the first policy you chance upon. We suggest comparing between different health plans before zeroing in on the best policy.

Types of Coronavirus Health Insurance

The answer is yes, your existing health insurance policy covers the expense of COVID-19 treatment.

While every health 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

There are some factors that need to be considered closely to make the right decision:

● Caps and Sub-limits

● Cover offered

● Life-Long Renewability

● Network Hospitals

● Claim Record

● In-house Claim Settlement Team

● Restore Benefit

● Waiting Period

An ideal health insurance plan for you is the one that offers you the desired coverage, here we have compiled a few health insurance plans based on some of your needs:

Health insurance policy eligibility criteria depend on pre-existing illnesses (if any), current medical conditions, the customer’s age, etc. The health 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:

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 health 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.

A comparison of health insurance policy can be difficult, we completely understand. That is why we have created our platform which specializes in making insurance simple for you.

There is no point in comparing something of which you know nothing about. With Coverfox on board, just sit back and relax. Let us do the hard work for you. Comparing Health Insurance on our platform is very easy. We have a detailed page that explains you the importance, benefits of comparison. You also get to know how you can perform quickly.

With over 25 insurance companies and more than 200 health insurance products available in India, performing a comparison of various benefits, features of health insurance plans and finding the best quote becomes a daunting task. Here are some important tips to make an informed decision:

• Select the Appropriate Sum Assured

The country’s healthcare inflation is rising and is increasing at the rate of 17% to 20% annually. To take care of growing expenses in health care, it is essential to select the maximum available sum insured at the best possible premium rate.

• Provide Complete & Right Details

Provide correct information about your health in the proposal form, as any inaccurate information can make the insurer reject your claim form.

• Remember the Factors That Influence the 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.

• See the Credibility of the Health Insurance Company

Check the history of the health insurance company from where you are planning to buy your health insurance plan. It is best if you select the health insurance company based on the following 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 a health insurance company, look for the average ICR of all the health insurance companies online on Coverfox.com and go for the one closest to this average for 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.

Due to busy schedules these days, it has become challenging to visit different health insurers’ offices or branches to compare various medical insurance policies.

You don’t have to worry as Coverfox understands the dilemma of the customers and hence, has a tech-enabled platform that helps you compare different health insurance quotes online.

Listed below are some of the advantages of buying a health insurance plan online:

• Access to Right Information: Provides easy access to every medical insurance policy available in the market, saving the buyers from the pain of dealing with the agents who are known to provide unreliable and biased information most of the time.
• Time Efficient and Convenient: This process saves the user’s time. You no longer have to keep meeting agents to compare and choose the best plans. Additionally, paying premiums, renewing the health insurance plans, etc., are also more accessible via online mode.
• Pocket-Friendly: If a customer buys a health plan online, he/she can then compare the premium and choose the one that fits in the budget with no brokerage or agent fees, saving a significant amount of money.
• Availability of Provider/Plan Reviews: Reviews will aid in getting an overall idea of an insurer’s reputation, assisting in making an informed decision.

Arogya Sanjeevani is a health insurance policy offered by every Indian health insurance company. Arogya Sanjeevani policy covers your primary health 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 Rs. 1 lakh to Rs. 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 Rs. 1 lakh, and the maximum sum insured is Rs. 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.

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.

Before believing the information, it is imperative to check the facts and then buy a health 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 INR 60,000 to INR 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 health 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 health 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 health 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.

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 health 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 health 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 health insurance premium calculator will help you compare the premium for different health insurance 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.

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

Buying health insurance can be hassle-free if you approach the right channel. Having said this, Coverfox.com provides you with a tech-enabled platform where you can compare the best health insurance and then can choose the one the suits your requirement. Well, visit Coverfox and get expert advice along with an informed, unbiased opinion that will clear all your doubts and help you buy the perfect plan. Moreover, enjoy the attention of a service manager who will assist you with all your post-sale requirements- from claims processing to renewals! What more can you hope for?

Buying health insurance can be hassle-free if you approach the right channel. Having said this, Coverfox.com provides you with a tech-enabled platform where you can compare the best health insurance and then can choose the one the suits your requirement. Well, visit Coverfox and get expert advice along with an informed, unbiased opinion that will clear all your doubts and help you buy the perfect plan. Moreover, enjoy the attention of a service manager who will assist you with all your post-sale requirements- from claims processing to renewals! What more can you hope for?

Now buy health insurance online in no time from Coverfox. Here are the steps to buy medical insurance:

• 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 select your age
• Step 3: Now click on continue and enter your city where you are living in 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

To begin with, let us understand what premium is all about. A health insurance premium is the annual cost of the insurance plan. It is the cost of providing health cover (an amount you pay to buy your coverage).

For example, suppose you buy a new health insurance policy for Rs. 1500 per year for a cover of Rs. 5 lakhs. As per this plan, Rs. 1500 is the premium amount which you have to pay every year and Rs. 5 lakhs is the financial cover you get by paying Rs. 1500 as premium for a single year.

Check our page on Health Insurance Premium Calculator to know in detail factors that affect your health insurance premiums.