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Health insurance policy is like an annual contract in which the insurance company pays for the medical expenses that occur during the policy tenure. The medical expenses include hospitalization due to sickness, accident, surgeries etc. These expenses can be availed by paying a fixed amount called premium. A medical insurance policy provides these expenses in the form of either reimbursement or cashless treatment.
Health insurance is an agreement wherein the insurance company provides medical coverage to the insured person for a fixed premium amount. Health insurance has become the need of the hour, especially since COVID-19 pandemic started. People have become more aware of the various benefits that come with medical insurance policy.
A health insurance policy protects you from heavy hospitalization expenses during medical emergencies. This includes hospitalization expenses, day-care expenses, ICU charges, and other medical expenses. The benefits offered depend on the health insurance plan and the insurance company you have chosen. You can also avail of tax benefits under Income Tax Act, 1961 if you possess a health insurance policy.
According to the Budget, the spending on 'medical and public health' in 2022-23 is Rs 41,011 crore due to "lower requirement of vaccination." The Union Budget has allotted Rs 86,200.65 crore to the health sector, a 16 percent increase above Rs 73,931 crore in 2021-22.
In addition, while delivering the Union Budget for the fiscal year 2022-23 on February 1, 2022, Finance Minister Nirmala Sitharaman made some significant announcements in the healthcare sector.
This involves the launch of the National Tele-Mental Health Programme and the rollout of an open platform for the National Digital Health Ecosystem. The National Digital Health Ecosystem will include digital registries of health providers and facilities, a unique health identity, a consent framework, and universal access to health care services.
|Best Health Insurance Policies||Sum Assured||Waiting Period||Room Type & Rent||View Plans|
Care - No Claim Bonus Super
Star Health Insurance Young Star (GOLD)
Raheja Arogya Sanjeevani
Disclaimer: Sum Assured & Waiting Period of policies is depend upon the age, policy type, location & Add-ons.
When you have health insurance, you don’t need to have a huge bank balance during medical emergencies. A health insurance plan does the following;
You get a cover amount of up to 1 CR every year. You can use this amount for any hospitalization treatment throughout the year.
Just get admitted & give your cashless card to the hospital. The hospital takes money from your insurance company while your treatment goes on.
Pays for your accident hospitalization bills from day one of your policy. Both indoor & outdoor accident hospitalization bills are covered.
Pays for any seasonal illnesses like covid19, viral fever, dengue, malaria, typhoid, pneumonia, diarrhoea & many more immediately after 30 days of buying the policy
Any pre-existing illness before buying the policy is covered after 3-4 yrs. after buying the policy. These include heart, lung, liver, kidney, diabetes, blood pressure & many more.
If you don’t have any pre-existing illness before buying the policy & if you suddenly get any critical ailment, it’s covered after 30 days. These include heart, lung, liver, kidney, diabetes, blood pressure & many more.
Pays for any general surgery after a waiting period of 2-3 years. These include piles, fissures, gallbladder, kidney stone & any surgeries listed in your health plan.
Here is a comprehensive list of top Medical Policies.
Disclaimer: The above table has been compiled by sourcing information from the insurance company’s website. The Incurred Claim Ratio has been sourced from IRDAI Annual Report 2018-19.
There is a wide range of health insurance policies & plans in India. Here's a list of some popular health insurance plans:
An individual health insurance policy or plan provides coverage for a single individual only. This plan covers for your medical expenses related to hospitalization, 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.
Under a family floater health 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 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 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.
Apart from this IRDAI has directed insurance companies to launch two special standard health insurance products, namely Corona Kavach Policy and Corona Rakshak, were launched.
This plan provides you with a cover against hospitalization due to Covid-19. However, one needs to get hospitalized for a minimum of 24 hours. This plan covers for your covid-19 hospitalization cost, bills related to AYUSH treatment that go up to Rs. 5 Lakh & expenses related to home treatment. The cost of items that are consumable are also covered. These consumable items include PPE kits, oxygen cylinders, ventilators, masks, gloves etc.
The benefits provided to the policy holder under the terms and conditions of the Corona Kavach Policy remain the same regardless of the insurance provider.
|Age of Entry||18 to 65 yrs.|
|Types of Coverage||Family floater or Individual|
|Sum Insured Amount||Rs. 50,000/- to Rs. 5,00,000/-|
|Discount Percentage on Premium||5% for doctors & health workers|
If you are covid positive & it is diagnosed in the policy term period, you receive a lump sum amount on your hospitalization. However, the hospitalization needs to be for a minimum of 72 hours. The duration of Corona Rakshak Policy on the minimum is 3.5 months & 9.5 months on the maximum.
|Age of Entry||18 to 65 yrs.|
|Types of Coverage||Individual|
|Sum Insured Amount||Rs. 50,000/- to Rs. 2,50,000/-|
|Discount Percentage on Premium||5% for doctors & health workers|
The decision to acquire the correct medical insurance policy is an important one and requires an in-depth examination on your end to ensure it meets your needs. The following factors must be considered closely to make the right decision:
Coverage Offered: The insurance coverage and the amount insured will determine the type of illnesses and operations that can be claimed during the policy term. Pay close attention to the benefits offered like hospitalization expenses, daycare expenses, covid 19 coverage, etc. before choosing the policy.
Adequate Sum Insured: The sum insured must be equivalent to your requirements. It is important to choose the plan with the highest coverage for your needs. In the current situation where covid 19 coverage is crucial, an insured sum between 10 lakh to Rs 1 Crore is recommended. If you are buying a family plan, the higher the sum, the more beneficial it is.
Type of Policy: It is vital to choose the right type of medical insurance policy online as each policy serves specific needs. As per your requirement, you can select an individual plan, a family floater plan, a group medical insurance, or a critical illness plan.
Waiting Period: The waiting period is the time you cannot file a claim under your medical insurance coverage. You have to wait for the deadline to expire. The waiting period typically applies to pre-existing illnesses, maternity benefits, etc. Thus, look at the Waiting Period when buying health insurance policy online and choose the one with the least waiting period.
Co-Payment Clause: Some medical health insurance plans online consist of a Co-Payment clause. Under this clause, a portion of your coverage is borne by you. This does not reduce the total medical insurance coverage but can put pressure on you as you could be paying a part of the expenses out of your pocket when the need arises. The clause does result in a reduction of the premium amount. If you do not wish to opt for this, look for another policy.
Network Hospitals: Network Hospitals are directly associated with health insurance companies. They help you avail of cashless facilities at the time of need. Take a look at the network hospitals of your insurance company when choosing a medical insurance policy online.
Lifelong Renewability: Health insurance policies are generally renewed every year. The process of renewal is quite simple & can be done entirely online. As a part of the renewal process you are required to pay your health insurance policy premium. It is important that you choose a health insurance policy coverage that has renewal options on a life-long basis.
Claim-Settlement Ratio: You should assess your health insurance company’s credibility based on its Claim-settlement ratio. If the ratio is higher, the more confident you can be that your claim can be fulfilled at the time of need. Ideally, a car insurance company with a claim settlement ratio of 80% is a good option.
Exclusions: Exclusions are the conditions under which the claim cannot be fulfilled. Such exclusions must be examined beforehand by the policyholder. An ideal health insurance policy is the one that meets your requirements, provides adequate coverage, and requires minimum medical insurance premium. But before that, it is essential to know the type of insurance policy suitable according to your needs. Mentioned below are some health plans based on your needs:
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:
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:
The eligibility criteria for a Health insurance policy depends on certain pre-existing illnesses or pre-existing ailments, policy holder's age & current medical conditions. 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:
Age Criteria to Buy Health Insurance Plans?
The entry age for Adults: 18 to 65 years (70 and above, depending on the plan and the insurer).
The entry age for Children is 90 days to 18 years, and in some plans, it goes up to 25 years.
Pre-medical Screening Before You Buy Health Insurance Plans?
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 health 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 plans might vary according to the policy terms and conditions.
Pre-existing Diseases To Mention Before You Buy Health Insurance Plans?
While buying a medical insurance policy, you must inform the insurer about the health diseases you have or any pre-existing illness that you or your family members have. It would be best if you did not keep it a secret as it can create problems at health insurance 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 them 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 understanding of the eligibility criteria.
Different health insurance companies offer various impressive features, and it can become challenging to choose the right policy. Therefore, comparing various health insurance plans online is a great idea. We offer you a systematic way to compare top health insurance policies so that you can select the most suitable & convenient plan.
Here are some of the significant advantages of comparing and buying a health insurance plan online:
Buying Health Insurance Policy online through the Coverfox website is quite an easy task. Coverfox gives you detailed insights, on-call customer service & an efficient tech-enabled interface. These factors make your online health insurance buying process quite smooth & easy. We get you expert advice along with an informed, unbiased opinion that will clear all your doubts and help you buy the perfect plan.
Follow the steps given below in order to buy a health insurance policy online with the Coverfox website.
Once you select the plan which meets your needs with the least amount of premium, you can go ahead and pay the health insurance premium or talk to our customer service to avail of the insurance policy. While it is understandable to choose the policy with the least insurance premium, it is essential to know that various factors can affect your health insurance premium.
Some factors influencing the premium of a health insurance policy include lifestyle, family health history, personal medical history, proposer’s age, sum insured etc. These factors are considered before the premium amount is determined. It is important to take note of these to make an informed decision.
It is essential to pay a fixed premium regularly in order to keep the policy in force. Have you ever wondered how this premium is calculated? Certain factors affect health insurance premiums like your family’s medical background, your personal medical history, and so on.
Depending on that, you might want to calculate your premium to know how much you would have to pay for the policy. It can be done via a Health Insurance Premium Calculator. A premium calculator is an online tool that calculates the premium to be paid as per your information. At Coverfox.com, you can calculate your medical insurance premium easily.
As the medical facilities are advancing, so are the health care costs. The primary benefit of health insurance is that it takes care of healthcare costs. It give you a financial security if any unanticipated serious illness or accidental injuries drains all your savings. Learn how the cost of your insurance premium is determined:
Arogya Sanjeevani is a health insurance policy offered by every Indian health insurance company. Arogya Sanjeevani policy covers your primary medical insurance needs. It is a good option for those who do not have medical insurance cover, particularly in smaller towns.
As mandated by the IRDAI, the Arogya Sanjeevani Policy offers health cover ranging from ₹ 1 lakh to ₹ 5 lakhs. A primary waiting period of 30 days is applicable from the date of policy issuance. The waiting period for specific illnesses ranges from 24 months to 48 months, depending on the disease.
If the policyholder is hospitalization he/she needs to submit certain documents as mentioned below for making a reimbursement claim:
A policy holder does not have to carry on with their current health insurance policy provider, if he or she doesn't want to. IRDAI gives you a provision to change the insurance provider. This switch happens without the policy holder having to compromise on the existing policy benefits 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.
A medical insurance policy needs to be renewed annually upon its expiry. On-time health insurance renewal can reap you with the following benefits:
In case of a critical medical condition that needs treatment, you need an active health insurance plan. Not having an active health insurance plan will force you to bear all the medical expenses & burn your savings. When you renew your health insurance plan it keeps your loved ones protected. Renewing your health insurance policy keeps it active & you can always use it in times of emergency.
A health insurance policy is an annual contract which means it is valid for one year after which you need to renew it upon its expiry. If you do not renew health insurance policy on time, you may lose all the benefits that you have accumulated during the past tenure. Here are some basic steps to follow for health insurance renewal process:
Step 1: Visit your insurance company's official website.
Step 2: Within the website, visit the section that deals with health insurance.
Step 3: Put in your previous health insurance plan no. & your registered mobile no.
Step 4: Checkout the health insurance plans details & the plan renewal premium.
Here is the list of documents required while buying or renewing a health insurance policy.
The best way to get the highest coverage with health insurance without splurging is through additional riders. You can add riders as per your needs and enhance your policy coverage.
The minimum age to purchase a health insurance plan is 18 years.
Your policy will lapse or get terminated if you fail to pay your premiums.
There is no limit on how many health insurance plans you can purchase.
Cashless treatment under health plans ensures that you do not have to pay anything when you get admitted to one of the network hospitals of your health insurance provider.
No, health insurance is quite affordable. For instance, under a basic health plan with a sum insured of Rs. 5 lakh, you might have to pay a premium of Rs. 5,000 - Rs. 10,000 per year. The premium depends on your age, type of policy, and other factors.
Yes, you can add family members like your spouse, children, parents or parents-in-law under a family floater which offers cover for the entire family.
Every policy comes with a waiting period after which your cover gets activated. The waiting period for most health policies is 30 days but we suggest checking with your insurance provider on the same.
Yes, your health insurance policy will still cover you if you are admitted to a non-network hospital. The only difference is that you will have to pay the bills and then file for reimbursement as opposed to getting cashless treatment.