What are the challenges faced when it comes to purchasing health insurance for older parents? Learn the factors that you need to consider with the help of a story.
What is Health Insurance?
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
What are the types of Health Insurance Plans in India?
Health Insurance in India can be broadly classified into the following types-
Hospitalization Plans- Hospitalization plans are those health insurance plans that reimburse the hospitalization and medical costs of an individual, subject to the sum insured. Hence, these plans are also known as indemnity plans.
Family floater Plans- Family health insurance plans cover the entire family in one health insurance plan. It works under the assumption that not all members of a family will suffer from illness at one time. These plans cover hospital-related expenses which can be pre and post hospitalization. Most health insurance companies in India offering family insurance have a wide network of hospitals that help the insured people in times of an emergency.
Senior Citizens Plans- As the name suggests, senior citizen health insurance plans are for the older people of the family. These plans cover health issues arising during old age. As per IRDAI guidelines, each insurer must provide cover up to age of 65 years.
Maternity Plans- Maternity health insurance plans provide coverage for maternity and other additional expenses. These policies take care of both pre and post-natal care, and delivery of baby i.e. normal or caesarean deliveries. Just like other health insurance plans, the maternity insurance providers usually have a wide range of network hospitals and also takes care of ambulance expenses.
Hospital Daily Cash Benefit Plans- Hospital Daily cash benefits is a defined benefit policy that provides a certain sum of money for every day of hospitalization.
Critical Illness Plans- These plans are benefit-based policies, where a lump sum benefit amount is paid on diagnosis of covered critical illness. These diseases are usually specific, with high severity and low frequency in nature. Hence, the treatment cost is high when compared to day to day medical / treatment need. Some of these illnesses include heart attack, cancer, stroke etc.
Why Health Insurance is Important?
Investing in a health insurance plan is extremely important for multiple reasons. They are-
- Medical treatments are a fiscal burden on the family
- Uninsured people may receive less medical care due to lack of funds
- They are prone to more risks as they do not have access to regular medical checkups.
- It protects one’s family through unexpected, unforeseen health-related financial situations.
What do Health Insurance Plans cover?
Health insurance plans offered in India provide cover for the following essential health benefits:
- In-Patient Hospitalization - Medical expenses related to hospitalization due to an illness or an accident, which is for a period of more than 24 hrs.
- Pre-Hospitalization - Medical expenses that one incurs due to illness during the days immediately preceding the hospitalization.
- Post-Hospitalization - Medical expenses that one incurs for a certain period after being discharged from the hospital.
- Day-Care Procedures - Medical expenses for treatments, which do not require 24 hours hospitalization due to technological advancement.
- Domiciliary Treatment - Covers the expenses for treatment done at home for which hospitalization would be needed.
- Emergency Ambulance - Costs related to using ambulance service for reaching the hospital.
- Ayush Benefit - Treatment done using Ayurveda, Unani, Sidha and Homeopathy.
What do Health Insurance Plans not cover?
There are a couple of benefits not covered by health insurance plans in India. They are-
Pre-existing medical conditions- Pre-existing medical conditions are the ailments that you might already be suffering from while applying for insurance. In all probability, pre-existing medical conditions are not covered under medical insurance plans. However, health insurance providers have started providing coverage for pre-existing medical conditions after a waiting period ranging between two to four years.
Cosmetic surgeries- Cosmetic surgeries are one of the most common health insurance exclusions. However, cosmetic or plastic surgeries that are performed after accidents are covered in several health insurance plans. Also, joint replacements and dental treatments are usually excluded in health insurance policies.
Injuries caused during suicidal attempts- An insured is not covered in case he intentionally causes harm to himself. Hence, injuries caused during suicidal attempts are not covered in health insurance plans by any insurance provider.
Therapies- Health insurance plans do not cover therapies such as acupuncture, naturopathy, magnetic therapies and alternative forms of therapies.
How can you choose the best health insurance plan for your family?
There are several parameters to be considered before you invest in a health insurance plan. Some of them are-
Your budget- One needs to consider the financial budget of the family, based on which he/she invests in a health insurance plan that covers all risks related to health of the insured and their family members.
Co-payment- Another consideration factor that one must consider is whether or not the health insurance plan provides a co-payment facility. A standard feature, co-payment is defined as a fixed percentage of each claim amount that has to be paid by the insured.
Number of family members covered- While investing in a health insurance plan, one must always consider the number of family members that shall benefit from the policy. Most insurance providers cover up to 4 to 6 family members under a family floater health insurance plan in India.
Claim settlement process- Claim settlement was a cumbersome process which obstructed a person from investing in a health insurance plan. All insurance providers in today’s day and age, provide easy, hassle-free claim settlement procedures that makes it convenient for the insured.
Addition of new family member- Addition of a new family member is a moment of joy. Hence, when investing in a health insurance plan, one must also consider the conditions in the policy in case you wish to get the new family member added and insured under your health insurance policy.
Compare health insurance plans- Before investing in a health insurance plan, one must compare the policies from the best insurance providers and select the one that best suits his needs.
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:
Premium Vs Coverage: Assess if the cover and sum assured are suitable against the premium paid. Choose add-ons as per your needs.
Room Rent Limit: Be sure of the insurer's network hospitals in your area. You can avail of cashless services only at these hospitals.
Network Hospitals: 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.
Exclusions: Check what is permanently excluded and which treatments are possibly covered after waiting for a certain period.
How to Find Affordable Health Plan Using Health Premium Calculator
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.
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!
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.
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.
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.
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.
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.
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.
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 accidents 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 co-pay?
Co-pay is a clause in the health insurance policy that underlines that the insured will have to share the claim burden and co-pay a pre-determined amount.
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.
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.
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.