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Top Benefits of Individual Health Insurance

Individual health insurance policy, as the same suggests, covers only an individual. Do you want to know what the top benefits of individual health insurance are? Here is the list of the most important benefits of buying an individual health insurance plan.

There are over 20 general insurance providers along with 7 stand-alone health insurers in India which offer health insurance plans. Each of these insurance companies offers more than one type of health insurance plans in India. There are several types of health insurance policies available in the market, such as individual health insurance, family health insurance, group health insurance, critical illness health insurance, senior citizen health insurance, etc.

Under a family health insurance policy, while most of the health insurance companies cover only a couple and two dependent children, you will also find some insurance providers who offer complete family cover wherein dependent parents are also included in the health plan. This means that in a single health plan, you can cover your spouse, two dependent children and dependent parents. On the contrary, an individual health insurance policy, as the name suggests, covers a person only. In case of family health insurance policy, the same insured amount covers all the family members. In contrast, the sum insured in an individual health insurance policy will cover only one Individual – The insured.

However, you can buy an individual health insurance plan for each family member, with a separate sum insured assigned to every individual. If you have a family member who requires additional cover and chances that his/her medical costs may exceed, it is always advisable to purchase an individual health insurance plan for him/her. Doing so will prove to be more helpful from both perspectives – health and monetary.

Here are a few critical benefits of buying an individual health insurance policy.

Made for your specific needs: One of the significant benefits of buying an individual health insurance policy is that you get to select the plan that fits your medical bill. You can get a policy to cover your specific health insurance needs. This kind of flexibility may not be available with a family floater or group insurance plans.

Cashless claim service: In an unforeseen event of a medical emergency, where you are supposed to be hospitalised, you can avail cashless hospitalisation benefit offered by your health insurance policy. Cashless hospitalisation benefit provided by health insurance companies allows an individual to avail medical treatment without paying for the same to the hospital. This facility is available only at the network hospitals of the insurance company. Under cashless hospitalisation, the health insurance company settles claim directly to the hospital.

Guaranteed coverage amount: If you buy health insurance, you have a dedicated sum insured that goes towards covering your medical needs. This is wise even if you buy individual health insurance in bulk for all your family members. For instance, 25-year-old Amar bought individual health plans for himself, his mother, and dependent brother. The coverage was Rs. 2 lakhs each. Hence, when his brother was hospitalised for a prolonged period, he had a guaranteed coverage of Rs. 2 lakhs at his disposal.

Tax benefits: According to Section 80D of the Income Tax Act, 1961, any premium you pay towards your individual health insurance policy is subject to avail tax benefits. Moreover, if you are also covering your senior citizen parents, the tax benefit increases.

Risk and premium: When you buy a family floater policy, the insurance company takes in to account the highest risk by a member. So, family floater plans may turn out to be costly affairs if you have high-risk individuals in your family, like senior citizens or those with pre-existing diseases. In such cases, an individual health insurance policy may turn out to be a cheaper and better option.

Coverage Offered Under Individual Health Insurance Policy

Individual health insurance policies are designed in a way to provide a cluster of facilities to the policyholder. Individual health insurance plans cover pre and post hospitalisation expenses incurred around 30 to 60 days before and 90 to 120 days after hospitalisation. It also offers cashless hospitalisation facility when you get your treatment done in a network hospital. During a non-cashless treatment, the medical expenses are reimbursed after a formal approval process. The policy also covers ambulance charges and diagnosis tests up to a certain limit. Daycare facilities are also included and are subject to certain terms and conditions.

Pre-existing diseases except for injury due to accident are treated after a defined waiting period which may vary from one insurance provider to another. Surgeries such as Hernia, Piles, Asthma, etc., maternity-related treatment, or psychiatric disorders are covered after the specified waiting period.

Exclusions of individual health insurance policy

  • Pre-existing diseases are not covered as soon as you purchase the policy, and there is a definite waiting period for the same.
  • For a few illnesses, the coverage amount may vary from 10% to 90% of the sum insured, depending on the health insurance provider.
  • Generally, Ayurvedic, non-allopathic and Homeopathic treatments are not included under health insurance plans.
  • Self-inflicted injuries, suicide, attempt to suicide are not covered under the policy.
  • The policy does not cover the expenses incurred on the treatment of HIV/AIDS.
  • The policy does not cover the cost of hospitalisation resulting due to war, riots, nuclear weapons, etc.

It is rightly said that health is wealth and needs to be taken care of the whole life. At present, where technology is reaching new heights, even diseases are escalating at a rapid speed. The expensive treatments and medical emergencies become a tension for many individuals. An individual health insurance policy takes care of your health, and costly medical treatment related to medicines or hospitalisation due to accident, sudden illness, or surgery during the term of the policy. Health insurance policy is the best solution for people who cannot afford quality medical treatment because of the cost of treatment and unavailability of cash.

Recommended Link:What Is The Difference Between Group and Individual Health Insurance?

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