Author: Samskrita Jain

Every family incurs heavy medical expenses at some point. As a support for this financially draining experience, the government offers tax benefits on health insurance as well as on treatment-related expenditures. To make deductions more easy and streamlined, the government has recently issued a notification simplifying the tax benefit on serious ailment expenses. Here is all you may need to know about claiming tax benefits on expenses due to serious ailments and the new process to do so.

What are the tax deductions on treatments and medical insurance premiums?

Sections 80D, 80DD, 80U, and 80DDB of the Income Tax Act,  offer rebates on health insurance premiums and expenses incurred during treatments for serious ailments and disabilities.

Section 80D: All citizens below the age of 60 years can obtain a maximum tax rebate of Rs. 25,000 on the premiums paid for health insurance. If you are above 60 years, you are eligible for deductions up to Rs. 30,000. If you are paying health insurance for your parents, you can obtain a further deduction of Rs. 30,000 if your parents are above 60 years and Rs. 25,000 if your parents are below 60 years.

Section 80U: Any differently abled person with 40% or more disability incurring medical expenses for treating themselves can claim tax rebates of up to Rs. 75,000 under Section 80U depending upon the severity. This amount goes up to Rs. 1.25 lakhs in case of persons with more than 80% disability. Anyone financing the treatment of differently abled dependents can also avail the same deductions

Section 80DDB: You can avail deductions on medical treatment of specified ailments under Section 80DDB. The limit here is up to Rs. 40,000 for assessees below 60 years of age, and Rs. 60,000 for assessees above 60 years. For seniors above 80 years, the maximum limit is up to Rs. 80,000.

Claims have become easier with new change in the tax system

1. Until recently, one needed a certificate from a doctor working in a government hospital to avail the deductions under these. The Central Board of Direct Taxes recently issued a notification, wherein you no longer need the certificate issued by a doctor working in a government hospital to claim deductions. A certificate from any certified specialist doctor will work to get claims for expenses incurred while treating a serious disease.
2. The amount of tax deduction remains untouched.
3. It is no longer mandatory to file the certification from a doctor using Form 10L. A prescription from a specialist would now suffice to claim tax deduction against serious ailments.
4. Specifying the name and age of the patient in the certificate are still mandatory, but just a prescription is sufficient to file a claim.

What to know before claiming deduction under section and 80D and 80DDB

If you receive reimbursement for the treatment from your insurance company or employer, you are not eligible to stake a claim for deductions under Section 80DDB. However, if you receive only partial reimbursement from your employer  or insurance company, you can stake claim to avail deduction for the remaining amount.

With the new amendment, the government has taken another step in clearing roadblocks in tax deductions, especially in health care. We hope it gets better with each year to come.

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Everyone and their family face a few situations when their medical costs are pretty high.  In order to help the family ease the burden of these health care costs syphoning money, there are tax benefits which you can claim for your health insurance and medical treatments at the end of a financial year.

Tax deductions can be complex and nerve-racking. To streamline the process, the government has recently issued a notice. The tax benefit process for expenses related to severe ailments have now been simplified. Let us see in detail, what these processes are to claim tax benefits on such ailments.  

What are the tax deductions on treatments and medical insurance premiums?

Sections 80D, 80DD, 80U, and 80DDB of the Income Tax Act, provides rebates for money spent on treatment of disabilities and serious ailments. It also offers rebates on health insurance premiums.

Section 80D: Any Indian citizen, below 60 years of age, can get a maximum tax benefit up to Rs 25,000 on the amount of premium he/she pays for health insurance.

For citizens above 60 years of age, one is eligible for tax returns up to Rs, 30,000. For all those paying for their parent’s insurance premiums, you can get an additional tax rebate of Rs. 30,000 if parents are above 60 years of age and if parents are below 60 years of age, Rs 25,000.

Section 80U: A person suffering anywhere between 40-80% of disability can get tax rebates of up to an amount of Rs 75,000 on the health care expenses they incur for the treatment of the same. Similarly, for a person with disabilities of over 80%, the tax rebate is up to 1.25 lacks. These rebates can also be availed by anyone financing the treatment of a disabled person.  

Section 80DDB: This section offers deductions on medical expenses incurred for the treatment of certain specified ailments. People under the age of 60 years, can get rebates up to Rs 40,000 and Rs 60,000 for those older than 60 years.

Here is the list of ailments covered under section 80DDB of income tax act:-

• Neurological diseases with severity more than 40% like Ataxia, Dementia, motor neuron disease, chorea, aphasia, Dystonia Musculorum Deformans, hemiballismus and Parkinson’s disease.
• Full-blown AIDS
• Chronic renal failure
• Malignant cancers
• Hematological disorders which include hemophilia and thalassemia

Claims have become easier with new change in the tax system

1. Until recently, one needed a certificate from a doctor working in a government hospital to avail the deductions under these. The Central Board of Direct Taxes recently issued a notification, wherein you no longer need the certificate issued by a doctor working in a government hospital to claim deductions. A certificate from any certified specialist doctor will work to get claims for expenses incurred while treating a serious disease.

2. The amount of tax deduction remains untouched.

3. Now one does not need to provide a doctor’s certificate using the Form 10L.  You just need to get a prescription for a certified specialist in the field to get your tax deduction claim for a serious ailment. However, the certificate needs to specify the name and the age of the patient. 

What to know before claiming deduction under section and 80D and 80DDB?

If your company or employer reimburses you for your treatment, then you cannot file a claim for tax deduction under Section 80DDB.  If your employer reimburses you only partially, then you can file a claim for the remainder of the amount.

With this new amendment, the government is ensuring that tax deduction process becomes easier and hassle-free in the health care area. With such deductions, investing in a good health insurance plan is wise.  Visit Turtlemint.com, to find a suitable health insurance plan for you.

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She may be a homemaker or a breadwinner, but there is no scope for doubt that a household cannot function without her. Hence, her health and her safety are of prime importance to everyone in the family. It is essential that when in need she gets the best health care that is out there to protect her and her family. So, as far as health insurance is concerned, a good one is essential for working  women as well as homemakers.

However, despite the importance of this, only 10% of the total women workforce has some kind of health cover.

Uninsured women are more likely to suffer serious health problems as they tend to wait too long to seek treatment because of the costs involved.

“Only 10% of the total women workforce has some kind of health cover”

In a study published in the Indian Journal of Medical Research, the leading causes of death in women of reproductive age in India in India were listed.

So in a nutshell, anaemia, communicable diseases, injury, poisoning and cancers are the major killers amongst reproductive age group women.

A majority of the maternal deaths indicating the need to strengthen the maternal health care. Similarly, breast cancer is one of the most common cancers in women in urban areas.

With all the above diseases, taking a toll on women’s health in our country, it points out, that a good health care can significantly reduce these numbers.  However, with the increasing costs of health care, proves to be a major hurdle between women and good health. This is where an effective and affordable health care plan comes into play.

Since women have certain gender specific ailments, there are quite a few health insurance plans designed keeping them in mind. Some of them are as follows:

1. Wellsurance Woman policy by Tata AIG. It is a combination of hospitalization benefit and critical illness cover. It pays a lump sum in case the policyholder is diagnosed with any of 11 specified critical illnesses, including cancer, heart attack, stroke and kidney failure. It also pays out a daily cash benefit in case of hospitalization. But such a policy should be taken only as an addition to the basic health plan that covers hospitalization.

2. Bajaj Allianz’s critical illness cover: The policy covers eight women-specific critical illnesses, including paralysis and cancers (breast, ovarian, cervical, uterine, vaginal and fallopian tube). The treatment protocol for such illnesses is not only lengthy but also expensive and involves a lot of lifestyle modifications, such as giving up of job, ergonomic modifications at home, and so on.

Read more about benefits of critical illness policy

3. Maternity Add-On Cover: Most health insurers provide a maternity cover, which covers hospitalization charges related to pregnancy and childbearing. However, this add-on has a waiting period of 4 years and needs to be purchased in advance of the expected pregnancy.

Read more about maternity cover a must have benefit

For options on covers suitable for women of a particular age and pre-existing conditions, you can check out health insurance page. You can compare various insurances for your requirements and needs and choose specific add-ons.

Now, equipped with all the information, make sure every woman in your life is protected and secure.

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Turtlemint wishes all women a very Happy Women’s Day.

You are the wise one, and you have made up your mind to get health insurance. Everyone tells you that why you should get it, but no one tells you what to check and expect. Well, we are here for that. Just keep some simple facts in mind, when narrowing down on any health insurance policy.

What is Health Insurance?

‘Health Insurance’ is a  type of insurance coverage that pays for medical and surgical expenses that are incurred when a health insurance policyholder receives treatment.

Now let us look at the points to keep in mind when buying  an insurance policy

1. Know the difference between Inpatient vs. Outpatient Treatment

You’re an outpatient if you’re getting emergency department services, observation services, outpatient surgery, lab tests, or X-rays, or any other hospital services.

Once the doctor writes an order to admit you to a hospital, then one becomes an inpatient.

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A lot of health insurance policies and their basic plan, cover inpatient expenses. Out patient can be covered for routine treat post hospitalization for which you were admitted. If you would like to avail outpatient cover as well, contact the insurance company and list your requirements.

2. Understand Pre-existing  conditions and the Policy T&Cs for them

Any personal illness or health condition that was known and existed prior purchasing the insurance policy. Health insurance policies will often identify a customer’s pre-existing conditions before writing an insurance contract. They will typically not cover pre-existing conditions until a specified period of time has elapsed. In some cases, pre-existing conditions may not be covered at all.

3. Have a sound knowledge of the claim process

For an insurance policy, there can be 2 kinds of claim options: Cashless and Reimbursement. Cashless claims usually happen in network hospitals which have tie ups with insurance companies. Cashless means that post the treatment, the insurance company clears the bills for the medical procedures directly with the hospital. For a reimbursement claim, the insured/patient, needs to pay the bills and claim the reimbursement after.

4. Compare Insurance Companies to know the Pros and Cons

We put in effort in comparing small things like household brands and the cosmetics we use. But for an investment, whose benefits you will reap in your most crucial time, a well thought of plan is essential. Which choosing a plan, keep in mind that cheaper is not essentially better.  List out all the features of both plans and compare the cost to feature ratio. Have a sound idea of what feature is important for you.

Seems like a lot of work to choose a good plan? Well, it isn’t. Visit Turtlemint, to compare all the policies out there and get beyond the fine print.

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When you buy health insurance, most companies promise a cashless claim at the hospital. With a cashless claim, the insured can be admitted to a Network hospital without any deposit at check-in and has to bear no medical bills after the commencement of the treatment.

The magical insurance card, submitted at the time of the treatment does the trick. The hospital contacts the insurer and the company settles the bills directly. The insured just needs to take care of the overhead expenses, like extra services if any is availed.

But sometimes this cashless claim is declined. Let us examine the scenarios and see the solution to them.

When you check in a Non-Network Hospital

Every insurance company has a list of network hospitals in particular pin codes. This means that insurer has a tie-up with these hospitals and you can avail a cashless treatment there.

However if in case of an emergency or any other situation, if one decides to get admitted to another non-network hospital, the bills have to be cleared initially by the insurer and then one can go for a reimbursement claim (Explained below)

If the hospitalization is due to a pre-existing conditions in the initial years of the policy

A pre-existing condition like diabetes may not be covered in the insurance policy for 3-4 years. So if a person with advanced diabetes is admitted to the hospital because of stroke, then one may not receive the cashless claim, as it is a condition arising from diabetes. In such a situation, it is important to read the policy details carefully and know the time after which pre-existing conditions are covered.

Non-Disclosure or Incorrect mention of facts during policy purchase or claims

A cashless claim can be rejected, in the event of a discrepancy in details entered while buying or claiming the policy. This can be non-disclosures, partial disclosures and wrong disclosures of significant facts such as age, nature of the occupation, income, existing insurance policies, major ailments or pre-existing medical conditions. Coverage is offered based on the information provided by the insured on the proposal form and hence any gap between what is declared and the reality at the time of filing claims can be a reason for rejection. So, always answer all questions honestly when you apply for a health policy.

Superfluous Expenditure on a treatment or service from the hospital

Sometimes, a hospital, in its quest to generate maximum revenue, may perform medical procedures which may not be necessary, on patients covered by a medical insurance policy. The policyholder is also relaxed about it as he mistakenly assumes the money will be paid by the insurance company.

What to do when your Cashless Claim Gets Rejected

If a cashless claim is rejected, for any reasons, then one can still be eligible for a reimbursement claim. In such a situation,

1. Immediately notify the insurance company or the Third Party Aggregator (TPA) about the hospitalization and rejection of the claim.
2. Clear your hospital bills upon discharge.
3. Fill and sign the Reimbursement claim form of the insurer. You can find it on their website, under the claims tab.
4. Submit the claim form along with all the hospital documents, at a branch of the insurance company or TPA near you.
5. Track the progress of your claim and stay in touch with the insurance company.  

In order to avoid any of the above situations, be sure to understand your policy document clearly. It is also advised to compare all the plans out there. Visit Turtlemint to find a policy, which suits your needs.

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Insurance understanding and knowledge is not easy. The fine print which accompanies any policy is tricky and it is tedious for a layman to understand and comprehend it. The language is very convoluted and boring to read. So, a lot of buyers, fail to understand the policy and settle for an unsuitable one. Insurance agents capitalize on this impulsive nature of the buyer. They end up mis-selling the policy for immediate gains. This leads to expectation mis-match.

What does Mis selling a policy include?

Mis selling is selling a policy by giving a wrong picture of the policy. It may include, giving wrong information, giving unrealistic information, and not giving full details of the product.

What is IRDA doing to Prevent Mis selling?

In the past few months the Insurance Regulatory Development Authority has taken several steps to increase transparency and further the policyholders’ cause. They have made laws against mis-selling strict and take action against fraudulent cases.

You healthcare policy comes with a free look period. This means that a policyholder can return the policy within 30 days from the date of receipt if terms and conditions are not agreeable or suitable.

How can you Avoid being a Victim of Mis-selling?

Know the track record of your insurance agent and ask questions clearly

Insurance agents usually push plans which fetch them high rates of commissions. They capitalize on the ignorance of the regular customers and latch onto them plans which may not be very useful for them. Often, after the policy is sold, they magically disappear and do not help in claim processing as promised. To avoid such a situation, make sure you go to a reliable agent with a good track record. Be patient and ask him/her all the questions.

Understand all Policy Exclusion thoroughly before settling down for one

Whenever a person buys an insurance plan, he/she is more focussed on the price comparison between premiums and the sum insured. They miss the limits, hospitals covered, diseases covered and the sub clauses and their wordings. Make sure you know what you are looking for, double check to see if those particular conditions are included or not.

Understand the product well and refrain from under or over investing for Health Insurance

The lack of awareness of the available insurance products can be detrimental. As a buyer you need to know the actual value of the product ‘for you’.  If are in your 20s, with no liabilities, then you can start with an insurance cover which is lower.

Be on a lookout for Limits and Co-pays if Any

Many health insurance policies have room rent capping which means that you are eligible to claim expenses only up to a room costing below this capping.

For instance, you room capping is Rs 4000/day and you opt for a room worth Rs 7000/day, you will have to bear the additional expenses on your own. Room capping may not only be for room rent, but other facilities as well which come with it.

Also, a number of policies, especially as you age, come with clauses of co-pay for certain parts of the claim. For instance, if your policy has a co-pay of 50% for a cardiovascular surgical procedure, you will have to bear half the expense.  Look out for words like limits, deductible, co-pay in the policy and especially the terms and conditions associated with each of them.

Avoid having unrealistic prediction of returns

A lot of buyers are misguided, about the terms and conditions of a policy. They are shown unrealistic predictions of the returns. This tactic is to lure the customer into getting the policy. Whenever you decide to buy a particular company’s policy, make sure to check their claim settlement ratio and the reviews provided by other users.

Compare all policies out there and find the best one to suit your needs

Whenever you are opting for an insurance policy, you need to evaluate all the options out there. There are policies which will suit your need. You need to opt for one which fits your requirements. At Turtlemint, you can find all the policies and compare them at a glance to find the one for you. We decode the fine print, and highlight all the key factors to make decision making simple and clear.

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Be Insurance Smart 🙂