What is a health insurance policy?
Health insurance, also called Mediclaim, is a way to pay for advanced
medical treatments that typically require you to be in hospital overnight. It also covers certain
other day care procedures like cataract surgery, etc. that don't require you to be hospitalized but
are expensive nevertheless. A health insurance policy, therefore, covers your medical expenses and
gives you financial relief.
Why is health insurance policy important & why should you buy it?
Medical insurance is a form of insurance which covers the medical costs
incurred in case of medical emergencies. These plans, thus, take care of the financial burden associated
with medical contingencies. In today’s age, when illnesses and diseases are on the rise,
a health insurance plan becomes necessary. Though medical developments have provided a
cure for most of the illnesses, such as cures and treatments come at very expensive costs.
These costs become unbearable for the common middle-class man. A health plan, by covering
these costs, takes off the financial strain caused by frequently occurring illnesses. It, therefore,
proves to be an essential requirement for every individual looking to secure his finances against medical
contingencies.
Health insurance calculator
A health insurance calculator, also known as a medical premium calculator,
helps you in calculating the premiums that you need to pay for any certain health insurance policy.
It is an online tool that is available on insurance marketplaces and health insurance websites.
You just need to enter a few details such as your age, general health, profession and insurance needs,
as the premium depends on primary factors like the amount of sum assured, number of people covered under
the insurance, type of coverage etc. when you fill in the details, you will be shown the amount that you
would have to pay towards your health insurance premium.
Before investing in any health insurance plan, it is equally important to calculate the premiums that
you will have to pay monthly, quarterly, half-yearly or yearly. This way you will know exactly the amount
you need to invest, thus, making a proper financial plan.
Types of health insurance we offer
- Individual health insurance plans:
Individual health insurance plans which cover a single individual under the cover
- Family floater health insurance plans:
Family floater health insurance plans which cover the entire family under the plan. A family consists of the policyholder, spouse, dependent children, and dependent parents. One plan covers the entire family on a floater basis. The sum insured is shared by the family members. Any member can make a claim up to the sum insured.
- Critical illness health insurance plans:
Critical illness health insurance plans which cover major critical illnesses. If the insured is diagnosed with any covered illness, the sum insured is paid. The policyholder can use the sum insured to meet the cost of advanced treatments or pay for any other financial obligations
- Top-up health insurance plans:
Top-up health insurance plans which provide supplemental coverage at minimal rates of premiums. If individuals feel that their coverage is low, they can buy top-up plans to increase the coverage. There is a deductible limit under these plans. Any claim which is in excess of the deductible limit is paid.
- Super top-up health insurance:
Super top-up health insurance plans which are also called aggregate health plans. These also help to enhance the sum insured at affordable premium rates. Super top-up plans are like top-up plans. They also have a deductible limit and claims exceeding the limit are only paid. However, while top-up plans consider each instance of claim separately, super top-up plans aggregate the total claims made in a policy year and then apply them against the deductible limit. If the aggregate claims exceed the deductible, the claim is paid
- Senior citizen health insurance plans:
Senior citizen health insurance plans which are meant to cover individuals in their older ages. Individuals who are 61 years and above can be covered under senior citizen health insurance plans. The sum insured under these plans are limited and premiums are affordable.
- Hospital cash plans:
Hospital cash plans which pay a fixed benefit for each day of hospitalisation. If the insured is hospitalised, a daily allowance would be paid every day up to a maximum period.
- Disease-specific health plans
These can be indemnity oriented or fixed benefit health insurance plans which cover specified illnesses like diabetes, cancer, heart-related ailments, dengue, etc.
You should understand the types of medical insurance plans before choosing the best plan suiting your requirements.
Why should you buy health insurance online?
There has been a constant rise in the percentage of health-related
risks over a few decades. This has made it more and more necessary for us to get ourselves insured
and avoid any financial crisis during medical emergencies. Buying insurance policies online has a
number of benefits over traditional mode of investing in policies-
- Time Saving
The availability of so many policies online has made it easy to
get quotations for the policies of your choice and it also helps you in saving the time you
would have spent talking to an insurance agent.
- Easy Comparison
With all the information available within the reach of your hands,
you can compare the policies, calculate the premiums and choose the best plan for your budget.
- Lot of Choices
When you come to an insurance platform like Turtlemint, you have a lot
of options, making it easy to go through a range of plans and products.
- 24*7 Availability
You can get policy-related information and service all round the clock
- Instant Coverage
Online health insurance providers provide you with an policy document
and thereby making your insurance active immediately. Although the method is so fast, it is
extremely reliable and safe. At Turtlemint, we make sure that your transactions are kept safe
and private.
- Discounts
Most insurance companies offer premium discounts when you buy a policy online.
You must always be on a lookout for the best deals that are easily available online.
Top plan of health insurance in India
Here is a list of some of the best plan of health insurance in India which you can buy for a comprehensive scope of coverage–
| Name Of The Plan | Entry Age Limit | Sum Insured Levels | Salient Features |
|---|
| Star Health Family Health Optima Plan | Children – 16 days onwards
Adults – 18 years to 25 years | INR 3 lakh to INR 25 lakhs | - Auto recharge of the sum insured free of cost
- Coverage for assisted reproductive treatments
- Annual free health check-ups
|
| Religare (Now known as Care Health) Care Plan | 91 days onwards. No maximum entry age | INR 4 lakhs to INR 6 crores | - Wide range of coverage variants to get the best fit
- Free annual health check-ups
- Range of optional add-ons with add-ons specifically for COVID coverage
|
| HDFC ERGO Optima Restore | 91 days to 65 years | INR 3 lakhs to INR 50 lakhs | - Doubling up of the sum insured through Multiplier Benefit within 2 claim-free years
- Sum insured restoration
- Premium discounts for developing the habit of walking
|
| ICICI Lombard Complete Health Insurance | ndividual coverage – 6 years onwards
Floater coverage – dependent children 3 months to 5 years
Adults – 18 years onwards | INR 3 lakh to INR 50 lakhs | - The benefit of sum insured restoration
- A range of optional additional coverage benefits for all-round protection
- Value-added and wellness benefits
- Free annual health check-ups
|
| Aditya Birla Activ Health Platinum – Enhanced | 91 days onwards. No maximum entry age | INR 2 lakhs to INR 2 crores | - The inbuilt benefit of sum insured restoration
- Lump-sum recovery benefit for hospitalisation exceeding 10 days
- Health Returns for a healthy lifestyle
|
| Future Health Suraksha | 90 days to 70 years | INR 50,000 to INR 10 lakhs | - Hospital daily allowance for senior citizens
- Additional 25% sum insured for accidental hospitalisation
- Sum insured recharge benefit
|
| Universal Sompo Complete Healthcare Insurance | 1 day to 70 years | INR 1 lakh to INR 10 lakhs | - Accidental dental expenses are covered under the policy
- Coverage for OPD expenses
- Vaccination coverage against animal bites
|
How to buy health insurance online?
When investing in a health insurance plan, it is recommended that you
first browse through the wide range of policies that are available online. You would like to choose
a policy which is hassle free and serves your unique needs. There are a few factors that you should
consider while buying an insurance online:-
- Check For The Insured Sum
Many companies limit the amount that you can invest in a policy. If you wish to invest a higher sum,
look for insurance that suits your requirements. Generally, having a cover that is six times of your
annual salary is good. If you have plans of starting a family in a few years, don’t forget to explore
the maternity coverage option. - Check For The Hospitals
Different companies have tie ups with different hospitals. Make sure that your insurer provides cashless
coverage at the top hospitals in your city. This would make the entire process smooth. - Check The Policy Terms
Different plans have different limits and sub-limits. Hence, before making any investment be sure that
you have read and completely understood the guidelines. Be very sure regarding how much cost would be
covered by your insurance per hospitalization.And what are the pre and post limits of the plan as well.
Some companies provide 30 day pre and 60 day post hospitalization costs while some companies provide 60
and 90 days period.
Certain exclusions are included in each and every plan. Make sure you read through
them carefully. Check for the waiting periods and co-pay. Shorter waiting period and voluntary co-paying
is ideal. - Don’t forget Additional Benefits
Most health insurance companies offer additional benefits with the policies to hold themselves up in
the competitive market. The no claim benefits and restoration benefit are the most popular ones.
Make sure that the company you are choosing has a good market reputation, is trusted and provides
good customer care service 24*7 throughout.
Key features of health insurance
The notable key features of any health insurance in present market are-
- Coverage
The coverage includes the comprehensive expense of everything that can happen during a health emergency.
It includes pre-hospitalization, post-hospitalization and ambulance charges. Most insurances also cover
critical health diseases like cancer, stroke, heart attack, etc. - Renewal Benefits
Most companies offer a no claim bonus benefit to its customers if no claim request is made by them in
the previous year. Some companies also offer benefits in the form of discounted premiums or increased
cover or a complete free health check up every year as well. - Co-payment
It is one of the great features offered by good health insurance companies, helping to reduce the yearly premium.
You have to pay a percentage of the total expense while the company will pay the balance. - Cashless Treatment
Most health insurance companies have a collaboration with a number of healthcare centres and hospitals.
When you seek treatment in a network hospital, the insurance company will pay your bills directly and
you will have to pay only for the uncovered expenses. - Tax Benefits
Under section 80D of Tax Act 1961, you will enjoy tax exemptions for paying premiums on health insurance.
The tax benefit can be enjoyed both by you and your family members. - Flexibility
You can change the premiums to be paid every month or the term life of your policy after a
certain period.
Benefits of comparing health insurance plans online
- It is Easy and Convenient
To compare the different policies on Turtlemint, all you have to do is go through the different options,
compare and then choose the best plan. The added advantage is you can do it at your convenient time since
the information is always available. You don’t need to visit the providers or agents again and again for
details. - It is Free
You can compare the policies online for absolutely free of cost. It means you can get a quote from the
insurance policy companies as many times as you want without fearing to get charged for it. - It is Economical
Most of the companies offer policies at reasonable rates and thus charge lower premiums on the
insurances purchased online in comparison to the offline insurances, without compromising on the coverage. - It helps you Calculate The Premium
The online premium calculators help you in determining the premiums to be paid based on the policy you
plan to buy and the amount you want to invest. You can try different permutations and combinations and
choose the best plan for yourself. Hence, it helps you in making a proper financial plan. - You Can Choose Desired Coverage
Online health insurance calculator is a great tool to help you in understanding the different coverage
options you can opt for, be it for your family health insurance plan or personal health insurance.
You can go through different plans’ inclusions and exclusions before choosing the best for you. - You Can Choose Your Add Ons
Apart from the coverage amount and premium amount, you should also know about the claim settlement ratio.
You can opt for a policy that offers annual medical check ups, free emergency ambulance service, shorter
waiting period and similar benefits so that your out-of-the-pocket treatment cost is minimised.
Benefits of health insurance plans & policies
Medical insurance policies offer various advantages and come with unique features which are as follows –
- Medical insurance plans cover all medical costs incurred right from the time the insured falls sick to his hospitalisation and also after being discharged from the hospital. Thus, the plan has a wide scope of coverage for medical costs
- There are value-added coverage benefits in medical insurance policies too. These include free health check-ups after a specified period, second medical opinion for serious illnesses, etc.
- Health plans allow tax advantages. Premiums paid for medical insurance policies for self, family and dependent parents qualify for tax deduction under Section 80D. The limit of deduction if INR 25, 000 for covering self and family and another INR 25, 000 for covering dependent parents. Moreover, if either the policyholder and/or dependent parents are senior citizens, the maximum limit increases to INR 50, 000 in each instance. Thus, a maximum of INR 1 lakh can be claimed as tax deduction though health insurance plans
- No Claim bonus is allowed in all medical insurance plans if no claim is made in a policy year. This bonus is either allowed as an increase in the sum insured or additional benefits can be availed like gift vouchers, annual health check-ups, etc.
- Lifelong renewals are offered by health plans with no maximum cover ceasing age
- The term of the plan can be for one, two or three years. Moreover, if long term plans are chosen, a premium discount is also allowed
- Individuals can claim premium discounts for covering two or more family members, by choosing a longer duration, by choosing voluntary co-payment, etc.
- Cashless claims are settled by the health insurance company if the policyholder seeks treatments at a hospital which is tied-up with the insurance company. In cashless claims, the policyholder does not have to bear the burden of medical expenses. The expenses are settled directly by the insurance company with the hospital.
Does my existing health insurance policy include coronavirus (COVID-19) treatment?
Yes, your existing plans of health insurance in India would cover Coronavirus treatments if you are hospitalised. However, the policy would exclude the costs of consumables incurred on such treatments. Since the cost of consumables is high, you can opt for COVID-specific medical insurance policies which are available. IRDAI has launched these plans of health insurance in India for providing complete coverage against COVID. The plans are as follows –
- Corona Kavach
This is an indemnity oriented health insurance plan which covers all medical expenses incurred on COVID treatments. The policy covers hospitalisation costs as well as home quarantine expenses without any deductibles or sub-limits.
- Corona Rakshak
This is a fixed benefit health insurance plan which covers COVID. If you suffer from Coronavirus and are hospitalised for 3 days or more, the policy would pay the sum insured in a lump sum to provide you with the financial assistance needed for COVID treatments.
Health insurance policy inclusions
A basic medical insurance plan provides all the essential coverage features. You would find coverage for the following –
- Inpatient hospitalisation
this includes coverage for room rent, ICU room rent, cost of treatments, doctor’s fees, surgeon’s fees, nurses’ fees, etc.
- Pre and post hospitalisation
expenses incurred before being actually hospitalised and after being discharged from the hospital are covered under this head
- Ambulance costs
costs incurred in transporting the insured to the hospital is covered up to a specified limit
- Daycare treatments
treatments which do not require hospitalisation for a minimum of 24 hours are covered under this section
- Organ donor expenses
expenses incurred on harvesting an organ from a donor are covered
- Domiciliary treatments
treatments taken at home because the insured cannot be moved to the hospital or because there are no vacant beds in the hospital would be covered
- AYUSH treatments
these treatments are alternative, non-allopathic treatments like Ayurveda, Unani, Siddha and Homeopathy. Most health plans cover medical expenses incurred on these treatments.
Besides these common coverage features, different medical insurance policies provide different coverage features too which make the plan comprehensive in nature.
Health insurance policy exclusions
Though medical insurance plans provide coverage for most of the medical expenses, there are some expenses which are not covered. These are called plan exclusions. Some common ones include the following –
- Pre-existing illnesses during the waiting period
- Illnesses occurring within the first 30 or 60 days of buying the policy
- Congenital ailments and diseases
- Cosmetic treatments
- Pregnancy-related treatments, unless specifically covered
- HIV/AIDS infection
- Illnesses or injuries occurring due to war or related perils, aviation, nuclear contamination, self-inflicted injuries, alcohol or drug abuse, etc.
To know the exact exclusions, you should read the policy document. Different medical insurance policies have different inclusions and exclusions. So, understanding the policy details before buying the policy becomes essential. It’s best to disclose your medical history truthfully before you buy a policy to ensure your claim expectations are met. Discuss this with our expert to figure out your best options - we will maintain strict confidentiality.
What is the difference between health insurance and mediclaim policy?
| Basis | Mediclaim | Health insurance |
|---|
| Coverage Offered | A mediclaim plan covers only hospitalisation, accident-related treatment
and pre-existing diseases up to a pre-specified limit. | A health insurance plan provides comprehensive medical coverage
for pre-hospitalization charges, hospitalisation charges, post-hospitalization
charges, ambulance expenses, and more. On top of it, the plan offers compensation
in case of loss of income due to an accident. |
| Add-on Covers | No add-on cover is available. | It may offer multiple add-on covers, including critical illness cover, personal
accident cover, maternity cover, etc. |
| Flexibility | Mediclaims are not flexible in terms of coverage. | Health insurances are flexible when it comes to coverage and premium.
The premium can be increased or decreased, especially for long term plans.. |
| Critical Illness Cover | Mediclaims do not cover critical illnesses. | Health insurance covers more than 30 critical diseases, such as cancer, stroke, kidney failure, etc. depending on the policy. |
| Claims | Claims can be made multiple times until the assured sum is exhausted. | Claims can be made multiple times until the assured sum exhausts and sometimes with restoration benefit, even beyond that. |
| Hospitalisation | To avail mediclaim benefits, getting hospitalised is necessary. | To avail health insurance benefits, it is not necessary for the insured to get hospitalised. Health insurance provides pre-hospitalization,
post hospitalisation and daycare coverage too. |
Health insurance riders
Riders are the facilities that come with insurance policies that can be purchased for extra cover
and added benefits. Here are top 5 insurance riders that you must know about-
- Maternity Cover Rider
This add on covers the expense of childbirth. The primary coverage will be provided
for the delivery and might be restricted for pre and post delivery. It may not cover
the child care expenses and vaccinations. Howeverclass="linkaction" , it entirely varies among policies.It can be
availed after the waiting period is over. - Accidental Disability Rider
Critical illness policy adds coverage if you are disabled due to an accident. If completely disabled,
the total assured sum is provided. However, you’re partially disabled only a percentage(depending on severity)
of the assured sum is provided. - Hospital Cash Rider
Under this rider, you will receive a cash amount for every day that you spend in hospitalisation. For most policies,
you must spend at least 24 hours before availing the coverage. - Critical Illness Rider
Under this policy, if you are diagnosed with any of the critical diseases listed under the policy then you will receive the assured sum under the rider.
This can be purchased along with insurance or a stand alone. - Room Rent Waiver
Certain policies come with a cap on room rent. For example, if the room you rented charges you INR 4,000
everyday but your insurance covers only INR 2,000, you’ll have to pay the rest of the amount from your
pocket. To avoid this you can avail this waiver. One added benefit is, you can choose your own room
(subject to certain conditions).
Factors to consider while deciding the health insurance company and its plan
Since medical insurance plans are important in providing financial security, they are quite popular.
Almost all general insurance companies in India offer a wide variety of health insurance plans for individuals.
Among the hundreds of plans available, it becomes very difficult for individuals to understand which plan would
be the best health plan for them. So, here is a guide to choose the
best health insurance in India –
- Understand the type of coverage required
first and foremost, individuals should understand the type of health plan which would suit their needs. If they don’t have any health insurance, a family floater or individual plan is recommended. If there is an existing health plan, a top-up plan is good for enhancing coverage at low health insurance quotes. Critical illness plans are also a must for protection against major illnesses while disease-specific plans are helpful in protecting against specified ailments. Individuals should assess their requirement and choose the most suitable plans for themselves.
- Ensure that all family members are covered
health contingencies can strike anyone and so individuals should endeavour to cover all of their family members under health insurance plans.
- The sum insured should be optimal
the sum insured of the medical insurance plan should be sufficient to pay for the high medical costs which would incur in an emergency.
- Look for comprehensive coverage features
the medical insurance plan which provides the most inclusive coverage benefits would be the best health plan. Individuals should look for such comprehensive plans and see if the coverage benefits are relevant to their needs.
- The premium rate should be reasonable
besides the coverage benefits which should be all-inclusive, the premium of the best health insurance plan should also be reasonable and affordable. If the plan has very high premiums, it would not be the best health insurance plan.
- Compare before buying
to choose the best health insurance plan in India, the best way is to compare the different plans and then buy one. Comparing lets you see the available plans and helps you in choosing one plan which is the best from the rest.
Health Insurance claim settlement procedures
To make a successful claim in a health insurance policy, policyholders are required to follow the below-mentioned process –
- The policyholder should inform the insurance company of the claim. This information is to be given by filling up and submitting a pre-authorisation form. The insurance company analyses the form and approves cashless claim settlements. The form should be submitted at least 4-5 days before a planned hospitalisation. If, on the other hand, the hospitalisation was an emergency, the form should be submitted within 24 hours of hospitalisation
- The health card or the policy bond should be produced to the hospital along with the identity proof of the insured
- The company would then take care of the medical expenses
- All medical documents, reports and bills should be submitted to the insurance company along with the claim form.
In case of reimbursement claims
- The insured should get admitted to a non-network hospital and avail the necessary medical treatments. Payment for the treatments would have to be done by the policyholder himself
- Once the insured is discharged from the hospital, the discharge summary or discharge certificate should be collected
- The claim form should be filled and submitted with the discharge certificate, medical reports and all original medical bills
- The insurance company analyses the documents submitted and reimburses the claim amount to the policyholder’s bank account.
Why buy A health insurance plan at an early age?
There are too many reasons to justify the point why an individual must
start investing early in his life:-
- Comprehensive cover
If you make the wise decision of buying a health insurance plan early in life then you’ll enjoy
the benefit of a much more comprehensive coverage. You will get more security and enhanced coverage
that would be difficult at a later stage. - Cheaper Premiums
The company charges less premiums from younger individuals as they are expected to be in the pink
of health and thus less chance of claim. - Tax benefits for long
Under section 80D of Tax Act 1961, you will enjoy tax exemptions for paying premiums on health insurance.
If you purchase it at a younger age, you’ll enjoy the benefit for a longer time. - Long tenure of coverage
Taking health insurance at a young age assures more coverage in the longer period of time. - Bonus
Most insurances provide a ‘no-claim’ bonus when the policy is renewed and the cover is not availed
in the previous year. If you buy the insurance at a young age and keep collecting the no-claim bonuses
on policy renewal, it will increase your coverage amount when you’re old and grey. - Waiting period
Most coverage features come with a waiting period of 30 days to 4 years, if you invest early in the policy, you may avail
the facilities when required instead of stumbling on the waiting period.
Tax benefits of health insurance
What’s better than enjoying two facilities with one investment? Under the
section 80D of Tax Act 1961, if you invest in the premiums of a health insurance, you can enjoy tax
exemption upto a certain limit. The following table shows the tax breakdown-
| Eligibility | Exemption Limit* as per the Budget Bill FY 2022-23 |
|---|
| For self and family (spouse, dependent children) | Up to INR 25,000 |
| For self, family + parents (all below 60 years of age) | Up to (INR 25,000 + INR 25,000) = INR 50,000 |
| For self and family (where the eldest member is below 60 years of age) + parents (above 60 years) | Up to (INR 25,000 + INR 50,000) = INR 75,000 |
| For self and family (eldest member is above 60 years of age) + parents (above 60 years of age) | Up to (INR 50,000 + INR 50,000) = INR 1,00,000 |
List of documents required for health insurance claim settlement
For successful claim settlement in your health insurance policies, you have to submit a set of documents. These documents include the following –
- The claim form, filled and signed
- Pre-authorization form for cashless claims
- Doctor’s recommendation for advice on hospitalisation
- All original medical bills
- All investigative and diagnostic reports in original
- All hospital records in original
- Consulting medical practitioner’s certificate
- All pharmacy and medicine bills
Eligibility criteria for health insurance
Here are some of the important eligibility criteria of health insurance plans –
- A health insurance policy can be bought by an adult aged 18 years and above. The maximum entry age under many plans is 65 years or 70 years while some plans allow lifelong entry. Children can be covered under health insurance plans on an individual basis from 5 years onwards. Under floater coverage, though, dependent children can be covered from 91 days onwards till a maximum of 23 or 25 years of age till they are considered to be dependent on their parents
- Health insurance plans are renewable for life and there is no coverage ceasing age
- The sum insured starts from INR 50, 000 and the maximum limit depends on the policy that you choose
- Under floater plans, you can cover yourself, spouse, dependent children and parents. Many plans also allow extended coverage for parents-in-law, grandparents, siblings and other close relatives of the family
- The term of health insurance plans is one year but many plans allow you to buy a multi-year policy where the term can be taken for a continuous period of 2 or 3 years
Understand terms included in your health insurance policies
Before investing in any policy be confident that you have understood every term and
condition mentioned over there. There might be certain formal words that could make it tough for you to understand the policies.
Let us quickly discuss them one by one-
- AYUSH treatment
For those who wish to opt for alternate treatment,
companies also offer AYUSH treatment that covers Ayurveda, Yoga, Unani, Sidha and Homeopathy.
- Claim
The amount of money requested by the insured person due to payment
settlement at the hospital.
- Claim Settlement
The procedure of you filing a claim and the company paying you the money/ paying it on your behalf is the claim settlement.
- Co-payment
Cost payment is sharing the cost under a health insurance policy.
When the policyholder agrees to bear a specified percentage of the payment of hospital bills, then
the premiums charged are lessened by the insurance company, while the sum insured remains the same.
- Cumulative Bonus
Cumulative bonus, also known No-claim bonus is offered on every
claim free year, provided the policy is continuously renewed. The sum insured increases by a fixed
percentage however, it cannot exceed more than 50% of the main sum insured.
- Daycare Procedures
Most policies only cover expenses of hospitalisation that is
for over 24 hours. However, certain companies also offer coverage for procedures that do not require
a long hospitalisation. For example dialysis, chemotherapy etc.
- IRDAI
IRDAI stands for the Insurance Regulatory and Development Authority of India.
This apex body regulates the Indian insurance industry.
- Premium
A fixed amount of money that has to be paid in order to avail the insurance
coverage benefit.
- Policy
It is the legal contract between the insurer and the insured person.
- Network Hospitals
A health insurance company has a tie-up with hospitals where their customers can seek cashless treatment.
Such healthcare centres are called network hospitals.
- Sum insured
It is the payout amount that the insurance company is liable to pay in
case of any eventuality. It works on the indemnity principle.
- Waiting period
It is the period of time during which you cannot enjoy certain
benefits of a policy, if the policy is new. It is usually a fixed period of time that commences from
the date of commencement of policy. After the waiting period is over, those benefits become available
to you.
How to calculate health insurance policy premium online?
Using a health insurance policy calculator is really easy. All you need
to do is enter certain details and choose the plan that suits your requirements the best, include add
ons if necessary and submit.
If you are looking for buying a insurance policy from an online portal, please follow the steps given below-
- Visit the website and under Health Insurance choose the compare plans option.
- hen include your details and of the people you want to secure. Details like age of the eldest member, pin code, mobile and other relevant pieces of information.
- Once you click the ‘Get Quote’ button, all the options will be available to you.
- Then pick the plan that best suits your needs and proceed forward.
- Based on your choice, now the calculator will display the premium you need to pay for availing the health insurance.
- Now, you can customise your plan based on your requirements and to maximise the coverage amount.
What are the factors that affect health insurance premiums?
There are certain
major factors that affect the type of coverage you will receive on your insurance.
Some of the most important of them are as follows-
- Age
The general rule of thumb is, higher the age, higher the premium. It is because older
people are more likely to suffer and claim the insurance than young people who are in
the pink of their health. - Past Medical History
It highly affects the amount of premium you are going to pay. If you have a pre-medical
condition, then the premium charged is higher. However if you are relatively healthy,
the premium is less.
- Occupation
Your occupation highly influences your premium rates. For example, if you are a corporate
employee or a teacher, the premium would be less, however, if you work at a construction
site or factory, premiums are generally high. This happened due to the degree of risk factor
that is involved with both kinds of task. - Body Mass Index (BMI)
People with a higher BMI are prone to more ailments like heart diseases, type 2 diabetes,
breathing problems, high blood pressure and cancer than people with lower body mass index.
Hence the premium is higher for the people with more BMI. - Smoking habits
Insurance companies view smokers as high-risk insurance buyers since they are more inclined towards health risks. Therefore,
smokers are charged more premium in comparison to non-smokers. - Geographical Location
The location where you stay affects your premium cost since certain regions
lack proper healthy food options, climate and health facilities. - Policy Duration
If you choose a longer term plan, the premium would be less that is why investing earlier in health
insurance is always suggested. - Co-insurance feature
If you choose the co-insurance feature of the company while purchasing the policy,
your premiums reduce to a great extent.
Some myths about health insurance
When it comes to health insurance, there are still many who are not
very well versed with its components. Due to lack of information, often myths can arise. Here
are some of the most common myths regarding health insurance and its coverage-
- Myth: I am young and fit. I don't need health insurance.
Reality
It is the best time to invest in a health policy while you are young and fit. Companies will charge
you a lower percentage of premium and you will receive a greater amount of coverage over a
long period of time.
Certain diseases do not show early symptoms and by the time they become
critical and evident, it becomes too late to invest in a policy and avail the benefits because
pre-existing health conditions come with a waiting period of 36 to 48 months generally from the
day of buying the policy.
- Myth: 24-hour hospitalisation is mandatory for making a claim
Reality No, it's not. With the rapid improvement in medical technology, certain surgeries/
daycare procedures get completed within 24 hours and do not require hospitalisation.
Such coverage is offered by most companies, yet make sure your policy contains all such benefits.
- Myth:
My health insurance policy will cover 100% of my hospital bills
Reality Every policy has different caps and limits when it comes to claim settlement. Hence, a
certain amount of the entire expense is usually provided by the insurance companies at
every claim settlement. There are certain exclusions in every policy, these uncovered
expenses are to be borne by the policyholder.
- Myth:
I do not have to disclose all my medical details.
Reality Disclosing all the medical details to the insurer is required in order to confirm that
your medical condition falls under the coverage terms of the company. It is also necessary
to give proof of expense for making claims. Hiding information can lead to rejection of claims
and even legal trouble.
- Myth:
If I have a health issue, I will not be able to buy health insurance.
Reality You can buy special health insurance if you have pre-existing conditions.
There are certain health insurance products specially made for people who have
some medical issues. However, the effect of your health condition will directly
affect the premium to be paid.
- Myth:
A health plan does not cover maternity benefits.
Reality Not all health plans cover maternity benefits, so be sure to check the same
while investing in a policy. However, most insurances offer that add-on and
maternity benefits can be enjoyed only after the completion of the waiting period.
There are companies that have especially made health insurance products for women.
- Myth:
Buying health insurance through an agent is the best way to buy.
Reality Nowadays, with so much information available online, it is best to invest in health
insurance after proper comparison with all the other companies. You can use the premium
calculators to find policies online and compare. Buying health insurance online will not
only save you time and effort, but can also help you get a good deal.
Health insurance portability
Health insurance portability means switching to another health insurance plan either offered by the same insurance company or by another insurance company but retaining the no-claim benefits of the earlier plan.
Porting can be done using the following ways -
- The medical insurance company should be informed about the porting request, in writing, at least 45 days before the renewal date
- A porting request should be sent to the insurance company
- Apply with the new insurance company and provide the details of the existing policy
- The company checks the existing policy details and then allows porting
- A new proposal form of the new policy should be filled and submitted with the new insurance company
- The premium should be paid
- The plan would be ported and a new insurance policy would be issued containing the renewal benefits of the existing policy
Only if the above steps are followed will the health plan be ported.
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