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Health insurance, also called as Mediclaim, is way to pay for advance medical treatments, that typically require you to be in-hospital overnight. It also covers certain other day procedures like cataract surgery, etc that don't require you to be hospitalized but are expensive nevertheless.

Online premium calculators are available for calculating the premiums payable for health insurance plans. These calculators are available both on insurance companies’ websites and also on insurance aggregators’ websites. Insurance aggregator websites calculators are better because they let individuals compare the health insurance quotes of different plans at once.

The calculator works on the input provided by individuals. Individuals have to enter the following details in the calculator to arrive at the health insurance quotes –

• The number of members to be covered
• The age of all the members who are being covered
• The sum insured which is required
• Any additional coverage benefits which are to be added. Additional coverage benefits, if chosen, would attract an additional premium
• The term of the plan
• If the insured or any other members suffer from any pre-existing illness or not
• Any discounts which are applicable to the premium

When all the above-mentioned details are put in the calculator, the calculator calculates and lists the health insurance quotes of different medical insurance plans available in the market. Individuals can, then, compare the premium rates and coverage benefits and select a health insurance plan.

Health insurance claims are of two kinds –

• Cashless claims
• Reimbursement claims

In cashless claims, the insurance company settles the medical bills directly with the hospital. The policyholder does not have to pay for any medical costs himself. Cashless claim settlement can be availed if the policyholder chooses to get admitted to a hospital which is tied-up with the insurance company.

In the case of reimbursement claims, the medical expenses are to be borne by the policyholder initially. Thereafter, when the insured is discharged from the hospital, the claim is submitted to the insurance company with all the relevant bills and medical documents. The company analyses the claims and then reimburses the policyholder for the medical expenses incurred. Reimbursement claims are applicable if the policyholder does not choose a networked hospital for treatments

Yes, the online medium provides not only an easy way to buy health insurance, it is safe too. If you choose reputed and trusted websites, you can buy a health plan online without worrying about safety.

Pre-existing illnesses are covered after the first few years of the plan. This period, when pre-existing illnesses are not covered, is called the waiting period. Health insurance plans have a waiting period ranging from one year to four years.

No, exclusions are those expenses which are not covered by the health insurance plan. Thus, you would not get a claim for an excluded expense.

 A family floater plan covers the entire family in one plan. Thus, the entire members get coverage jointly as well as independently. The premiums are lower compared to individual health plans for individual members.

Yes, there is no restriction on buying health insurance plans. You can buy more than one health plan without any limitations

Women can buy all types of health insurance plans available in the market. However, there are special critical illness health insurance plans which have been specifically designed for women keeping their needs in mind. Such plans cover women-centric critical illnesses and offered by a few health insurance companies.

Yes, there are separate cancer care plans which are designed to cover cancer. These plans pay a fixed amount in case the insured is diagnosed with any form of cancer.

Health plans which provide cover internationally are called overseas health plans. International travel insurance plans are usually called overseas health plans as they cover international hospitalisations and also other travel-related contingencies. 

No, a personal accident policy would cover only accidental death and disablements. Health insurance plans, on the other hand, have a wider scope of coverage. They not only cover accidental injuries but hospitalisation due to illnesses as well. However, coverage for accidental death is not available in health insurance plans.

Yes, minors can be covered in health insurance plans. In case of family floater plans, they are covered as dependents from the age of 3 months onwards. In the case of individual plans, minors would be covered only if either of the parents is also covered under the same individual plan.

Yes, some family floater health plans allow coverage for dependent parents. Moreover, there are separate senior citizen health insurance plans which can be taken for covering parents.

Yes, the sum insured can be increased when the health plan is being renewed.

Yes, smoking is a health hazard and so it increases the premium being charged under the plan.

Health insurance plans come with a term of one, two or three years, as chosen by the policyholder. After the term of the plan comes to an end, the coverage can be continued by renewing the policy. To renew, the renewal premium should be paid and the policy coverage would continue.

Health plans allow lifelong renewals. Thus, there is no limiting age at which renewal would not be allowed.

If the health plan is not renewed on time, the coverage would lapse once the term is over. Any claims made in a lapsed policy would be rejected by the insurance company. Renewal benefits of health insurance are also lost. However, the insurance company provides a grace period for renewing the policy after it has lapsed. If the policy is renewed during the grace period, the renewal benefits continue. However, if the grace period also lapses, the renewal benefits also lapse.

The policy can be renewed online or offline. If you choose the offline mode you either have to approach a health insurance intermediary or get the policy renewed from the office of the insurance company. Online renewals, on the other hand, can be done from anywhere using the phone or computer.

Online renewals are better because of the following reasons -

• They are simple and convenient
• When you renew online, you can see other available plans too. Then you can compare the available plans with your current plan. If you find better coverage in another plan at a lower rate of premium, you can port your health plan and enjoy better benefits of health insurance.

So, renewing online is always better than renewing offline.

When renewing the plan, the following factors should be considered -

• The sum insured and whether it is sufficient 
• The members covered and whether any new members are to be added or old members to be deleted
• The premium across different health plans vis-a-vis the coverage offered

The plan should be renewed only after these factors are weighed in.

There are two renewal benefits which are allowed to be ported. One is the accumulated no claim bonus in the existing policy and the other is the reduction in the waiting period.

The requirement for medical check-up depends on your age, medical health and sum insured. Usually, health plans don’t require medical check-ups if the age is up to 45 years and the sum insured is INR 5 lakhs. For higher ages and/or sum insured levels, medical check-ups might be necessary.

Health plans consider diabetes to be a pre-existing illness and provide coverage after a waiting period. If diabetes is severe, coverage might be restricted or not available at all. There are diabetes-specific health plans too which allow coverage even if the individual is suffering from diabetes.

TPA stands for Third Party Administrator. TPA is the bridge between the insurance company and the insured in case of a claim. The claim is coordinated by the TPA.

Dental treatments are not covered in health insurance plans. However, accidental injuries which require dental treatments might be covered. Moreover, there are health insurance plans which provide OPD coverage benefit. Dental treatments might be covered under this benefit up to a specified limit.

The Government has launched some health insurance plans for the economically weaker sections of society. These plans are, therefore, available to individuals who belong to the backward class. Moreover, even if you qualify for the health plan, the coverage is limited and not sufficient to take care of the high medical costs which incur in recent times.

Yes, come health insurance plans cover Ayurvedic and alternative treatments taken by individuals. However, there might be a limit to the coverage allowed.

There are many health insurance plans which allow coverage for maternity-related expenses. Expenses incurred in childbirth, prenatal and postnatal treatments are covered. In many plans, the newborn baby is also covered for any medical complications till the first 90 days. However, maternity treatment is available only after a waiting period of 2 to 6 years across plans.

Hospitalisation due to dengue is covered in all health insurance plans. However, OPD expenses might not be covered. There is a dengue plan offered by Apollo Munich which specifically covers dengue and all its related expenses whether incurred on an inpatient or on an outpatient basis.

Under top-up plans, there is a deductible limit. If the claim exceeds the deductible limit, the top-up plan pays the excess medical costs incurred. For instance, in a top-up plan of INR 5 lakhs, there is a deductible of INR 2 lakhs. Now, in this case, if the claim exceeds INR 2 lakhs, the plan would pay the benefits. So, if the claim is INR 2.5 lakhs, the top-up plan would pay INR 50, 000 as a claim.

Super top-up plans, like top-up plans, have a deductible limit. However, the aggregate claim made in a policy year is considered when the deductible limit is applied. If the aggregate claim exceeds the deductible limit, the claim is paid. For instance, in a super top-up plan of INR 5 lakhs, the deductible is INR 2 lakhs. Now, there are three claims in a policy year of INR 1 lakh, INR 1.5 lakhs and INR 2 lakhs respectively. The first claim would not be paid by the super top-up plan. However, in the second claim, the total claim becomes INR 2.5 lakhs. Since this is higher than the deductible, INR 50, 000 is paid as claim. Similarly, in the third instance, the aggregate claim is INR 4.5 lakhs. The super top-up plan would, therefore, pay INR 2.5 lakhs as a claim.

Room rent is the rent paid to the hospital for occupying a hospital bed. Some health plans have a limit on the maximum room rent which is covered. You should, therefore, choose a room whose rent is within the specified sub-limit. If the actual room rent exceeds the sub-limit, the total health insurance claim is reduced.

Claim settlement ratio determines the number of claims settled by the insurance company against the total claims made on it in a financial year. A higher ratio is better as it shows that the company settles most of its claims.

Yes, a health insurance policy, once bought, can be cancelled during the free-look period allowed under the plan. Upon cancellation, the premium paid is refunded after deducting the costs incurred in issuing the policy.

The waiting period is the period during which coverage is not allowed for specified illnesses. 

Co-pay means that the policyholder would have to pay the specified claim from own pockets. Co-pay is applicable if the insured is 61 years and above and the co-pay ratio ranges from 10% to 25% across different health insurance plans.

NCB stands for No Claim Bonus. This bonus is allowed if no claim is made in a policy year. Insurance companies usually allow NCB as an increase in the sum insured without increasing the premium. Some plans also allow a discount in the renewal premium while some offer gift vouchers. In case of increase in sum insured, NCB is cumulative in nature. The sum insured is increased every year till a claim is made.

Pre-existing illnesses are illnesses which the insured suffers from when buying a health insurance plan. Since the illnesses are already present, the insurance plan covers such illnesses after a waiting period.

Yes, health insurance plans allow various discounts which can be used to reduce the premium outgo. Discounts are offered for the following -

• For buying a multi-year policy and paying premiums at once
• For covering 2 or more family members under the same plan
• If a voluntary deductible limit is chosen 
• If the plan is bought online 
• In some plans, discounts are also allowed for making no claim in the previous policy year