Top 10 things to ask before buying a health Insurance
Choose the right health insurance policy by asking these quick questions.
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Understand the concept of ‘Room Rent Limit’ in health insurance.
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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.
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.
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-
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 | individual 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 |
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:-
The notable key features of any health insurance in present market are-
Medical insurance policies offer various advantages and come with unique features which are as follows –
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 –
A basic medical insurance plan provides all the essential coverage features. You would find coverage for the following –
Besides these common coverage features, different medical insurance policies provide different coverage features too which make the plan comprehensive in nature.
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 –
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.
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. |
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-
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 –
To make a successful claim in a health insurance policy, policyholders are required to follow the below-mentioned process –
In case of cashless claim settlement
In case of reimbursement claims
There are too many reasons to justify the point why an individual must start investing early in his life:-
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 |
For successful claim settlement in your health insurance policies, you have to submit a set of documents. These documents include the following –
Here are some of the important eligibility criteria of health insurance plans –
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-
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-
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-
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-
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 –
Only if the above steps are followed will the health plan be ported.
FAQ
Frequently Asked Questions
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 –
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 –
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 -
So, renewing online is always better than renewing offline.
When renewing the plan, the following factors should be considered -
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.
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.
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 -
*Prices will vary on the basis of your individual profile