What is Health Insurance?

Health insurance is an agreement among you and your insurance company whereby the insurer pays the medical costs of the insured if the insured becomes sick or injured due to covered causes, or due to accidents. The insurer may be a private insurance company or a government agency. The insurance may pay for medicine, visits to the doctor, hospital stays, other medical expenses, depending on the conditions covered and the benefits and choices of treatment available on the policy.

Why Health Insurance is needed?

A medical emergency can strike at any time. It can be in nature of an accident or any disease/ illness. With present life style of stress, traveling, long working hours, irregular and unhealthy eating habits, makes us very susceptible to illnesses. Often such medical emergencies are unforeseen and may cause great financial crisis to you. Very often, existing savings, future family goals are compromised to arrange for such medical expenses. Taking an adequate medical and health insurance would help you cover your cost of treatment and hospitalization, other medical expenses and may reimburse you for your lost income during period of recovery. Health insurance is your safeguard against financial impact and stress that accompanies any illness or accident.

Compare Health Insurance/ Medical Insurance Before you Buy

There are a number of insurance advisor such as Five force advisory that help you compare the best health insurance plans for you and your family. Certain parameters that should be considered while comparing medical insurance plans include the features of the health insurance plan, the add on benefits offered by the insurance provider, the sum insured under the policy and the network of hospitals allied with the insurance provider. These factors not only are a major differentiating factor from their competitors, but are also a testament of good service to their end customer. Selecting a suitable health plan to protect everyone in your family is not an easy task (Unless, you have been buying insurance only to save on tax so far). Thus, always compare health insurance plans on the basis of the following crucial factors.

PREMIUM VS COVERAGE

Assess if the cover and sum assured are suitable against the premium paid. Choose add-ons as per your needs.

NETWORK HOSPITALS

Be sure of the insurer’s network hospitals in your area. You can avail of cashless services only at these hospitals.

ROOM RENT LIMIT

Since hospital room rents vary, some insurance plans pay only a part of the actual rent. It’s always best to go for higher or no room-rent limit plans.

EXCLUSIONS

Check what is permanently excluded and which treatments are possibly covered after waiting for a certain period.

Features of Health Insurance

Health insurance companies offer a wide variety of policies, tailored to unique health necessities of their customers. Hence, numerous plans encompass different functions associated with medical remedies, surgeries, etc.

Hospitalization Expenses

Coverage for all hospitalization expenses, that could occur due to an illness or accident. Treatment and hospitalization for the Covid-19 too, will be covered under this.

PRE-HOSPITALIZATION EXPENDITURES

Coverage extends to medical expenses incurred between 30 to 60 days earlier than hospitalization is included. (Clinical diagnostic tests, medication, etc.) Hospitalization expenditures include costs incurred for the duration of hospitalization for a minimal duration of 24 hours. Expenses generally blanketed are clinic room rent charges, operation theatre charges, ICU charges, doctors’ consultation fee, surgical operation charges, and other crucial fees like blood, anesthesia, oxygen, etc.

POST-HOSPITALIZATION EXPENDITURES

Expenditures incurred between 60 days and 180 days after hospitalization is generally covered by most insurance companies. These charges include follow-up doctors’ consultation fees, medical diagnostic tests, medication, etc.

Domiciliary Hospitalization

Medical charges incurred because of remedies undertaken at domestic for a duration of greater than three days.

Expenses for Organ Donation

Some health insurance plans cover medical charges incurred within the process of organ donation. If you’re being donated an organ, your donor may be financially secured by way of your medical health insurance plan.

Day Care Procedures

Day care methods or medical treatments like dialysis, angiography, radiotherapy, chemotherapy, appendectomy, colonoscopy, lithotripsy, hydrocele, eye surgical procedure, amongst others. Certain high-end medical health insurance plans cover all day care treatment techniques.

AYUSH Treatment

Alternative clinical remedies or AYUSH, which stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy are covered for policyholders who’ve opted for it.

Cumulative Bonus

For every claim-free year, you and your family get rewarded with a 5% bonus in your sum insured!

Hospital Cash

Daily expenses for food, health center stay, etc. which might be incurred by way of your caretaker in the course of your hospitalization may be provided on medical health insurance plans or can be available as a rider. Health insurance plans also provide compensation for the loss of income because of health issues.

Ambulance Cover

Health insurance policies cover expenses for ambulance service.

Check-ups

General fitness check-ups are included with the umbrella of some health insurance plans.

Vaccinations

Certain medical insurance plans cover vaccination fees for bee stings, dog bites, etc.

HOSPITAL CASH

Daily expenditures for food, hospital stay, etc. that are incurred by your caretaker during your hospitalization may be offered on health insurance plans or may be available as a rider. Health insurance plans also offer compensation for the loss of income due to health issues.

Documents Required for Buy Health Insurance Policy

• Proof of Age: Acceptable documents are Birth Certificate, Aadhar card, PAN Card, Voter’s ID, Driving License, Passport, School or College Certificate, etc.
• Photo Identity Proof: Aadhaar Card, PAN Card, Driving License, Passport, Voter’s ID, etc.
• Proof of Address: Acceptable documents are Ration Card, Telephone Bill, Electricity Bill
• Medical Checkup: If asked by the insurance company

Who is Eligible for Medical Insurance?

• Policyholder: The minimum entry age varies between 18 years and 21 years, depending on the insurance company. The maximum entry age varies between 60 years and 70 years, with the flexibility of renewal being extended to whole life.
• Dependents: Spouse, children and parents are referred to as dependents of the policyholder. The entry age for children starts from 91 days till 18 years or 25 years, depending on insurers.
• Renewability: Health insurance policies can generally be renewed for the entire life, but this again varies from one insurance company to the other. After a certain age, medical tests maybe recommended and companies may ask for higher premium rates.