Health Insurance is an insurance policy to cover the expenses of the insured person’s medical and surgical treatments. The insured may either choose to initially pay out of pocket and then reimburse the paid amount or insurer or the health insurance provider can directly pay to the provider. Provider here may refer to a doctor, clinic, laboratory, hospital, healthcare practitioner or a pharmacy depending on the case. An individual can have an own health insurance policy or from the employer or both.
In today’s date in India, where the medical treatment costs are at their all-time high, and owning to unhealthy modern lifestyle more and more people are now facing more health ailments. With an already high cost of living and comparatively lower income, medical treatments are costly affairs even for nuclear families, whether they live in a metro city like Bangalore or a small town. A health insurance cover provides great relief at least to the pocket with their facilities such as very low premiums, high coverage and the option of cashless treatments. On top of this the insured can also avail tax benefits on the paid premium amount under the Section 80D of the Income Tax Act, 1961.
Health Insurances, in technical terms, are a contract between the insurer and the insured, wherein the insurer will bear the costs of treatments of the insured, either by reimbursement or direct payment to the service provider, as long as the insured satisfies all the terms and conditions of the policy. For a health insurance policy to be valid, the insured has to pay premiums to the insurer, and in turn the insurer will pay for the costs of the treatment, right from the day of the commencement of the policy. Generally one may avail a health insurance policy on their own, but some employers also do provide a medical insurance to their employees, but with a limited coverage.
Highlighting Features & Benefits of a Health Insurance Policy
Health Insurance policies do provide the cover for the medical expenses but that is not all about them. A good understanding of the features of the medical insurance policy will help you to choose the best insurance policy for yourself and your family. Let us have a quick look at the different features of a health insurance policy.
- Facility to Apply & Renew Online: Even the insurance sector has embraced digitisation in the modern world. All the top insurance providers in India now provide the facility to apply for health insurance online. Their websites are always updated and offer a lot of facilities that a customer may ask for: information, application, renewal, status information and contact details as such. This enables an interested individual to research online and apply from anywhere anytime as per their wish and comfort.
- Cashless Treatments: Health Insurance providers now provide health insurance cards which can be used like a prepaid card/debit card at a medical centre or pharmacy to pay directly for the costs. This way the insurer directly pays for the policyholder.
- Free Annual Health Check-ups: Health insurance providers have partnered with different medical facilities and diagnostic centres around the country to provide free annual full body health check-ups to their policyholders. This encourages a policyholder to stay fit and stay aware of their health. This also helps a policyholder to maintain a statistics of their health from time to time.
- Discounts for Family: Those policyholders who enrol their family members or any other person in the insurance plan, the insurer provides some discounts and loyalties to such policyholders for bringing in new customers to them. These discounts vary from a 5%-10% discount on the premium amount.
- Renewable for Lifelong: It cannot be predicted who will remain fit for how long. Even those who have remained fit throughout their younger lifespan may develop problems later on. To address this issue, the health insurers provide the facility to keep renewing an insurance plan for lifelong.
As soon as a policy expires it can be renewed, even online.
- Fitness Bonus/ No-claim Bonus (NCB): Just in case if a policyholder does not makes any claim for the entire year, the insurance provider gives a certain discount to the policyholder. This encourages two things: the policyholder refrains from making petty claims and secondly it encourages them to stay fit and healthy so that they do not need to make even petty claims. NCB is provided at the time of the policy renewal, either as a discount on premium or as an increase in the coverage amount for the same premium paid.
- Quick Settlements & Updates of Claims: All thanks to the intense competition in the field of health insurance, all the insurers are now forced to provide a high quality customer service. As such, so as to retain their existing customers, the health insurance providers, treat the customer claims professionally and send them regular updates about the status of their claims via email/SMS/phone call. The competition in the sector has also affected the claim settlement ratio which has now gone up in the last few years.
- Tax Benefits on Paid Premium: Health Insurance policyholders can claim tax benefits under the section 80D of the Income Tax Act, 1961, towards the amount paid as health insurance premium. This ah.
- Plan Portability to Other Insurer: The health insurance plans are portable which means that they can be transferred any other insurer. A policyholder may choose to do so if they feel that they can get same or better facilities with another insurance provider, and the original provider will allow the policyholder to do so. The portability does not compromise on any features or benefits of the policy which were available with the original insurer.
- Round-the-clock customer support: All health insurance providers provide round the clock support to the policyholders, as any medical emergency can happen with anyone anytime and sometimes it might be difficult for a policyholder to understand a certain thing about the policy. As such all health insurance providers provide 24/7 customer support.
Types of Health Insurance Policies Available in India
These are the most popular types of the health insurances policies that are available in the Indian insurance sector.
- Critical Illness Health Insurance: A Critical Illness Health Insurance Plan provides the cover for the treatment expenses, should the policyholder is diagnosed with one of the critical illnesses mentioned in the policy document within the term of the policy. Just like any other plan, the policyholder pays a premium and purchases a policy from an insurance provider. Should anything happen during the term, the insurer will provide the promised coverage.
- Family Floater Health Insurance: Family Floater Health Insurance Plans provide health insurance coverage to entire family members under just one plan. This is very cost-effective in comparison to buying individual insurance plans for every member of the family. Family Floater Insurance Plans provide cover for the policyholder, spouse, and the dependent children; however, some insurers also allow policyholders to include their dependent siblings, parents, and parents-in-laws in the same plan.
- Group Health Insurance: Group Health Insurance Plans are provide by employers to their employees as an incentive to boost morale and retain personnel. The employees can opt for additional coverage to cover their family members and also can get tax deductions on premiums paid towards group health insurance as per the Income Tax Act of 1961. Group Health Insurance provides cover for self, spouse, children, and parents. Some health insurance providers also provide cover for pre-existing conditions and maternity expenses.
- Individual Health Insurance: As the name suggests, this health insurance policy is for individuals, so that they can have maximum cover at the most affordable premiums, while still providing benefits like tax benefits and cashless treatment.
- Maternity Health Insurance: Maternity Health Insurance Plans provide coverage to help people cope up with their maternity expenses without breaking their savings, at an affordable price. A Maternity Insurance Rider can be attached to a base health insurance policy to provide cover for pregnancy and childbirth expenses. Maternity Insurance is offered as add-on in group insurance policies offered by employers with a sub-limit of up to ₹50,000.
- Personal Accident Insurance: A Personal Accident Insurance provides cover for the medical expenses caused due to an accident, along with providing the policyholder’s family or survivor or nominee a sum assured amount in case of an insured person’s sudden demise. This keeps the survivor/family financially safe in case of any eventuality. A personal accident cover is a rider that can be attached to the base insurance policy.
- Preventive Health Insurance: Preventive Health Insurance provide preventive healthcare packages to cover the expenses like regular health check-up at network hospitals, employee health check-up, family preventive healthcare to cover the self, spouse, children, and dependent parents, child preventive healthcare package for children aged 0 to 13 years, diabetes preventive healthcare and many more. Preventive Health Care Insurance Plans are also available based on the age of the insured.
- Senior Citizen Health Insurance: Senior Citizen Health Insurance Plans provide medical insurance cover to people aged 60 years and above in the case of a hospitalization. The premium depends on the age of the policyholder and the sum insured. The IRDAI has mandated that the minimum entry is 60 to 65 years and is granted lifetime renewability.
- The number of illnesses that a human being can get in contact with is increasing day by day.
- Post-hospitalisation expenses like consultation fees, tests, and doctor visits have increased too.
- One of the very important benefits of having a health insurance plan is the cashless benefit offered by the insurer. Without a health insurance plan, a person will be forced to pay the hospital bills from his/her own pocket. Whereas, when you have a health insurance plan, you can walk into a network hospital, avail the treatment, and the insurer will settle the bill directly with the hospital.
- It gives you a peace of mind as you know you are covered in case of any eventuality.
- A comprehensive health insurance plan also covers your spouse, children, and any other dependents like parents. This protects your family and loved ones from any financial crisis that they might face even if you are absent.