Health insurance sector in India has seen rapid changes. The high cost of medical treatment has made people buy health insurance plans to cover medical expenses. People without health insurance plans will end up spending their savings on medical treatment. So, availing a health insurance plan will make sure, you don't dip into your emergency funds, in case you fall ill. Here are some of the advantages of availing health insurance plans.
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The greatest gift you can give your family and loved ones is a healthy you. Also, you can’t enjoy wealth if you are not in good health. Health is worth more than all the riches in the world. Make sure you don’t become poor when you fall sick. This is the reason why you should get a Health Insurance Plan for yourself and family.
While you try your best to keep illness at bay, it is impossible to bid a total goodbye. Illness and accidents are uninvited guests. God forbid, if tomorrow you or a family member suffers a major illness, you will have to spend a lot of money on hospitalization and recovery.
Global Medical Trends Survey 2017, conducted by Willis Towers Watson, shows that healthcare costs in India have increased by 20%. According to a report made by the National Sample Survey Office [NSSO] on Health and Morbidity known as 'Social Consumption on Health, only 14.1% of people in rural India and 18.1% people in urban India are covered by any kind of Health Insurance.
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Higher the out-of-pocket expenses, greater are the chances of losing control over your monthly budget. Spending on expensive hospital treatment from your pocket will limit the ability to fulfill family obligations.
Health Insurance inclusions:
Health Insurance inclusions are the expenses that are covered by the health insurance plan. Following are the common inclusions of a health plan at the discretion of your insurer:
OPD Care, Maternity cover and Newborn cover are selectively offered by a few Health Insurance providers.
The main purpose of availing a health insurance plan is to cover all your medical expenses, without affecting your health and savings. Health insurance plan covers hospitalization expenses, pre-hospitalization and post-hospitalization charges. Hospitalization expenses are the expenses which are incurred during the period of hospitalization.
Pre-hospitalization expenses refer to the expenses incurred, 30 days before a patient is moved to a hospital for treatment. Medical Tests and Medicines are considered as pre-hospitalization expenses. Post-hospitalization expenses refer to the expenses that are incurred 30 days after hospitalization.
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You can avail critical illness insurance either as a standalone plan or as a rider. Critical illness plan covers life-threatening diseases. Insurers cover more than 20 diseases under the critical illness plan. Some of these are cancer, coronary artery bypass surgery, heart attack, stroke, kidney failure, aorta surgery, heart valve replacement, major organ transplant and paralysis.
The insured will be entitled to get the lump sum amount on diagnosis of any of the critical illness from the predetermined list.
SEE ALSO: Tips To Port Health Insurance Plan
Under a cashless health insurance plan, an insurer directly settles the claim amount with the hospital. The main purpose of providing cashless facility is to make sure that you (insured), does not incur any out of pocket expenses. Insured can avail cashless benefit only if he is admitted to the network hospitals.
You can enjoy cashless facility by filling out a pre-authorization form and displaying the health insurance card.
Payment made towards health insurance premium is eligible for deduction under section 80D. Individuals less than 60 years can claim deduction up to Rs 25,000 a year on the health insurance premium paid for themselves, spouse and dependent children. One can also claim deduction up to Rs 25,000 a year, for the premium paid towards parents health insurance plans.
If your parents are senior citizens, you can claim a deduction on health insurance plan up to Rs 30,000 a year.
Are you not sure of how to get your maternity expenses covered in a Health Insurance plan? What if you already have an Individual Health Insurance plan or a Group Health Insurance plan? Are your pregnancy and maternity expenses covered by these? What about your newborn, is it covered in your plan? Here are the answers for all your questions:
Health insurers treat pregnancy and maternity as pre-existing conditions. Therefore, individual Health Insurance plans do not cover costs relating to pregnancy and maternity. However, some Health Insurance plans offer maternity coverage as a sub-limit.
For example, in a Health Insurance plan with a sum insured of Rs 3-5 Lakhs, maternity benefits are only covered up to a sub-limit of Rs 50,000. Also, they come with a waiting period of 2 to 4 years. If you want to reduce waiting period, you will have to pay additional or higher premiums. This becomes a costly affair.
Therefore, you can opt for a maternity cover rider. This comes at an additional cost which increases your premium. This enhances your basic Health Insurance plan. This is specially designed for maternity purposes. It covers:
Porting a Health Insurance plan means converting one plan into another. Porting can be external or internal. Internal porting is where you can opt to port plans under the same insurer and external is where you may port to a policy with a new insurer. In any case, the new insurer should not ask you to serve a waiting period for pre-existing conditions.
Reasons for portability:
You must apply for porting at least 45 days before renewal of the existing policy. A delay may result in the refusal of the application by the new insurer.
If your health insurance plan has a reset option, the basic cover gets reinstated if you utilize the entire sum insured during the policy tenure. If you fall sick and a claim arises after you have exhausted the entire sum insured, with a reset option, your insurer will reset or refill your sum insured after the first claim. Thus, the insurer will also cover the second claim for the year. Reset options may be for a partial or total exhaustion of sum insured.
You can either buy a Health Insurance online through aggregators or offline from insurance agents. Online aggregators help you compare the features and premiums of various policies across companies. Aggregators only help you with buying the policy. The policy will be issued by the insurance company.
Buying a Health Insurance online is a simple process. You do not have to approach an agent who might not give you a good deal. The agent may try to sell you a health insurance plan of an affiliated company. They might not disclose all the relevant details to you.
1. Once you buy insurance online, keep the insurer's toll-free number saved on mobile phones of yourself, your family members and the phone diary. This will help you in filing a claim quickly when the need arises.
2. Keep the mediclaim card with you. It will help in times of emergency.
3. Keep copies of all the documents, bills and letters that you submitted with the insurance company. Aggregators play no role when a claim is made.
4. Contact your insurer or their third party administrator (TPA) in case you want to file a claim.
5. Go for an online health insurance plan only if you are completely aware of the finer details of the policies.
6. Also, let your family know about all the details of the plan that you bought online. In the absence of an agent, the responsibility of handling the claim process lies with the family.
If you think you are better off buying a Health Insurance policy offline, you can compare plans online and buy it offline through an agent who is trustworthy.
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