Health Insurance Plans
Posted by Creditkaro
Health Insurance Plans
Health Insurance And Top Plans
Health Insurance or medical insurance is
an agreement between the insurer and policyholder where the insurance company
offers medical coverage to the insured up to the sum insured limit. Multiple
benefits on health plans are available, like coverage for pre &
post-hospitalization, medical check-ups, room rent coverage, cashless facility,
etc.
Some of the top health insurance plans
are Niva Bupa (formerly known as Max Bupa and starting at Rs 566 per month),
Care Health (starting at Rs 482 per month), Star Health (starting at Rs 619 per
month), Aditya Birla (starting at Rs 433 per month), Digit (starting at Rs 453
per month), Reliance (starting at Rs 552 per month) Royal Sundaram (starting at
Rs 449 per month), Oriental (starting at Rs 637 per month), Liberty General
Insurance (starting at Rs 415 per month), Future Generali (starting at Rs 610
per month) and Raheja QBE (Rs 261 per month).
Key Reasons to
Buy Health Insurance Plan
The inflation
in the medical industry is going high every day. Naturally, it is making
treatments expensive. Whenever people are admitted to hospitals for critical
illnesses or lifestyle diseases, they might be forced to end up losing all their
savings. Buying health insurance plans can be the major solution that can help
the patients avail quality treatments at affordable expenses. Some of the major
reasons are here that can help people to buy health insurance plans:
Beating Medical
Inflation -A health
insurance policy can help the respective clients to make payments of their
medical bills, including pre and post-hospitalization expenses despite the growing
medical expenses.
Quality Medical
Treatment at Best Reasonable costs-Buying health insurance plans can help the respective
customers afford the best quality medical treatments and care to concentrate mainly on getting cured.
The solution to
Fight Lifestyle Diseases – Health insurance schemes help the respective clients to
pay for the long-term treatment needed for lifestyle diseases like cancer,
heart attack, etc. all these have been on the climb with the changing
lifestyles.
Major Benefits of Health Insurance
Plans in India
Health insurance plans provide a
wide range of health benefits to the insured. However, it all depends on the insurance
plans. Following are the major benefits of buying health insurance plans in
India:
Hospitalization
Expenses- Health
insurance schemes cover the medical expenses of the insured persons and it is
being brought upon themselves on getting admitted to the respective hospitals
for more than 24 hours. It includes room rent, doctor's fees, medicine costs,
diagnostic test fees, etc.
Pre & Post
Hospitalization Expenses –Health insurance plans cover the medical expenses that respective
persons may have acquired on respective illness before being hospitalized as
well as follow-up treatment expenses borne after getting discharged. The
pre-hospitalization and post-hospitalization expenses are covered up to a fixed
number of days as specified in the policy document.
ICU Charges -Health insurance plans also cover the expenses
of availing treatment in the ICU during hospitalization.
Ambulance Expense
–Health
insurance schemes cover the cost of ambulance services used to reach the
nearest hospitals during a medical emergency.
Cashless Treatments
-All health
insurance plan providers in India offer cashless treatment facilities at their
network hospitals. The people admitted to the hospitals will not have to worry
about arranging money to pay the hospital bills. it will be settled by respective
insurers under cashless claims.
Day Care
Procedures –Health
insurance schemes cover also the expenses of availing of day-care treatments
that require hospitalization for less than 24 hours.
Pre-existing
Diseases -The best health
insurance policy also offers coverage for pre-existing diseases after respective
patients have completed the waiting period. Generally, pre-existing diseases
are covered up after a waiting period of two to four years.
AYUSH Treatment
–Health
insurance plans cover the expenses of availing of medical treatments through
the AYUSH school of medicines that include Ayurveda, Unani, Homeopathy, Siddha,
and Yoga.
Medical
Check-ups -Most health
insurance companies in India provide free preventive health check-up facilities
for the insured people at regular intervals depending on the policy terms and
conditions.
Two Major Types
Of Health Insurance Plans
Health
Insurance for Family: A family
health insurance plan is a kind of medical insurance that covers all the family
members of respective insured people in a single health insurance policy. Under
this plan, a fixed sum is insured and that is shared by all family members with
the assumption that not everyone will get sick at the same time. Most family
health insurance plans tender cashless hospitalization facilities, and
maternity benefits and cover pre and post-hospitalization benefits as well.
Senior Citizen Health Insurance Plans: Senior Citizen Health Insurance is a type of health insurance
plan that covers medical expenses borne by people above 60 years old. It endows
with preventive health check-up facilities for the elderly and cashless hospitalization
at network hospitals of the insurance companies. It provides pre-existing diseases,
hospitalization expenses, critical illness, pre and post-hospitalization
expenses, and even Corona-virus treatments for the insured citizens.
What is covered
and not covered in Health Insurance Plans?
Most health
insurance companies in India cover the following medical expenses under a health insurance policy:
In-patient
Hospitalization Expenses -The hospitalization expenses put up during the treatment of illness or
injuries are covered after more than 24 hours of hospitalization.
Pre-existing
Illnesses or Diseases -After completion of the waiting period, respective clients can file claims
for the expenses carried out for the treatment of any pre-existing illness or conditions.
Pre and Post
Hospitalization Expenses -Medical expenses are borne on blood tests, x-ray, and other medical
check-ups that are required before hospitalization are taken care of by the
insurance companies. Similarly, the medical expenses and expenses for preventive health check-ups, done to ascertain patients' health
after being discharged from the hospitals are covered under the health
insurance plans.
Ambulance
Charges -Although the
coverage amount varies between the insurance companies, most medical insurance plans
cover emergency ambulance charges.
Maternity Cover
-Medical
expenses incurred during pregnancy and delivery are taken care of along with
newborn baby expenses under health insurance schemes.
Preventive
Health Check-ups –Regular health
check-up facilities are also available in some health insurance plans in India.
Day-care
Procedures -Daycare
treatments where hospitalization is not required for more than 24 hours are
covered. It includes eye surgery, dialysis, and other common daycare surgeries
as mentioned in the policy document.
Home Treatment
Cover –Health
insurance plans also cover the costs acquired on getting medical treatment at
home on the advice of medical practitioners.
AYUSH Benefit – The people going through Ayurveda,
Unani, Siddha, or Homeopathy treatments can get reimbursements up to a
specified limit under health insurance plans.
Mental
Healthcare Cover–Several health
plans in India have come up with coverage against the medical expenses earned through
the treatment of mental illness, like depression.
However, the health insurance plans will not take care of the following medical expenses and situations. The situations are as follows:
In case of an accidental
emergency, claims arising during the initial 30 days of buying health insurance
plans are not covered. Then coverage of pre-existing diseases is subject to a
waiting period of two to four years. Then critical illnesses coverage generally
comes with three months waiting period. Then people will not get the help of
health insurance plans in case of injuries caused by war/terrorism/ nuclear
activity, self-inflicted injuries or suicide attempts, terminal illnesses,
AIDS, and other diseases of similar nature. The people undergoing cosmetic or plastic
surgery, or replacement of hormones surgery, will not get coverage under any
health insurance plan. The coverage against dental or eye surgery expenses is
not offered by any health insurance company. Coverage is not also offered to
those people who are going through bed rest for rehabilitation, common
illnesses, treatment or diagnostic tests, post-care procedures, and against adventure
sports injuries.
Health Insurance
Policy Coverage on Covid-19
The existing health insurance policies also cover the expense
of Covid-19 treatment. Several health insurers and general insurers have
already launched health insurance
plans for Coronavirus that cover the medical expenses acquired on the treatment against
Coronavirus. After the IRDAI guidelines, two special standard health insurance
products, namely Corona Kavach policy and Corona Rakshak
policy
have been introduced and are being purchased by many
people already.
Corona Kavach Policy
It is a protection-based health insurance plan that
covers Covid-19 hospitalization expenses, home treatment, and AYUSH treatment
costs. The cost of masks, gloves, ventilators, oxygen cylinders, and PPE kits,
is also covered. Under this plan, people can get a maximum sum of between Rs
50000 and Rs 5 lakh. The coverage is allotted to people who are between 18 and
65 years old.
Corona Rakshak Policy
Corona Rakshak policy is a
benefit-based product that provides a lump-sum payment for hospitalization
(minimum 72 hours) expenses upon the diagnosis of coronavirus during the policy
term. The minimum policy term is 3.5 months and the maximum is 9.5 months.
Under this plan, the maximum sum people can get is between Rs 50000 and Rs 2.5
lakh.
Key Factors
that affect Health Insurance Premium
The major benefits of health insurance are that it takes care of healthcare
expenses. It offers financial security to the clients and their families when
they fall into unanticipated serious illness or accidental injuries, saving
them from being exhausted after spending all their savings. Here is how the
cost of their insurance premium is determined:
Medical
History: Medical history
is one of the major determinants of the health insurance premium. Almost all
health insurers in India make mandatory pre-medical tests mandatory (after a
certain age) before allowing people to buy a health insurance policy. Some
insurance companies do not make medical screening mandatory. Rather they
consider the current medical conditions of the applicants, lifestyle-related
health risks, and the medical background of the respective clients' families.
That is why medical insurance premium for smokers is higher than for other
people.
Gender and Age:
Age is another
important determinant of the medical insurance premium. The premium varies
based on the age of the insured person. So it is recommended to buy a policy at
a young age because low premium costs apply to young applicants. Elderly people
are vulnerable to cardiovascular diseases, and other critical illnesses such as
cancer, kidney problems, etc. Therefore senior citizens' medical insurance
premium is usually on the higher side. Also, the premium cost for women's health insurance is lower than the male candidates due to
the lower risk of stroke, heart attack, etc.
Policy Term: The premium for a 2-year health
insurance plan will be higher than a 1-year plan. However, almost all insurance
companies offer a discount on long-term medical insurance plans.
Type of Health
Insurance Plan: The type of
health insurance policy clients select also affects the cost of the premium. If
coverage becomes high the higher will be the premium. With the help of an
online health insurance premium calculator, respective clients can compare the
premium for different health insurance plans before purchasing.
No-Claim-Discount:
If the clients have
not made claims during their previous policy terms, then they can earn NCB or
No Claim Bonus discounts. It is also known as a cumulative bonus, the savings
on premium ranges from 5% to 50% depending on the number of claim-free years.
It is also one of the most important factors that are taken into consideration
while calculating the cost of the premium.
Lifestyle: If respective health insurance buyers drink
or smoke regularly, chances are high that they will be charged more premium
amounts. In some cases, the insurance companies can also reject their request
for a medical insurance policy.
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