Health Insurance Plans

Health Insurance Plans

Posted by Creditkaro

General May 26, 2022

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.