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Health Insurance, where to buy and features

Health Insurance, is the medical coverage that helps you meet your health related expenses by offering financial assistance. It is a contract between the insurer and policyholder where the insurance company offers medical coverage to the insured up to the sum insured limit.
Some benefits like, it helps you pay for your doctor fees and sometimes prescription medicines coverage for pre & post hospitalization, medical check-ups, room rent coverage, cashless facility, etc.
Once you enrol into health insurance coverage, you and your health insurer each agree to pay a part of your medical expenses, usually small amount or percentage of the expenses.
It is noteworthy that medical emergencies can erupt anytime. Hence, it is important to have an adequate health insurance cover, which can help you financially manage medical emergencies better. It is noteworthy than having an optimal insurance coverage, is integral in the exercise of financial planning , which helps you to put your personal finance in order and aids you achieve long-term financial goals.

Why should you buy Health Insurance?

  • Health Insurance is necessary for every individual, keeping in mind the rising medical costs and spurt of lifestyle diseases. A medical emergency can attack anyone, anytime and impact an individual emotionally and financially.
  • Buying it early means better financial planning. With your age, premium increases, say if you are 22 years of age, the premium is 5000 and same for 30 years is maybe 7500. So buy it as early as possible to book the policy at the lowest possible premium.
  • With exponential increase in healthcare costs, the need for health insurance cannot be fulfilled with your employer cover.
  • Due to great incidence of lifestyle illnesses has increased.
  • Most of us have to travel extensive for work. A health insurance policy that covers emergency medical evacuation along with making available the best healthcare facilities around the world for some common yet critical diseases therefore makes total sense.

What are the features of Health Insurance?

Let's have a look at some features:

  • Limits on hospital room rents, specially ICU rooms which can cost you much, and we only realize when something happens to us.
  • Takes care of the life-threatening diseases like cancer, heart attack, Brain tumours and kidney failures. This plan can be taken as a stand-alone policy or can be added as a top-up to the existing policy.
  • This policy covers pre-existing diseases a person suffers before buying the policy. The diseases can be lifestyle diseases also.
  • Network hospitals are those which have a direct tie up with your health insurance company; so in case of a claim you can avail the cashless facility.
  • Pre-Hospitalization expenses are those expenses which are incurred before you are hospitalized while Post-Hospitalization expenses are those which are incurred after you are hospitalized.
  • Health insurance claim only erupts in the year of hospitalization, in the years where you've been in pink of your health (by God's grace), the insurance companies also provides you with a no claim bonus. This has an effect of increasing your sum assured in next renewal of the policy.

How does insurance reduce your financial risk?

Imagine you’re driving your car and you hit a deer, which damages your car. If you have the right kind of auto insurance policy, the insurance company will pay the costs of the car repairs (minus the deductible — the portion you have to pay). Now, imagine a water pipe bursts in your bathroom, ruining everything in that room and in the bedroom next to it. Typically, if you have homeowner’s or renter’s insurance, the insurance company will pay to replace some or all of the damaged property, once you pay your deductible. Insurance policies will only pay for things that are described in the policy. So, it’s important to read a policy carefully before you buy it, so you’ll know exactly what’s covered.

What are the Types of Health Insurance policy?

There are literally many types, however top 7 which almost covers everything are as follows:

What are the Top 3 Health insurance Companies?

Top 3 best complete Health insurance Companies:

  • Bharti AXA General Insurance Company Ltd
  • AEGON Life
  • HDFC Ergo Health

  • What are the Factors to Consider When Choosing a Health Insurance Company?

    Consider these factors for sure before enrolling into one. Detailed data can be found on each and every Sub-Insurance category.

    • About the Company
    • Why should you buy specially from them?
    • Features, that are going to benefit you in long term
    • Types of policies they provide.
    • What all they Cover in their policies.
    • What is excluded or not covered in the policy.
    • Premium Calculation
    • Documents required
    • Steps to renew the policy
    • Claim procedure, it should'nt be Hectic

    What is Covered under Health Insurance?

    A health insurance plan offers comprehensive medical coverage as discussed above, like:

    • Maternity Cover
    • Critical Illness
    • Personal Accident
    • Hospital Cash
    • Room Rent Waiver

    What is NOT-Covered under Health Insurance?

    The following medical expenses and situations are not covered in a health insurance plan:

    • Claims arising during the initial 30 days of buying a health insurance plan are not covered.
    • Pre-existing diseases coverage may have to wait for 2 to 4 years.
    • Critical illnesses coverage usually comes with 90 days waiting period.
    • Injuries caused by war/terrorism/ nuclear activity are mostly not covered.
    • Self-inflicted injuries or suicide attempts.
    • Fatal or Terminal illnesses like AIDS, and other diseases of similar nature.
    • Cosmetic/plastic surgery, replacement of hormones surgery, etc.
    • Dental or eye surgery expenses are usually not covered in basic plan.
    • Bed rest/hospitalization and rehabilitation, common illnesses, etc.
    • Treatment/diagnostic tests and post-care procedures.

    Health Insurance Premium and Premuim Calculator.

    Health insurance premium is the amount that you pay to the insurance provider to get health. If you have bought a one-year health insurance plan, you will have to pay the premium annually. If you have purchased a two or three-year plan, you will have to pay the premium altogether for the selected policy duration.
    Though the premium varies with Company, Age, location and many more, you still can get a basic idea by calculating here.

    What are the benefits of Health Insurance Policy?

    With the advancement in medical facilities, health care costs have also increased exponentially, as I mentioned above. So the main benefit of health insurance is that it takes care of healthcare expenses.
    It offers financial security to you and your family in the event of an unanticipated serious illness or accidental injuries that could drain all your savings.

    • It covers Pre and Post hospitalized expenses.
    • Cashless facility.
    • Ambulance and other transportation costs are covered.
    • No-Claim Bonus(NCB) which proved to be the best benefit if you don't claim your policy.
    • Basic room rents are covered, and with high premium addons some policies might cover ICU as well.
    • Periodic Medical check-ups.
    • Tax benefits.

    Things to consider before buying a Health Insurance policy.

    There are a few factors that you should consider closely to make the right decision while buying a health insurance plan:

    • Closely look at the benefits offered like hospitalization expenses, daily cash benefit, COVID hospitalization cover, critical illness cover, maternity cover, etc. while choosing a health plan.
    • The sum insured amount is a crucial deciding factor in selecting a medical insurance policy.
    • As per your requirement, you can choose to buy individual health insurance, senior citizen health insurance, family floater or critical illness plans.
    • If any claim is filed during the initial waiting period except for accidental hospitalization claims, the insurer can reject it. Moreover, the waiting period clause also applies to pre-existing diseases like thyroid, blood pressure, diabetes, etc. It is also applicable to specific illnesses, treatments, and maternity cover. You can choose a plan with a minimal waiting period.
    • The co-payment option does not have any effect on the sum insured. It allows you to reduce your premium to a certain extent but certainly increases your out-of-pocket expenses. Only opt for this clause if you can pay off a portion of your hospitalization bills, that can be 10% and above without a financial burden.
    • A health insurance plan may have various sub-limits and the most common one is the room rent sub-limit. For instance, if your medical insurance policy comes with a sum insured of Rs 3 lakh with a sub-limit of 1%on daily room rent, then your room cost will be covered up to Rs 3,000 per day. Any additional amount on room rent will have to be paid from your own pocket. So, a health plan with no or minimal sub-limits is advisable.
    • Check the list of network hospitals for an insurance company where cashless claims can be filed.
    • Medical insurance policies are usually renewed every year. When the policy term is about to end, in order to continue the insurance coverage, the insured has to pay the insurance premium at the time of renewal. When buying a health insurance plan, choosing a plan with a lifetime renewal option is beneficial in the long run.
    • Opt a medical insurance plan with no loading will save you from paying an extra premium. Some insurers also charge a claim loading. This aspect, though ignored in the beginning, usually increases your out-of-the-pocket expenses at the time of claim.
    • This is an important criterion to assess the credentials of an insurer. You should always go with a company with a good claim settlement record. A claim settlement ratio above 80% can be an ideal choice.

    What are the documents required Health Insurance Policy?

    In the event of a hospitalization, the policyholder needs to submit certain documents as mentioned below:

    • Discharge card issued by the hospital/network hospital
    • In-patient hospitalization bills signed by insured for authenticity
    • Doctors’ prescriptions and medical store bills
    • Claim-form with insured’s signature on it
    • Valid investigation report
    • Consumables and disposables prescribed by the doctors with complete details
    • Bills of doctors’ consultation
    • Copies of the Insurance policy from the previous year and the current year/copy of ID Card of TPA
    • Any other document(s) asked by the TPA

    What are the steps for Renewal of Health Insurance Policy?

    Renewal step vary from broker to broker, however they don’t differ much. Follow these steps

    • Visit the official website of the broker.
    • Go to the ‘Renew Your Policy’ option on the menu bar and click on ‘Health Renewal’
    • Log in to the website by entering your registered mobile number or policy number
    • Fill up other required details regarding your policy
    • Add/remove any coverage, family member or change the sum insured if desired
    • Make the payment for the renewal premium online via debit card/ credit card/ net banking
    • Once your payment is successful, you will be issued a digitally signed copy of the policy. The policy document can be downloaded and printed anytime.

    Is there any Health Insurance Policy which covers Coronavirus (COVID-19) Treatment?

    Several health insurers and general insurers have already launched health insurance plans for coronavirus that cover the medical expenses incurred on the treatment of coronavirus. After the IRDAI guidelines, two special standard health insurance products, namely Corona Kavach policy and Corona Rakshak policy were launched and are being purchased by a lot of people already.