Health Insurance

Health Insurance also known as Mediclaim is a facility provided by general insurance insurance companies, whereby in return for a small premium amount, the latter agreeing to bear the medical expenses including hospitalization, medical fees, tests and other related expenses due to illness or injury upto pre-decided amount till the policy is in force.

Key Health Insurance Covers & Benefits:

• Room & Boarding expenses: There are limits to this feature varying from company to company. 

• Cashless Hospitalization: So that there are no worries on availability of cash.

• ICU charges, doctor, consulting, anaesthetist and surgeon fees, operation and other diagnostic and surgical material costs, ambulance charges are covered. 

• Day-Care expenses such as Chemotherapy, Dialysis & Radiotherapy etc.

• Pre & Post Hospitalization Expenses which normally are 30 days prior and 60 days after hospitalization.

• Domicilliary expenses – these are expenses which may be incurred when the patient is at home.

• Usually TPA’s are assigned by the insurance companies who manage the cashless hospitalization as well as reimbursement claims.

Health insurance plan is designed to take complete care of the customer's medical needs and requirements. There are certain benefits of an affordable health care insurance plan; it will secure your future. You will be relieved of meeting exorbitant expenses and other associated costs with an affordable health insurance policy. Whatever your age is, you will need to insure yourselves with a health insurance policy and health care plan.

Now a days one can buy health insurance policy online and its issued instantly provided all the requirements are met. Insurance Companies may also ask for medical checkup depending on the cover provided and age of the applicant.

Since medical expenses have increased considerably in last few years health insurance policies are a must. Any incident of medical emergency can crumple your financial planning and may wipe out sizeable savings.

What are the benefits of health insurance?

Some of the key benefits of typical health insurance policies include:

Saving huge amount of unplanned expenses, in case of unexpected medical emergencies. 

Tax benefits under section 80D of the Income Tax Act. 

The amount of premium is usually small and manageable 

Added coverage of family members. 

Covers of hospitalization and medical bills. 

Domicilliary expenses 

Disability and custodial bills. 

What are the different kinds of Critical Illness covered under Health Insurance Plans?

Typically, a critical illness plan would provide cover for the illnesses mentioned below.

Cancer 

Coronary artery bypass surgery 

First heart attack 

Kidney failure 

Major organ transplant 

Multiple sclerosis 

Paralysis 

Primary pulmonary arterial hypertension 

Stroke

Is maternity benefit available under an individual Health Insurance Plan?

No maternity benefit is available under individual health insurance plans. However, it may be available on a group plan; this varies from company to company.

What are the factors that determine the premium payable for a health insurance plan?

Following factors determine the premium payable for a health insurance plan:

Age of the insured 

Previous medical history 

Sum Assured 

Term of the policy

What is meant by hospitalization?

An instance where the insured individual is hospitalized for a minimum period of 24 hours can be termed as hospitalization.

Specific treatments like dialysis, chemotherapy, radiotherapy, laser eye surgery, dental surgery, etc when the patient is discharged on the same day are also considered as hospitalization.

Is there a tax deduction on the premium paid?

Health insurance plans are covered under section 80 D, Income Tax Act, 1961. The limit for individuals is Rs. 15,000 and for senior citizens is Rs. 20,000.

Are there limits to the number of claims on a Health Insurance Plan?

There is no limit to the number of claims per annum but there is a limit to the amount that you can claim in a year. Usually, the maximum amount that you can claim in a year is limited to the sum insured.

If I avail of the cashless facility, will the insurance company pay the entire bill at the hospital?

The insurance company will pay parts of the bill which are covered under the policy. It is possible that there are certain expenses, which have been specified by the insurer which are considered inadmissible – it is recommended you read your policy wordings carefully or check with your insurance advisor.

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