Today technology is available to cure critical illnesses as well as basic health concerns. But, with this advancement comes the shooting
prices of health care services which are beyond the reach of common man.
Here, health insurance comes as a relief to rescue us in the difficult times of hospitalization.
This includes in-patient treatments, pre and post hospitalization charges, day care procedures, domiciliary treatments, etc.
Wellness Tips
Top Reasons to Buy Health Insurance Plans
Corporate Health Cover is Insufficient
With rising medical costs, the importance of health insurance
policy cannot be overstated. Check the cost of a two day’s hospitalization for a
regular ailment and then compare it with your company’s insurance coverage.
When you will retire or change a job, your corporate health plan will cease to exist.
So it is worthwhile to buy an individual health plan.
Increase in Incidence of Life Threatening Diseases
Sadly, India is grappling with life threatening diseases.
The effect of these diseases is felt on the productive workforce from 35-65 years.
Also, heart diseases among Indians occur five to ten years earlier than in any other population around the world.
Sedentary lifestyles lead to life-threatening diseases like cancer and heart diseases which are
critical and impose heavy expenditure burden on families. It is therefore imperative to insure oneself timely.
Moreover, health insurance policies offer annual health checks ups to encourage health awareness.
Tax Benefits
You can get exemption for paying the premium under Section 80D of the Insurance Act.
This year, India’s Finance Minister Mr. Arun Jaitley has increased the limit of deduction in health insurance
premium to Rs 25,000 from Rs 15,000. For senior citizens, the new limit is Rs 30,000.
Better Financial Planning
We often set goals and save regularly to meet those goals but a medical emergency
may play havoc in an individual’s financial planning. With Health Insurance policy, you may be rest assured
of attaining your financial goals.
Value for Money
New health plan cover you for day care procedures and OPD, not just serious hospitalization.
Depending on your level of cover, a health policy helps you pay for services such as ambulance,
day-care procedures in addition to a number of non-hospital related services such as
chiropractic, dental, physiotherapy, optical, dietary advice and some alternative
therapies like Ayurveda and Homeopathy as well..
Young buyers get a more comprehensive deal
Buying health insurance at a young age ensures there is no scope for
pre-existing diseases as you will be covered early, and any diseases diagnosed later will be
covered automatically.
What types of Health Insurance are available?
This policy takes care of insured and includes preventive care treatments
Individual
Preventing Health Care
Family Floater
Critical illness
Pre-Existing illness Coverage
Individual Plans
Health insurance covers medical expenses for illnesses, injuries and conditions.
But, unlike a plan through an employer, individual health insurance is something you select and pay for on your own.
Family Floater
A family floater health insurance, as the name suggests is a plan that is
tailor made for families. It is similar to individual health plans in principle; the only difference
is that it is extended to cover your entire family.
Senior Citizen Health Insurance
Senior citizen health insurance plan is a necessity,
especially when you are planning to retire and live on pension or interest income from savings.
Better Financial Planning
We often set goals and save regularly to meet those goals but a medical emergency
may play havoc in an individual’s financial planning. With Health Insurance policy, you may be rest assured
of attaining your financial goals.
A sudden medical emergency can result in a financial crisis. To avoid this, it is prudent to
take a comprehensive senior citizen mediclaim insurance policy. These senior citizen health
insurance policies are for people aged between 65 years and 80 years.
Critical Illness
Life threatening critical illnesses like paralysis, cancer, heart diseases,
brain tumours, not only leave the patient unable to earn but are also very expensive in nature.
Many families get devasted financially and emotionally. A critical illness policy covers the
insured in the event of such cases.
Hospitalization is not required because diagnosis is enough to get critical
illness benefits.
The insured receives the entire amount at once
Health Insurance glossary you should know:-
TPA - Third Party Administer -
Insurance claims throughout are settled by the insured or third party administrator.
In case of hospitalisation, whether cashless or reimbursement, your TPA would be your point of contact.
Always contact your service provider for any claim request.
Network Hospitals -
These are hospitals listed area wise, which are empanelled with your insurer to provide
cashless hospitalization should the need arise.
Cashless Hospitalization -
Your insurer will have a list of network hospitals which are covered to provide cashless treatment should there be hospitalization.
The insured need not pay hospital bill once approved, as it is already covered.
Pre and Post Hospitalization -
Before and after hospitalization, depending on the no. of days mentioned in the policy,
the expenses are covered by the insurer.
No Claim Bonus -
If the policy holder does not register any claims in the whole year, he is entitled to No Claim Bonus (NCB).
This is provided to insured as a deduction in renewal premium amount or increased sum assured.
Health Check-up -
Free Health Check –up facility is offered by some insurers
if there are no claims registered, depending on the policy type.
A health card is a card that comes along with the Policy.
It is similar to an Identity card with details like your policy no.,
policy validity, TPA nos. which can be very useful in case of medical emergency.
This card entitles you to avail cashless hospitalisation facility
at any of our network hospitals.
Yes. But each company will pay its rateable proportion of the loss, liability,
compensation, costs or expenses.
E.g. If a person has Health Insurance from company X for Rs. 1 Lac and Health
Insurance from company Y for RS. 1 Lac, then in case of a claim, each policy
will pay in the ratio of 50:50 up to the Sum Insured.
By Pre-existing Condition we mean any condition, ailment or injury or
related condition(s) for which you had signs or symptoms, and / or were diagnosed,
and / or received medical advice/ treatment, within 48 months prior to
the first policy issued by the insurer
Pre- and Post-hospitalization expenses cover all medical expenses incurred
within 30 days prior to hospitalization and expenses incurred within 60
days post hospitalization provided the expenses were incurred for the
same condition for which the Insured Person’s hospitalisation was required.Â
Co-payment means a cost-sharing requirement under a health insurance
policy that provides that the insured will bear a specified percentage
of the admissible costs. A co-payment does not reduce the sum insured.
In a Family Floater plan all insured members are covered on floater
sum insured basis. The sum insured for a family floater is our maximum
liability for any and all claims made by all the insured members.
With rapidly changing demographics and lifestyles prevalence of critical
illness is on the rise in India. With rise in life expectancy and chronic
nature of critical illness there is a requirement of additional funds to
afford high medical costs for treating such critical illnesses.
The insured member is compensated by a lump sum payment if there is a
diagnosis of critical illness.
The appropriate cover amount ought to be determined on the basis of the following factors:
Your age : Age is a critical factor for determining the cover since health risk increases with age.
Pre-existing / hereditary diseases : Pre-existing diseases are covered subject to sub-limits and waiting period.
For example: A person whose parents suffer from Diabetes is more prone to the disease, so we recommend a higher cover at an early age so that the pre-existing disease also gets covered.
Moreover, also consider your financial status and lifestyle before selecting the coverage amount.
Pre- and Post-hospitalization expenses cover all medical expenses
incurred within 30 days prior to hospitalization and expenses incurred
within 60 days post hospitalization provided the expenses were incurred
for the same condition for which the Insured Person’s hospitalisation was required.Â
The company ties up with hospitals for cashless claim process.
When you avail of a cashless treatment in any of these network hospitals,
the company would settle the claim with the hospital directly.
For a complete list of network hospitals, log on to Service
Provider's or TPA's website. Hospital network list of each Service
Provider or TPA may vary.
Non-network Hospitals
Non network hospitals are the ones with which the company does
not have a cashless tie up. When you avail treatment here,
you first settle the bills yourself and then submit the
relevant documents and bills to the service provider or TPA.
The amount, consequently, is reimbursed to you based on policy
terms and conditions
Pre-authorisation is basically an authorisation issued either by the
insurance company or the service provider, specifying the value of the
medical treatment that can be claimable under their insurance policy.
To receive a pre-authorisation, you need to submit duly fill in the
Pre-authorisation form.
Video links from you tube explaining various Health features
